code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Assistant Surgeon,,,,,0
,,Assistant Surgeon (when a qualifed resident surgeon is not available),,,,,0
,,Bilateral Procedure,,,,,0
,,Minimum Assistant Surgeon,,,,,0
,,PBD Adjustment,,,,,0
,,Return to the operation room for a related procedure during the postoperative period,,,,,0
,,Surgical Team,,,,,0
,,Two Surgeons,,,,,0
,,Unknown,,,,,0
APR-DRG,8800,945/946 - REHAB - SPINAL/PARA,,,52167.81,52167.81,4
APR-DRG,8801,945/946 - REHAB - SPINAL/QUAD,,,94424.09,94424.09,4
APR-DRG,8802,945/946 - REHAB - HEAD,,,29732.25,29732.25,4
CDM,10000,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,264.35,198.26,3.17,237.92,119
CDM,100008,IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,1380.78,1035.58,16.57,1242.7,119
CDM,100009,"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",192.96,144.72,2.32,173.66,238
CDM,100035,FENOFIBRATE 160 MG TABLET,2.33,1.75,0.03,2.1,119
CDM,100074,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,85.0,63.75,1.02,76.5,119
CDM,100075,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,127.5,95.625,1.02,153.0,238
CDM,10009,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
CDM,10011,FAMOTIDINE 20 MG TABLET,0.45,0.34,0.01,0.4,119
CDM,100115,"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",6.35,4.76,0.08,5.72,119
CDM,100128,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,61.29,45.97,0.74,55.16,238
CDM,100133,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,4.45,3.33,0.05,4.0,119
CDM,100144,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,238
CDM,100266,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,2.16,1.62,0.03,1.94,119
CDM,100345,PREGABALIN 25 MG CAPSULE,4.65,3.49,0.06,4.19,119
CDM,100346,PREGABALIN 50 MG CAPSULE,4.52,3.39,0.05,4.07,119
CDM,100347,PREGABALIN 75 MG CAPSULE,8.08,6.06,0.1,7.27,238
CDM,100348,PREGABALIN 100 MG CAPSULE,8.08,6.06,0.1,7.27,238
CDM,100349,PREGABALIN 150 MG CAPSULE,5.7,4.28,0.07,5.13,119
CDM,100366,RAMELTEON 8 MG TABLET,6.79,5.09,0.08,6.11,119
CDM,10037,FINASTERIDE 5 MG TABLET,0.8,0.6,0.01,0.72,119
CDM,100394,INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,600.0,450.0,7.2,540.0,119
CDM,100399,GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS,15.36,11.52,0.18,13.82,119
CDM,10041,FLECAINIDE 100 MG TABLET,4.37,3.2749999999999995,0.04,4.82,238
CDM,100417,BRIMONIDINE 0.1 % EYE DROPS,558.58,418.94,6.57,718.18,357
CDM,10043,FLECAINIDE 50 MG TABLET,2.06,1.55,0.02,1.85,119
CDM,10044,FLUCONAZOLE 100 MG TABLET,6.65,4.99,0.08,5.98,119
CDM,10045,FLUCONAZOLE 200 MG TABLET,12.23,9.18,0.15,11.01,119
CDM,10046,FLUCONAZOLE 50 MG TABLET,4.71,3.53,0.06,4.24,119
CDM,10049,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,12.27,9.2,0.01,21.6,238
CDM,10050,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,55.2,41.4,0.32,75.6,238
CDM,100513,TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,332.42,249.31,3.99,299.18,119
CDM,100527,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,15.85,11.89,0.19,14.26,119
CDM,100531,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,15.22,11.41,0.18,13.7,238
CDM,100532,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,47.33,35.495000000000005,0.43,52.58,238
CDM,100533,MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE,45.32,33.99,0.54,40.79,119
CDM,100536,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,17.38,13.03,0.21,15.64,238
CDM,10054,FLUDROCORTISONE 0.1 MG TABLET,2.85,2.14,0.03,2.56,119
CDM,10055,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,357
CDM,100563,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.08,0.06,0.01,0.07,119
CDM,100584,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,43.2,32.4,0.52,38.88,119
CDM,100589,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,40.2,30.15,0.48,36.18,119
CDM,10059,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,1224.25,918.19,14.69,1101.82,238
CDM,100679,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,4535.34,3401.51,54.42,4081.81,119
CDM,100680,PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,2300.01,1725.01,27.6,2070.01,119
CDM,10069,FLUOXETINE 10 MG CAPSULE,0.49,0.36,0.01,0.44,119
CDM,10070,FLUOXETINE 20 MG CAPSULE,0.23,0.18,0.01,0.21,119
CDM,10080,FLURBIPROFEN 0.03 % EYE DROPS,162.0,121.5,1.94,145.8,119
CDM,100805,IOPAMIDOL 200 MG IODINE/ML (41 %) INTRATHECAL SOLUTION,459.48,344.61,4.65,478.12,238
CDM,100806,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRATHECAL SOLUTION,515.25,386.44,6.18,463.72,119
CDM,100841,ARIPIPRAZOLE 2 MG TABLET,7.2,5.4,0.09,6.48,119
CDM,100842,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,4160.32,3120.24,49.92,3744.29,119
CDM,10085,FLUVOXAMINE 50 MG TABLET,3.3,2.47,0.04,2.97,119
CDM,100887,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",164.7,123.52,1.98,148.23,119
CDM,100897,"TRAMADOL ER 100 MG TABLET,EXTENDED RELEASE 24 HR",16.17,12.13,0.19,14.55,119
CDM,100908,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,731.4,548.55,8.78,658.26,119
CDM,100922,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,7.01,5.26,0.08,6.31,119
CDM,100924,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",7.01,5.26,0.08,6.31,119
CDM,10093,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,2024.595,1518.4450000000002,24.11,1836.0,238
CDM,100938,"RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",8.4,6.3,0.1,7.56,119
CDM,100947,LUBIPROSTONE 24 MCG CAPSULE,6.0,4.5,0.07,5.4,119
CDM,100948,"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",441.31,330.98,5.3,397.18,238
CDM,101,ACETAMINOPHEN 325 MG TABLET,0.32,0.24,0.01,0.29,119
CDM,101027,SELEGILINE 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,296.72,222.54,3.56,267.05,119
CDM,101043,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",1.37,1.03,0.02,1.23,238
CDM,101045,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",231.57,173.68,2.78,208.41,238
CDM,101072,LEVOMEFOLATE CALCIUM 7.5 MG TABLET,11.81,8.86,0.14,10.63,119
CDM,101084,"BUPIVACAINE 0.5 %-EPINEPHRINE BITARTRATE 1:200,000 INJECTION,CARTRIDGE",13.99,10.49,0.09,18.43,238
CDM,101183,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,14.76,11.07,0.09,18.31,1190
CDM,101184,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,16.69,12.52,0.08,19.39,833
CDM,101188,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,48.9,36.67,0.59,44.01,119
CDM,101224,DECITABINE 50 MG INTRAVENOUS SOLUTION,603.4,452.55,7.24,543.06,238
CDM,101231,VARENICLINE TARTRATE 1 MG TABLET,5.89,4.42,0.07,5.3,119
CDM,101251,RASAGILINE 1 MG TABLET,61.33,45.99,0.74,55.2,119
CDM,101271,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",756.35,567.26,9.08,680.72,119
CDM,10130,GLYCOPYRROLATE 1 MG TABLET,0.71,0.54,0.01,0.64,119
CDM,101330,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,429.81,322.36,2.13,567.54,476
CDM,101333,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1751.96,1313.97,21.02,1576.76,119
CDM,101428,VIT A 300 MCG-C 200 MG-E 27 MG-LUTEIN 2 MG AND MINERALS TABLET,0.45,0.34,0.01,0.4,119
CDM,101431,APREPITANT 40 MG CAPSULE,364.985,273.74,4.38,328.49,238
CDM,10149,GUANFACINE 1 MG TABLET,2.7,2.03,0.03,2.43,119
CDM,101523,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,4481.98,3361.49,53.78,4033.78,119
CDM,101547,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,4254.68,3191.01,51.06,3829.21,119
CDM,101548,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,881.12,660.84,10.57,793.01,238
CDM,101549,DARBEPOETIN ALFA 25 MCG/0.42 ML IN POLYSORBATE INJECTION SYRINGE,550.7,413.03,6.61,495.63,238
CDM,101553,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,1276.4,957.3,15.32,1148.76,238
CDM,101554,DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE,2127.34,1595.5,25.53,1914.61,238
CDM,101590,DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,3191.01,2393.26,38.29,2871.91,238
CDM,101603,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,15.719999999999999,11.785,0.1,21.01,357
CDM,101681,POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,6300.0,4725.0,75.6,5670.0,119
CDM,101742,ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION,14.0,10.5,0.17,12.6,238
CDM,10176,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",33.03,24.775000000000002,0.19,39.26,952
CDM,101797,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,418.42,313.815,2.59,558.76,476
CDM,101808,BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,0.88,0.66,0.01,0.79,119
CDM,10181,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",12.12,9.09,0.13,22.46,595
CDM,101811,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,3.84,2.88,0.04,3.67,476
CDM,101831,"HEPARIN, PORCINE (PF) 1 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
CDM,101837,ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,40.9,30.67,0.49,36.81,119
CDM,101903,"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",113.17,84.87,1.36,101.85,119
CDM,101924,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,60.0,45.0,0.72,54.0,238
CDM,101957,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,38.22,28.665,0.38,40.5,357
CDM,101961,"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",28.78,21.58,0.35,25.9,119
CDM,102,ACETAMINOPHEN 500 MG TABLET,0.24,0.185,0.01,0.31,476
CDM,102084,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,367.07,275.3,4.4,330.36,119
CDM,102087,"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",3123.83,2342.87,37.49,2811.45,119
CDM,102089,LISDEXAMFETAMINE 30 MG CAPSULE,60.0,45.0,0.72,54.0,119
CDM,10209,HYDROCORTISONE 5 MG TABLET,1.03,0.77,0.01,0.93,119
CDM,102091,LISDEXAMFETAMINE 70 MG CAPSULE,60.0,45.0,0.72,54.0,119
CDM,10210,HYDROCORTISONE 100 MG/60 ML ENEMA,41.4,31.05,0.5,37.26,119
CDM,102238,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,18564.43,13923.32,222.77,16707.99,119
CDM,10225,HYDROMORPHONE 1 MG/ML ORAL LIQUID (REPACKAGING),686.88,515.16,0.14,1226.02,238
CDM,10226,HYDROMORPHONE 8 MG TABLET,4.76,3.57,0.06,4.28,119
CDM,102263,SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,8.32,6.24,0.1,7.49,119
CDM,102274,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,296.68,222.51,3.56,267.01,238
CDM,102288,ACETYLCYSTEINE 600 MG CAPSULE,0.44,0.33,0.01,0.4,119
CDM,102296,TEMOZOLOMIDE 180 MG CAPSULE,264.73,198.55,3.18,238.26,119
CDM,102329,FENTANYL(PF) 100 MCG/50 ML (2 MCG/ML)-BUPIV 0.125 % NACL EPIDURAL SYRG,83.51,62.63,1.0,75.16,238
CDM,10235,HYDROXYCHLOROQUINE 200 MG TABLET,7.54,5.65,0.09,6.79,119
CDM,10236,HYDROXYUREA 500 MG CAPSULE,5.52,4.14,0.07,4.97,119
CDM,102377,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1487.5,1115.62,17.85,1338.75,119
CDM,102398,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,144.0,108.0,1.73,129.6,119
CDM,102418,"CHOLECALCIFEROL (VITAMIN D3) 1,250 MCG (50,000 UNIT) CAPSULE",0.98,0.74,0.01,0.88,119
CDM,102437,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,118.28,88.71,1.42,106.45,238
CDM,102457,LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,4.4,3.3,0.05,3.96,119
CDM,10246,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,7.86,5.9,0.09,7.07,119
CDM,10248,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,120.32,90.24,1.44,108.29,119
CDM,10249,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,327.73,245.8,3.93,294.96,119
CDM,102522,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,803.63,602.725,7.47,886.01,238
CDM,102523,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,716.39,537.29,8.6,644.75,119
CDM,102531,HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE,414.46,310.85,4.97,373.01,238
CDM,102538,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,18.0,13.5,0.22,16.2,238
CDM,102551,SODIUM CHLORIDE 7 % FOR NEBULIZATION,2.63,1.9700000000000002,0.02,3.24,238
CDM,102554,"QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",1.2,0.9,0.01,1.08,119
CDM,102557,"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",354.42,265.81,4.25,318.98,238
CDM,10264,INDAPAMIDE 1.25 MG TABLET,1.91,1.43,0.02,1.72,119
CDM,1027,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,435.24,326.43,5.22,391.72,119
CDM,102752,AMBRISENTAN 5 MG TABLET,172.8,129.6,2.07,155.52,119
CDM,102753,AMBRISENTAN 10 MG TABLET,172.8,129.6,2.07,155.52,119
CDM,102757,CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE GEL IN A DROPPERETTE,2.2,1.65,0.03,1.98,119
CDM,1028,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,240.12,180.09,2.88,216.11,119
CDM,102861,HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE,543.36,407.52,6.52,489.02,238
CDM,102869,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,22.41,16.81,0.26,22.41,476
CDM,102964,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
CDM,103,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,238
CDM,10356,ISOSORBIDE MONONITRATE 10 MG TABLET,17.7,13.27,0.21,15.93,119
CDM,10364,ITRACONAZOLE 100 MG CAPSULE,28.13,21.1,0.34,25.32,119
CDM,10369,KETOCONAZOLE 200 MG TABLET,6.31,4.73,0.08,5.68,119
CDM,10372,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,20.520000000000003,15.39,0.21,21.38,357
CDM,10373,LABETALOL 100 MG TABLET,1.08,0.81,0.01,0.97,119
CDM,10374,LABETALOL 200 MG TABLET,1.71,1.28,0.02,1.54,119
CDM,104,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,6.1,4.58,0.07,5.49,238
CDM,10403,LEVOTHYROXINE 88 MCG TABLET,0.88,0.66,0.01,0.79,119
CDM,10404,LEVOTHYROXINE 112 MCG TABLET,0.99,0.74,0.01,0.89,119
CDM,10405,LEVOTHYROXINE 137 MCG TABLET,0.86,0.65,0.01,0.77,119
CDM,10406,LEVOTHYROXINE 175 MCG TABLET,1.4,1.05,0.02,1.26,119
CDM,1043,BETHANECHOL CHLORIDE 10 MG TABLET,1.9,1.43,0.02,1.71,119
CDM,10431,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",123.72,92.79,1.48,111.35,119
CDM,10434,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,49.56,37.17,0.59,44.6,119
CDM,1044,BETHANECHOL CHLORIDE 25 MG TABLET,2.74,2.05,0.03,2.47,119
CDM,10449,LISINOPRIL 10 MG TABLET,0.26,0.19,0.01,0.23,119
CDM,10451,LISINOPRIL 5 MG TABLET,0.39,0.29,0.01,0.35,119
CDM,10454,"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",1.34,1.01,0.02,1.21,119
CDM,10455,"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",1.78,1.33,0.02,1.6,119
CDM,10467,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.53,6.4,0.08,54.0,952
CDM,10470,LOVASTATIN 20 MG TABLET,1.28,0.96,0.02,1.15,119
CDM,10491,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.63,0.47,0.01,0.57,119
CDM,105,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,1.895,1.425,0.02,1.91,238
CDM,10521,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,216.0,162.0,2.59,194.4,119
CDM,10531,MERCAPTOPURINE 50 MG TABLET,19.02,14.26,0.23,17.12,238
CDM,10537,MESNA 100 MG/ML INTRAVENOUS SOLUTION,106.25,79.69,1.28,95.62,238
CDM,10544,METFORMIN 500 MG TABLET,0.38,0.29,0.01,0.34,119
CDM,10546,METHADONE 10 MG/ML INJECTION SOLUTION,1923.75,1442.81,23.08,1731.38,119
CDM,10549,METHENAMINE HIPPURATE 1 GRAM TABLET,14.78,11.08,0.18,13.3,119
CDM,10552,METHIMAZOLE 10 MG TABLET,2.58,1.94,0.03,2.32,119
CDM,10553,METHIMAZOLE 5 MG TABLET,0.9,0.68,0.01,0.81,119
CDM,10576,METHYLPREDNISOLONE 8 MG TABLET,8.65,6.48,0.1,7.78,119
CDM,10577,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",188.5,141.38,2.26,169.65,119
CDM,10581,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,109.26,81.94,1.31,98.33,119
CDM,10587,METOLAZONE 2.5 MG TABLET,3.9,2.92,0.05,3.51,119
CDM,10588,METOLAZONE 5 MG TABLET,4.5,3.38,0.05,4.05,119
CDM,10592,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,692.58,519.44,8.31,623.32,119
CDM,10595,MEXILETINE 150 MG CAPSULE,3.8,2.85,0.05,3.42,119
CDM,10596,MEXILETINE 200 MG CAPSULE,4.54,3.41,0.05,4.09,119
CDM,10607,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,3.99,2.99,0.05,3.67,476
CDM,10608,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,41.4,31.05,0.5,37.26,238
CDM,10609,MIDODRINE 2.5 MG TABLET,0.7,0.52,0.01,0.63,119
CDM,10610,MIDODRINE 5 MG TABLET,4.685,3.5149999999999997,0.03,6.16,238
CDM,10629,MISOPROSTOL 200 MCG TABLET,9.71,7.28,0.07,12.27,238
CDM,10630,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,1798.67,1349.0,21.58,1618.8,119
CDM,10632,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,692.35,519.26,8.31,623.12,119
CDM,10648,MOMETASONE 0.1 % TOPICAL OINTMENT,126.09,94.57,1.51,113.48,119
CDM,10655,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,27.435,20.575,0.04,46.41,238
CDM,10674,MUPIROCIN 2 % TOPICAL OINTMENT,53.99,40.49,0.65,48.59,119
CDM,10676,NABUMETONE 500 MG TABLET,0.69,0.52,0.01,0.62,119
CDM,10677,NABUMETONE 750 MG TABLET,0.74,0.55,0.01,0.67,119
CDM,10685,NALTREXONE 50 MG TABLET,11.61,8.71,0.14,10.45,119
CDM,10717,NICOTINE (POLACRILEX) 2 MG GUM,1.595,1.1949999999999998,0.02,1.73,238
CDM,10722,NIMODIPINE 30 MG CAPSULE,7.2,5.4,0.09,6.48,119
CDM,10724,NITROFURANTOIN MONOHYDRATE/MACROCRYSTALS 100 MG CAPSULE,3.0,2.25,0.04,2.7,119
CDM,10734,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,54.275000000000006,40.705,0.36,94.28,714
CDM,10747,NORETHINDRONE ACETATE 5 MG TABLET,3.6,2.7,0.04,3.24,119
CDM,10777,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,43.2,32.4,0.4,42.44,357
CDM,10778,ONDANSETRON HCL 4 MG TABLET,3.03,2.27,0.04,2.73,119
CDM,1080,BISACODYL 10 MG RECTAL SUPPOSITORY,2.12,1.59,0.03,1.91,119
CDM,10810,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,1550.97,1163.2250000000001,1.23,2699.79,238
CDM,10812,OXYCODONE 20 MG/ML ORAL CONCENTRATE,341.03,255.77,0.26,594.05,238
CDM,10813,OXYCODONE 5 MG/5 ML ORAL SOLUTION,37.17,27.88,0.45,33.45,119
CDM,10814,OXYCODONE 5 MG TABLET,2.7,2.03,0.03,2.43,238
CDM,10843,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",311.20500000000004,233.405,3.06,330.67,238
CDM,10855,PAROXETINE 20 MG TABLET,0.83,0.62,0.01,0.75,119
CDM,10917,PERMETHRIN 5 % TOPICAL CREAM,594.0,445.5,7.13,534.6,119
CDM,10947,PHENTOLAMINE 5 MG INJECTION SOLUTION,1742.17,1306.63,19.34,1693.31,357
CDM,1101029197,HC ECU SNF PRIV ROOM/BOARD,250.0,187.5,3.0,225.0,119
CDM,1101032097,HC MED/SURG/GYN W/TELE PRIV ROOM/BOARD,4717.44,3538.08,56.61,4245.7,119
CDM,1101163797,HC MED/SURG/GYN PRIV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,11076,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,16.2,12.15,0.19,14.58,119
CDM,11079,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,29.400000000000002,22.049999999999997,0.3,30.78,238
CDM,11083,"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",3.38,2.53,0.04,3.04,119
CDM,11110,PRAVASTATIN 10 MG TABLET,1.52,1.14,0.01,2.12,595
CDM,11111,PRAVASTATIN 20 MG TABLET,4.22,3.17,0.05,3.8,119
CDM,11129,PRIMIDONE 50 MG TABLET,1.46,1.09,0.02,1.31,119
CDM,11143,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,58.49,43.87,0.7,52.64,238
CDM,11144,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,58.49,43.87,0.7,52.64,119
CDM,11146,PROPAFENONE 150 MG TABLET,1.4,1.05,0.02,1.26,119
CDM,11147,PROPAFENONE 225 MG TABLET,2.3,1.73,0.03,2.07,119
CDM,11150,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,67.8,50.85,0.17,162.0,1071
CDM,1121184497,HC OB/ANTEPART PRIV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,11239,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,8.3,6.23,0.1,7.47,119
CDM,11291,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,741.02,555.77,8.89,666.92,119
CDM,11292,RIFAMPIN 150 MG CAPSULE,19.99,14.99,0.24,17.99,119
CDM,11293,RIFAMPIN 300 MG CAPSULE,22.04,16.53,0.26,19.84,119
CDM,113,ACETAZOLAMIDE 250 MG TABLET,20.94,15.71,0.25,18.85,119
CDM,1131194697,HC PEDIATRIC PRIVATE ROOM/BOARD,7414.88,5561.16,88.98,6673.39,119
CDM,11340,SELEGILINE 5 MG TABLET,8.83,6.62,0.11,7.95,119
CDM,11349,SENNOSIDES 8.6 MG TABLET,0.25,0.18,0.01,0.22,119
CDM,11350,SERTRALINE 100 MG TABLET,0.7,0.52,0.01,0.63,119
CDM,11351,SERTRALINE 50 MG TABLET,2.35,1.76,0.03,2.12,119
CDM,11364,SIMVASTATIN 10 MG TABLET,0.57,0.43,0.01,0.51,119
CDM,11365,SIMVASTATIN 20 MG TABLET,0.53,0.4,0.01,0.48,119
CDM,11366,SIMVASTATIN 40 MG TABLET,0.82,0.61,0.01,0.74,119
CDM,114,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,178.65,133.99,2.14,160.78,119
CDM,11403,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,30.0,22.5,0.36,27.0,119
CDM,1141144597,HC INPATIENT PSYCH PRIV ROOM CHG,4627.51,3470.63,55.53,4164.76,119
CDM,11421,SOTALOL 80 MG TABLET,1.68,1.26,0.02,1.51,119
CDM,11425,SPIRONOLACTONE 100 MG TABLET,3.21,2.41,0.04,2.89,119
CDM,11441,SUCRALFATE 100 MG/ML ORAL SUSPENSION,49.62,37.21,0.57,48.6,357
CDM,11442,SUCRALFATE 1 GRAM TABLET,2.3,1.73,0.03,2.07,119
CDM,11443,SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION,56.62,42.46,0.68,50.96,238
CDM,11500,TEMAZEPAM 7.5 MG CAPSULE,15.96,11.97,0.19,14.36,119
CDM,11507,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,48.225,36.169999999999995,0.09,79.79,357
CDM,11508,TERBUTALINE 2.5 MG TABLET,6.0,4.5,0.07,5.4,119
CDM,11561,TIMOLOL MALEATE 0.25 % EYE DROPS,24.54,18.405,0.21,28.08,238
CDM,11562,TIMOLOL MALEATE 0.5 % EYE DROPS,58.2,43.65,0.7,52.38,119
CDM,11565,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,328.885,246.665,3.74,311.87,357
CDM,11574,TRANYLCYPROMINE 10 MG TABLET,6.41,4.81,0.08,5.77,119
CDM,11576,TRETINOIN 0.025 % TOPICAL CREAM,950.94,713.2,11.41,855.85,119
CDM,11624,URSODIOL 300 MG CAPSULE,14.62,10.965,0.03,23.72,238
CDM,11627,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,239.465,179.595,1.76,298.8,238
CDM,11634,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,238
CDM,11635,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.58,68.85,2023
CDM,11664,WARFARIN 1 MG TABLET,1.7650000000000001,1.3199999999999998,0.02,2.0,238
CDM,11701,ZOLPIDEM 5 MG TABLET,0.63,0.47000000000000003,0.01,0.82,238
CDM,1171185897,HC ONCOLOGY PRIV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,1181032597,HC REHAB PRIVATE ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,1201031997,HC MED/SURG/GYN W/TELE SEMI-PRIV ROOM/BOARD,4717.44,3538.08,56.61,4245.7,119
CDM,1201165697,HC MED/SURG/GYN SEMI-PRV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,12025,MECLIZINE 25 MG TABLET,1.15,0.86,0.01,1.03,119
CDM,12098,"THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR",17.53,13.14,0.21,15.78,119
CDM,12184,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",3.01,2.26,0.04,2.72,238
CDM,122,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,69.515,52.135,0.75,68.97,357
CDM,12203,VENLAFAXINE 25 MG TABLET,6.3,4.72,0.08,5.67,119
CDM,12206,VENLAFAXINE 75 MG TABLET,0.86,0.65,0.01,0.77,119
CDM,12207,VENLAFAXINE 37.5 MG TABLET,1.93,1.44,0.02,1.74,119
CDM,1221184997,HC OB/ANTEPART SEM-PRV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,1224,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,16.14,12.1,0.19,25.11,476
CDM,123,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,82.92,62.19,1.0,74.63,238
CDM,1231195597,HC PEDS SEMI-PRIV ROOM/BOARD,7414.88,5561.16,88.98,6673.39,119
CDM,1241144797,HC INPATIENT PSYCH SEMI-PRIV ROOM/BOARD,5448.11,4086.08,65.38,4903.3,119
CDM,12580,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,2.4,1.8,0.03,2.16,119
CDM,1259,CAFFEINE 200 MG TABLET,0.82,0.62,0.01,0.74,119
CDM,12704,"LACTASE 3,000 UNIT TABLET",0.47,0.35,0.01,0.42,119
CDM,12724,TERBINAFINE HCL 250 MG TABLET,1.6,1.2,0.02,1.44,119
CDM,12803,PILOCARPINE 5 MG TABLET,2.45,1.84,0.03,2.2,119
CDM,1281211697,HC REHAB SEMI-PRIV ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,12885,CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION,552.9,414.675,4.66,645.84,238
CDM,1299,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",7.949999999999999,5.96,0.01,13.82,238
CDM,1300,"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",0.2,0.15,0.01,0.18,119
CDM,1306,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,85.94,64.45,1.03,77.35,238
CDM,13089,LISINOPRIL 2.5 MG TABLET,3.32,2.49,0.04,2.99,119
CDM,1312,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,162.0,121.5,0.72,291.6,714
CDM,13135,NAPROXEN SODIUM 220 MG TABLET,0.38,0.29,0.01,0.34,119
CDM,13184,"VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE",3.61,2.71,0.04,3.25,119
CDM,134524,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,37.02,27.76,0.44,33.32,238
CDM,134650,LEVOCETIRIZINE 5 MG TABLET,2.0,1.5,0.02,1.8,119
CDM,134722,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 500 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
CDM,134723,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 1,000 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
CDM,134981,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,20106.3,15079.73,241.28,18095.67,119
CDM,135024,OSELTAMIVIR 30 MG CAPSULE,12.75,9.565,0.12,14.04,238
CDM,135042,RALTEGRAVIR 400 MG TABLET,149.76,112.32,1.8,134.78,119
CDM,135079,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,5.37,4.025,0.06,4.86,357
CDM,135241,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",3.26,2.45,0.04,2.93,238
CDM,135264,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,77.1,57.82,0.93,69.39,119
CDM,135265,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,48.0,36.0,0.58,43.2,119
CDM,135382,BRIMONIDINE 0.2 %-TIMOLOL 0.5 % EYE DROPS,747.27,560.455,6.91,826.72,238
CDM,1355,CARBAMAZEPINE 100 MG CHEWABLE TABLET,3.16,2.37,0.04,2.84,119
CDM,135533,SEVELAMER CARBONATE 800 MG TABLET,12.59,9.44,0.15,11.33,119
CDM,135540,"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",113.47,85.1,1.36,102.12,119
CDM,135553,INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT,14169.6,10627.2,170.04,12752.64,238
CDM,135576,DICLOFENAC 1 % TOPICAL GEL,73.8,55.35,0.89,66.42,119
CDM,135581,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,34.5,25.875,0.4,32.4,238
CDM,1356,CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,423.9,317.92,5.09,381.51,119
CDM,135656,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,98.25,73.69,1.18,88.42,119
CDM,135687,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN,60.0,45.0,0.72,54.0,238
CDM,1357,CARBAMAZEPINE 200 MG TABLET,5.38,4.03,0.06,4.84,119
CDM,135702,PARENTERAL AMINO ACID 10 % COMBINATION NO.6 INTRAVENOUS SOLUTION,336.0,252.0,4.03,302.4,119
CDM,135716,"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",356.9,267.67,4.28,321.21,119
CDM,13577,FLUCONAZOLE 150 MG TABLET,16.49,12.37,0.2,14.84,119
CDM,135817,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,85.785,64.34,0.76,97.04,238
CDM,135818,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,62.18,46.635000000000005,0.74,56.3,238
CDM,135850,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,105.85,79.38499999999999,1.07,110.61,238
CDM,135851,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,491.58,368.68,5.9,442.42,238
CDM,1359,CARBAMIDE PEROXIDE 6.5 % EAR DROPS,11.34,8.5,0.14,10.21,119
CDM,135913,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,169.11,126.83,2.03,152.2,119
CDM,135950,DARUNAVIR 600 MG TABLET,6.0,4.5,0.07,5.4,119
CDM,136163,PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,462.0,346.5,3.89,540.0,238
CDM,136192,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",385.75,289.31,4.63,347.18,238
CDM,136260,CETIRIZINE 1 MG/ML ORAL SOLUTION,1.59,1.19,0.02,1.43,238
CDM,136275,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,15436.53,11577.4,185.24,13892.88,119
CDM,136278,BIFIDOBACTERIUM INFANTIS 4 MG CAPSULE,4.43,3.32,0.05,3.99,119
CDM,13632,"BISACODYL 5 MG TABLET,DELAYED RELEASE",0.16,0.12,0.01,0.14,119
CDM,136365,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2492.81,1869.61,29.91,2243.53,119
CDM,136385,MELATONIN 5 MG TABLET,1.29,0.97,0.02,1.16,119
CDM,136414,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11.94,8.96,0.14,10.75,119
CDM,136460,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,652.53,489.4,7.83,587.28,119
CDM,136501,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,120.0,90.0,1.44,108.0,119
CDM,136515,"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",1320.96,990.72,15.85,1188.86,119
CDM,13654,"ASPIRIN 325 MG TABLET,DELAYED RELEASE",0.07,0.05,0.01,0.06,119
CDM,136745,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,91.2,68.4,1.09,82.08,119
CDM,136779,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,21.295,15.969999999999999,0.17,25.24,476
CDM,136780,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,29.07,21.8,0.35,26.16,238
CDM,136781,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,94.24,70.685,0.75,113.6,238
CDM,136782,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,124.52,93.39,1.49,112.07,119
CDM,136882,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",42.0,31.5,0.5,37.8,119
CDM,136925,WHITE PETROLATUM-MINERAL OIL 94 %-3 % EYE OINTMENT,39.0,29.25,0.47,35.1,119
CDM,137104,"CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) TABLET",1.48,1.11,0.02,1.33,238
CDM,137118,FENOFIBRATE 54 MG TABLET,1.33,1.0,0.02,1.2,119
CDM,137150,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,294.75,221.06,3.54,265.28,119
CDM,137152,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,464.92,348.69,5.58,418.43,119
CDM,137177,DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,3127.5,2345.62,37.53,2814.75,119
CDM,137197,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,36.894999999999996,27.67,0.43,34.27,238
CDM,137209,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,68.85,51.64,0.79,65.03,238
CDM,137210,PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,4910.43,3682.82,58.93,4419.39,119
CDM,137212,PANITUMUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,19641.73,14731.29,235.7,17677.56,119
CDM,137233,LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM,20.395,15.295,0.2,22.07,238
CDM,137236,RADIOPAQUE PVC MARKERS-BARIUM SULFATE 24 MARKERS CAPSULE,83.7,62.78,1.0,75.33,119
CDM,137309,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,528.9,396.67,6.35,476.01,238
CDM,137314,CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMULSION,1057.8,793.35,12.69,952.02,238
CDM,137337,"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",2.5,1.88,0.03,2.25,119
CDM,137439,BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,210.0,157.5,2.52,189.0,119
CDM,137440,BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
CDM,137442,BICARBONATE DIALYSIS SOLN 11 (NO POTASSIUM) CALC 2.5 MEQ-MAG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
CDM,137443,BICARBONATE HEMODIALYSIS SOLUTION NO.2 K 2 MEQ-CA 3.5 MEQ-MG 1 MEQ/L,210.0,157.5,2.52,189.0,119
CDM,13818,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,57.305,42.980000000000004,0.15,91.8,238
CDM,138188,HYDROCORTISONE 2 MG/ML ORAL SUSPENSION CMPD,27.6,20.7,0.33,24.84,119
CDM,138249,URSODIOL 60 MG/ML ORAL SUSPENSION COMPOUND,173.52,130.14,2.08,156.17,119
CDM,138257,WARFARIN 0.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.6700000000000002,1.25,0.01,2.0,357
CDM,138258,WARFARIN 3.75 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),9.48,7.109999999999999,0.01,16.12,238
CDM,138376,TETRABENAZINE 12.5 MG TABLET,27.560000000000002,20.675,0.1,42.38,238
CDM,13884,COLESTIPOL 1 GRAM TABLET,6.31,4.73,0.08,5.68,119
CDM,138946,LACTATED RINGERS (UW),28.5,21.375,0.32,27.0,357
CDM,138949,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),27.75,20.810000000000002,0.19,29.7,833
CDM,138952,DEXTROSE 10% IN WATER (D10W) IV BOLUS (UW),34.5,25.87,0.38,33.75,238
CDM,139000,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,727.8,545.85,5.76,878.04,357
CDM,139027,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.4,0.3,0.01,0.36,119
CDM,139038,"MAGNESIUM 64 MG (MAGNESIUM CHLORIDE) TABLET,DELAYED RELEASE",0.5,0.37,0.01,0.45,119
CDM,139045,ELTROMBOPAG OLAMINE 50 MG TABLET,1678.61,1258.96,20.14,1510.75,119
CDM,139067,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,38.88,29.16,0.47,34.99,238
CDM,139070,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,103.5,77.625,0.86,121.5,238
CDM,139072,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,24.03,18.02,0.29,21.63,238
CDM,139076,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",127.5,95.63,1.42,122.85,238
CDM,139079,DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,49.94,37.45,0.6,44.95,119
CDM,139081,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,123.0,92.25,1.48,110.7,119
CDM,139083,NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,147.0,110.25,1.76,132.3,119
CDM,139086,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,2659.79,1994.84,31.92,2393.81,119
CDM,139087,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,5319.58,3989.69,63.83,4787.62,119
CDM,139094,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,53.4,40.05,0.3,58.05,357
CDM,139142,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,58.5,43.88,0.7,52.65,119
CDM,139150,RUFINAMIDE 200 MG TABLET,18.43,13.82,0.22,16.59,119
CDM,139178,VANCOMYCIN RETENTION IS 500 MG IN 100 ML OF NS,0.04,0.03,0.01,0.04,119
CDM,139295,"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",0.5,0.37,0.01,0.45,119
CDM,139296,"QUETIAPINE ER 150 MG TABLET,EXTENDED RELEASE 24 HR",0.7,0.53,0.01,0.63,119
CDM,139350,LIDOCAINE (PF) 3.5 % EYE GEL,105.125,78.845,1.26,94.62,238
CDM,139465,EPHEDRINE (PF) 25 MG/5 ML (5 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,155.7,116.78,1.87,140.13,119
CDM,139467,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,45.0,33.75,0.54,40.5,119
CDM,1395,CARISOPRODOL 350 MG TABLET,0.72,0.54,0.01,0.65,119
CDM,139510,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,23.73,17.8,0.28,21.36,119
CDM,139585,LIDOCAINE-MAALOX-BENADRYL SOLUTION,64.35,48.26,0.41,85.37,238
CDM,139826,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,34.5,25.88,0.41,31.05,119
CDM,139840,FEBUXOSTAT 40 MG TABLET,3.16,2.37,0.04,2.84,119
CDM,139886,"FESOTERODINE ER 4 MG TABLET,EXTENDED RELEASE 24 HR",14.28,10.71,0.17,12.85,119
CDM,139912,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1390.13,1042.6,16.68,1251.12,119
CDM,139920,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,2168.91,1626.68,26.03,1952.02,119
CDM,139963,LACOSAMIDE 50 MG TABLET,7.39,5.54,0.09,6.65,119
CDM,140148,"LEVETIRACETAM ER 750 MG TABLET,EXTENDED RELEASE 24 HR",3.5,2.62,0.04,3.15,119
CDM,140214,CALCIUM 200 MG (AS CITRATE)-VITAMIN D3 6.25 MCG (250 UNIT) TABLET,0.27,0.2,0.01,0.24,119
CDM,140416,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,93.3,69.97,1.12,83.97,238
CDM,140420,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,552.0,414.0,6.62,496.8,119
CDM,140450,ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,33.69,25.27,0.4,30.32,119
CDM,140482,MILNACIPRAN 50 MG TABLET,51.18,38.38,0.61,46.06,119
CDM,140496,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,393.12,294.84,4.72,353.81,238
CDM,140624,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,33.6,25.2,0.22,44.28,238
CDM,140880,WARFARIN 1.25 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),12.89,9.67,0.15,11.6,238
CDM,1408801,WARFARIN 1.25 MG PRE SPLIT TABLET,12.89,9.67,0.15,11.6,119
CDM,140896,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,26.97,20.23,0.32,24.27,238
CDM,140903,TOLVAPTAN 15 MG TABLET,249.0,186.75,2.99,224.1,119
CDM,140949,"LAMOTRIGINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",9.12,6.84,0.11,8.21,119
CDM,140950,"LAMOTRIGINE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",11.0,8.25,0.13,9.9,119
CDM,140951,"LAMOTRIGINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
CDM,14100,"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",16.6,12.45,0.2,14.94,119
CDM,14101,"DILTIAZEM ER 90 MG CAPSULE,EXTENDED RELEASE 12 HR",18.97,14.22,0.23,17.07,119
CDM,141042,TAPENTADOL 50 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,141065,"LIPASE-PROTEASE-AMYLASE (PORK)6,000-19,000-30,000 UNIT CAPSULE,DEL REL",12.88,9.66,0.15,11.59,119
CDM,141066,"LIPASE-PROTEASE-AMYLASE(PORK)12,000-38,000-60,000 UNIT CAPSULE,DEL REL",25.75,19.31,0.31,23.18,119
CDM,141067,"LIPASE-PROTEASE-AMYLAS(PORK)24,000-76,000-120,000 UNIT CAPSULE,DEL REL",51.02,38.27,0.61,45.92,119
CDM,141117,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,3637.56,2728.17,43.65,3273.8,119
CDM,14113,"ASPIRIN 81 MG TABLET,DELAYED RELEASE",0.05,0.04,0.01,0.05,119
CDM,141156,DRONEDARONE 400 MG TABLET,60.75,45.56,0.73,54.68,119
CDM,141183,PRASUGREL HCL 5 MG TABLET,4.95,3.71,0.06,4.46,119
CDM,141184,PRASUGREL HCL 10 MG TABLET,4.95,3.71,0.06,4.46,119
CDM,141235,LEVONORGESTREL 1.5 MG TABLET,121.23,90.92,1.45,109.11,119
CDM,14132,KETOCONAZOLE 2 % SHAMPOO,132.48,99.36,1.59,119.23,119
CDM,141517,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,6374.29,4780.72,76.49,5736.86,119
CDM,141518,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,9561.21,7170.9,114.73,8605.09,119
CDM,141582,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,11.66,8.75,0.14,10.49,238
CDM,141583,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,11.33,8.5,0.14,10.2,238
CDM,141592,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) SOLUTION FOR NEBULIZATION,12145.1,9108.83,145.74,10930.59,119
CDM,141605,UREA 10 %-ALPHA HYDROXY ACIDS 4 % TOPICAL CREAM,33.86,25.39,0.41,30.47,119
CDM,141736,ASENAPINE 5 MG SUBLINGUAL TABLET,21.61,16.21,0.26,19.45,119
CDM,141806,"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",3.3,2.47,0.04,2.97,119
CDM,14190,HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM,19.77,14.83,0.24,17.79,119
CDM,14203,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,81.88,61.41,0.98,73.69,119
CDM,142061,THYROID (PORK) 15 MG TABLET,3.18,2.39,0.04,2.86,119
CDM,142062,THYROID (PORK) 30 MG TABLET,6.07,4.55,0.07,5.46,119
CDM,142063,THYROID (PORK) 60 MG TABLET,6.74,5.05,0.08,6.07,119
CDM,142128,ROCURONIUM 50 MG/5 ML (10 MG/ML) INTRAVENOUS SYRINGE,53.7,40.28,0.64,48.33,119
CDM,142179,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,14.34,10.76,0.17,12.91,119
CDM,142257,TELAVANCIN 750 MG INTRAVENOUS SOLUTION,1868.91,1401.68,22.43,1682.02,119
CDM,142301,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,6.18,4.635,0.06,6.26,238
CDM,142306,ACETAMINOPHEN 325 MG/10.15 ML ORAL SOLUTION,10.9,8.18,0.13,9.81,119
CDM,14233,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,342.3,256.73,4.11,308.07,119
CDM,142713,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,0.13,0.09,0.01,0.12,119
CDM,142816,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,5.02,3.76,0.06,4.52,119
CDM,142817,ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,58549.48,43912.11,702.59,52694.53,119
CDM,142854,ESTRADIOL 10 MCG VAGINAL TABLET,87.29,65.47,1.05,78.56,238
CDM,142901,METRONIDAZOLE 50 MG/ML ORAL SUSP,144.6,108.45,1.74,130.14,119
CDM,142920,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1618.71,1214.03,19.42,1456.84,119
CDM,142921,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,4046.81,3035.1,48.56,3642.13,119
CDM,142922,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,8093.61,6070.21,97.12,7284.25,119
CDM,142934,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,38.81,29.11,0.47,34.93,238
CDM,142935,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,55.629999999999995,41.725,0.62,54.0,476
CDM,142978,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,4789.49,3592.12,57.47,4310.54,119
CDM,143125,RITONAVIR 100 MG TABLET,16.0,12.0,0.19,14.4,119
CDM,143142,"DALFAMPRIDINE ER 10 MG TABLET,EXTENDED RELEASE,12 HR",6.0,4.5,0.07,5.4,119
CDM,143147,ZINC OXIDE 13 % TOPICAL CREAM,33.22,24.92,0.4,29.9,119
CDM,143215,"MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)",688.89,516.67,8.27,620.0,119
CDM,143384,ELTROMBOPAG OLAMINE 75 MG TABLET,2517.92,1888.44,30.22,2266.13,119
CDM,143440,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,8709.04,6531.78,104.51,7838.14,119
CDM,143590,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,180.0,135.0,2.16,162.0,357
CDM,143619,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,289.275,216.95999999999998,3.21,280.12,357
CDM,143642,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,285.325,213.995,2.7,311.08,238
CDM,143678,SIROLIMUS 0.5 MG TABLET,34.82,26.11,0.42,31.34,119
CDM,143697,GANCICLOVIR 0.15 % EYE GEL,1980.05,1485.04,23.76,1782.04,119
CDM,143707,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,102.195,76.65,1.22,92.83,238
CDM,143737,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,158.85000000000002,119.14,1.41,179.82,238
CDM,143744,RIFAXIMIN 550 MG TABLET,239.54,179.66,2.87,215.59,119
CDM,143776,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,60.0,45.0,0.72,54.0,238
CDM,143777,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,50.0,37.5,0.6,45.0,119
CDM,143778,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,44.51,33.39,0.53,40.06,119
CDM,143900,TRANEXAMIC ACID 650 MG TABLET,26.07,19.55,0.31,23.46,119
CDM,143938,PITAVASTATIN CALCIUM 2 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,143986,GATIFLOXACIN 0.5 % EYE DROPS,212.72,159.54,2.55,191.45,119
CDM,144020,LACOSAMIDE 10 MG/ML ORAL SOLUTION,274.2,205.65,1.65,515.16,357
CDM,144054,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,4909.15,3681.86,58.91,4418.23,119
CDM,144118,SODIUM ACETATE 2 MEQ/ML IV(UW),38.4,28.8,0.46,34.56,119
CDM,144119,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),13.8,10.35,0.14,126.9,714
CDM,144120,POTASSIUM ACETATE 2 MEQ/ML IV(UW),67.2,50.4,0.81,60.48,119
CDM,144145,NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,294.0,220.5,3.53,264.6,119
CDM,144147,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,120.0,90.0,1.44,108.0,119
CDM,144148,VANCOMYCIN 1.5 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,169.5,127.12,2.03,152.55,119
CDM,144149,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,48.0,36.0,0.58,43.2,119
CDM,144150,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,285.0,213.75,3.42,256.5,119
CDM,144215,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,18.84,14.13,0.23,16.96,357
CDM,144240,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,36945.01,27708.76,443.34,33250.51,119
CDM,144277,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,39.05,29.285,0.4,40.5,476
CDM,144386,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,1.01,0.76,0.01,0.91,238
CDM,144389,DONEPEZIL 23 MG TABLET,12.245000000000001,9.184999999999999,0.13,12.24,238
CDM,1445,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.02,5.26,0.08,7.39,595
CDM,144630,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,2846.0,2134.5,34.15,2561.4,119
CDM,144636,BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
CDM,144668,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,13.36,10.02,0.16,12.02,238
CDM,144669,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,16.9,12.68,0.2,15.21,238
CDM,144732,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",619.145,464.36,6.27,644.21,357
CDM,144738,"MAGNESIUM 71.5 MG (MAGNESIUM CHLORIDE) TABLET,DELAYED RELEASE",0.85,0.64,0.01,0.76,119
CDM,144743,BIMATOPROST 0.01 % EYE DROPS,1095.43,821.58,13.15,985.89,119
CDM,144854,FINGOLIMOD 0.5 MG CAPSULE,50.0,37.5,0.6,45.0,119
CDM,145006,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,36.99,27.74,0.44,33.29,119
CDM,145046,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,1632.0,1224.0,19.58,1468.8,238
CDM,145066,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.695,4.85,1223.42,1309
CDM,14550,TERAZOSIN 1 MG CAPSULE,1.08,0.81,0.01,0.97,119
CDM,14552,TERAZOSIN 10 MG CAPSULE,1.08,0.81,0.01,0.97,119
CDM,14553,TERAZOSIN 5 MG CAPSULE,1.08,0.81,0.01,0.97,119
CDM,14626,"VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE",1.45,1.09,0.02,1.3,119
CDM,14628,"INDOMETHACIN ER 75 MG CAPSULE,EXTENDED RELEASE",7.5,5.62,0.09,6.75,119
CDM,14632,TRAMADOL 50 MG TABLET,0.88,0.66,0.01,0.79,238
CDM,14719,METFORMIN 850 MG TABLET,0.17,0.13,0.01,0.15,119
CDM,14776,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,453.0,339.75,5.44,407.7,119
CDM,14792,TIZANIDINE 2 MG TABLET,5.22,3.92,0.06,4.7,119
CDM,14793,TIZANIDINE 4 MG TABLET,0.95,0.71,0.01,0.86,119
CDM,14863,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,46.5,34.875,0.43,51.3,238
CDM,14869,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,37.19,27.89,0.45,33.47,119
CDM,14870,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",48.0,36.0,0.58,43.2,238
CDM,14983,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",102.0,76.5,1.22,91.8,119
CDM,14984,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",98.1,73.57,1.18,88.29,119
CDM,15053,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.98,0.73,0.01,0.88,119
CDM,15119,SEVOFLURANE 99.97 % INHALATION LIQUID,1075.0,806.25,12.9,967.5,119
CDM,15157,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,1135.55,851.67,13.63,1022.0,119
CDM,15235,HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,6.15,4.61,0.07,5.54,119
CDM,15236,CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,0.09,0.07,0.01,0.08,119
CDM,15340,"DICLOFENAC SODIUM 50 MG TABLET,DELAYED RELEASE",1.47,1.1,0.02,1.32,119
CDM,15341,"DICLOFENAC SODIUM 75 MG TABLET,DELAYED RELEASE",1.62,1.22,0.02,1.46,119
CDM,15426,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,77.06,57.795,0.91,70.74,238
CDM,1562,CHERRY FLAVOR (BULK) ORAL LIQUID,82.3,61.73,0.99,74.07,119
CDM,15706,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION (REPACKAGING),22.05,16.54,0.16,27.38,238
CDM,15723,SOTALOL 120 MG TABLET,0.41,0.31,0.01,0.37,119
CDM,15797,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,90.0,67.5,1.08,81.0,119
CDM,15816,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,12.48,9.36,0.15,11.23,119
CDM,15846,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",65.25,48.94,0.77,59.4,238
CDM,15849,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",52.065,39.045,0.48,57.38,238
CDM,15861,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
CDM,15863,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
CDM,15882,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,30.0,22.5,0.29,32.4,238
CDM,15918,DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
CDM,15954,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.88,22.41,0.36,26.89,238
CDM,15955,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",48.96,36.72,0.35,61.56,476
CDM,15982,"DOBUTAMINE 1,000 MG/250 ML (4 MG/ML) IN 5 % DEXTROSE IV DRIP",175.5,131.62,2.11,157.95,119
CDM,15985,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",81.0,60.75,0.97,72.9,238
CDM,15996,METHADONE 10 MG/ML ORAL CONCENTRATE,468.0,351.0,0.03,464.4,357
CDM,16005,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,123.87,92.9,1.49,111.48,119
CDM,16050,GLUCOSE 4 GRAM CHEWABLE TABLET,1.41,1.06,0.02,1.27,119
CDM,16052,DESMOPRESSIN 0.1 MG TABLET,6.29,4.72,0.08,5.66,119
CDM,16070,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,217.44,163.08,2.61,195.7,119
CDM,1611028197,HC HOSPITAL AT HOME,2707.5,2030.62,32.49,2436.75,119
CDM,16218,CALCITRIOL 1 MCG/ML ORAL SOLUTION,965.92,724.44,11.59,869.33,119
CDM,1623,CHLORDIAZEPOXIDE 25 MG CAPSULE,2.4850000000000003,1.865,0.01,3.57,238
CDM,1624,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.15,0.86,0.01,1.03,119
CDM,1635,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,134.28,100.71,1.61,120.85,119
CDM,16356,GLIMEPIRIDE 2 MG TABLET,0.4,0.3,0.01,0.36,119
CDM,16369,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.450000000000003,16.09,0.26,19.31,238
CDM,16371,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,38.25,28.69,0.27,41.65,476
CDM,16426,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,66.0,49.5,0.79,59.4,119
CDM,1649,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,130.0,97.5,1.56,117.0,119
CDM,1653,CHLORPROMAZINE 10 MG TABLET,0.82,0.61,0.01,0.74,119
CDM,1656,CHLORPROMAZINE 25 MG TABLET,23.41,17.56,0.28,21.07,119
CDM,1661,CHLORTHALIDONE 25 MG TABLET,0.9,0.68,0.01,0.81,119
CDM,16632,PAROXETINE 10 MG TABLET,1.03,0.77,0.01,0.93,119
CDM,16633,PAROXETINE 40 MG TABLET,1.21,0.9,0.01,1.09,119
CDM,16830,MELATONIN 3 MG TABLET,0.85,0.63,0.01,0.76,119
CDM,1685,CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,118.98,89.24,1.43,107.08,119
CDM,168537,ULIPRISTAL 30 MG TABLET,174.38,130.78,2.09,156.94,119
CDM,168558,DABIGATRAN ETEXILATE 75 MG CAPSULE,19.84,14.88,0.24,17.86,119
CDM,168618,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,198.09,148.57,2.38,178.28,119
CDM,168622,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,4012.86,3009.64,48.15,3611.57,119
CDM,168661,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,9030.11,6772.58,108.36,8127.1,119
CDM,168829,PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION,66289.81,49717.36,795.48,59660.83,119
CDM,168831,CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,238
CDM,168832,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,238
CDM,168879,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,206.15,154.615,2.25,202.5,357
CDM,168880,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,319.74,239.8,3.84,287.77,119
CDM,168923,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2390.75,1793.06,28.69,2151.68,119
CDM,168924,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,4781.5,3586.12,57.38,4303.35,119
CDM,168925,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,9563.0,7172.25,114.76,8606.7,119
CDM,168928,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",61.2,45.9,0.68,58.86,238
CDM,169008,LURASIDONE 40 MG TABLET,4.0,3.0,0.05,3.6,119
CDM,169380,TETRACAINE HCL (PF) 0.5 % EYE DROPS,79.32,59.49,0.95,71.39,119
CDM,169421,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 25 MG IV SOLUTION,60.0,45.0,0.72,54.0,119
CDM,169924,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,1806.5,1354.87,21.68,1625.85,119
CDM,169925,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,5815.0,4361.25,69.78,5233.5,119
CDM,169937,IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,113.5,85.13,1.36,102.15,119
CDM,170007,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,524.0,393.0,6.29,471.6,238
CDM,170045,SODIUM NITRITE-SODIUM THIOSULFATE 300 MG/10 ML-12.5 GRAM/50 ML IV SOLN,671.42,503.56,8.06,604.28,119
CDM,170071,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,25264.51,18948.38,303.17,22738.06,119
CDM,17010,"HYOSCYAMINE ER 0.375 MG TABLET,EXTENDED RELEASE,12 HR",4.74,3.56,0.06,4.27,119
CDM,1701028997,HC NURSERY/COUPLET CARE ROOM/BOARD,4175.94,3131.96,50.11,3758.35,119
CDM,17012,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,244.275,183.20499999999998,2.44,256.78,238
CDM,17023,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,2.7,2.03,0.03,2.43,119
CDM,170528,GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,2365.5,1774.125,17.93,2913.3,238
CDM,170529,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,403.52,302.64,4.84,363.17,119
CDM,170530,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,534.0,400.5,6.41,480.6,119
CDM,170532,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,373.5,280.12,4.48,336.15,119
CDM,170533,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,498.0,373.5,5.98,448.2,119
CDM,170534,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,747.0,560.25,8.96,672.3,119
CDM,170844,TACROLIMUS 1 MG/ML ORAL SUSPENSION COMPOUND,27.02,20.27,0.32,24.32,238
CDM,170845,LEVOTHYROXINE SODIUM 25 MCG/ML ORAL SUSPENSION,17.76,13.32,0.21,15.98,119
CDM,170961,ROFLUMILAST 500 MCG TABLET,3.6,2.7,0.04,3.24,119
CDM,170963,ABIRATERONE 250 MG TABLET,11.25,8.44,0.14,10.12,119
CDM,170970,LINAGLIPTIN 5 MG TABLET,78.76,59.07,0.95,70.88,119
CDM,170986,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3790.85,2843.14,45.49,3411.76,119
CDM,171019,VILAZODONE 20 MG TABLET,6.75,5.06,0.08,6.08,119
CDM,1711183397,HC NURSERY/NICU LEVEL 1 ROOM/BOARD,7420.22,5565.16,89.04,6678.2,119
CDM,171766,IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION,425.0,318.75,5.1,382.5,119
CDM,171768,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,5899.13,4424.35,70.79,5309.22,119
CDM,171770,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,67.32,50.49,0.81,60.59,238
CDM,171806,FIDAXOMICIN 200 MG TABLET,956.31,717.24,11.48,860.68,119
CDM,171814,"AMIODARONE 150 MG/100 ML (1.5 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",208.2,156.15,2.5,187.38,119
CDM,171815,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",277.2,207.9,3.33,249.48,119
CDM,171888,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,29117.14,21837.85,349.41,26205.43,119
CDM,171914,BELATACEPT 250 MG INTRAVENOUS SOLUTION,2760.28,2070.21,33.12,2484.25,119
CDM,171954,METHOHEXITAL 100 MG/10 ML (10 MG/ML) IN STERILE WATER (PF)  IV SYRINGE,139.5,104.62,1.67,125.55,119
CDM,171970,RIVAROXABAN 10 MG TABLET,85.44,64.08,1.03,76.9,119
CDM,172017,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,180.0,135.0,2.16,162.0,119
CDM,172113,TICAGRELOR 90 MG TABLET,46.48,34.86,0.56,41.83,119
CDM,1721181097,HC NICU LEVEL 2,8533.25,6399.94,102.4,7679.92,119
CDM,172139,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500-15,000 UNIT CAPSULE,DEL REL",10.88,8.16,0.13,9.79,119
CDM,172202,KIT FOR PREPARATION OF TC 99M-ALBUMIN 2.5 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,119
CDM,172216,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,135.54,101.66,1.63,121.99,238
CDM,172697,EPISHUGARCAINE IRRIGATION,12.0,9.0,0.14,10.8,119
CDM,172759,MORPHINE 250 MG/50 ML (5 MG/ML) IN NS HIGH DOSE PCA,135.0,101.25,1.62,121.5,119
CDM,172808,"GABAPENTIN ER 300 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
CDM,172893,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,714
CDM,172923,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,27584.2,20688.15,331.01,24825.78,119
CDM,172939,METHADONE 10 MG/ML INTRAVENOUS SYRINGE,96.19,72.14,1.15,86.57,119
CDM,173000,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,3832.32,2874.24,45.99,3449.09,119
CDM,1731181497,HC NICU LEVEL 3,9178.88,6884.16,110.15,8260.99,119
CDM,173571,EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,119
CDM,173576,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,33.99,25.495,0.38,32.56,357
CDM,173699,POTASSIUM CHLORIDE 20 MEQ/250 ML (80 MEQ/L) IN NS IV (PERIPHERAL LINE),27.62,20.72,0.33,24.86,119
CDM,173840,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1439.9299999999998,1079.945,13.03,1614.65,476
CDM,173843,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,128.655,96.49000000000001,1.12,147.38,238
CDM,173844,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,580.675,435.505,2.27,875.01,238
CDM,173845,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,35.769999999999996,26.825,0.38,35.69,238
CDM,173882,RIVAROXABAN 15 MG TABLET,85.44,64.08,1.03,76.9,119
CDM,173883,RIVAROXABAN 20 MG TABLET,85.44,64.08,1.03,76.9,119
CDM,173936,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.5,40.88,0.65,49.05,119
CDM,173967,RUXOLITINIB 5 MG TABLET,1126.4,844.8,13.52,1013.76,119
CDM,173968,RUXOLITINIB 10 MG TABLET,1126.4,844.8,13.52,1013.76,119
CDM,173989,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",27.9,20.925,0.27,29.7,476
CDM,1740,CLINDAMYCIN HCL 150 MG CAPSULE,0.86,0.65,0.01,0.77,119
CDM,174008,DOCUSATE SODIUM 283 MG/5 ML ENEMA,11.19,8.39,0.13,10.07,119
CDM,174018,AFLIBERCEPT 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,4182.85,3137.14,50.19,3764.57,119
CDM,174050,LACTULOSE 20 GRAM/30 ML ORAL SOLUTION,10.98,8.24,0.13,9.88,119
CDM,174059,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,8.22,6.17,0.1,7.4,119
CDM,174074,CLOBAZAM 10 MG TABLET,10.51,7.88,0.13,9.46,119
CDM,1741181797,HC NICU LEVEL 4,9916.88,7437.66,119.0,8925.19,119
CDM,1742,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,144.72,108.54,1.74,130.25,119
CDM,174215,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,2299.01,1724.26,27.59,2069.11,119
CDM,174222,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN,3022.86,2267.15,36.27,2720.57,119
CDM,174240,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,13196.36,9897.27,158.36,11876.72,119
CDM,174242,KIT FOR PREPARATION TC-99M-SUCCIMER 1 MG INTRAVENOUS SOLUTION,3918.385,2938.79,27.62,4981.5,357
CDM,174285,LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,2.42,1.81,0.03,2.18,119
CDM,1743,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,25.6,19.2,0.31,23.04,238
CDM,174335,"LEVETIRACETAM 1,000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK",180.0,135.0,2.16,162.0,238
CDM,174427,LURASIDONE 20 MG TABLET,4.0,3.0,0.05,3.6,119
CDM,174467,PENTETATE INDIUM DISODIUM IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4574.02,3430.52,54.89,4116.62,119
CDM,174581,LIDOCAINE 5 % TOPICAL OINTMENT,223.695,167.76999999999998,0.72,348.69,238
CDM,17464,BUSPIRONE 15 MG TABLET,2.72,2.04,0.03,2.45,119
CDM,17465,MIRTAZAPINE 30 MG TABLET,2.25,1.69,0.03,2.02,119
CDM,17466,MIRTAZAPINE 15 MG TABLET,1.78,1.34,0.02,1.6,119
CDM,174832,ISOFLURANE 99.9 % INHALATION LIQUID,100.0,75.0,1.2,90.0,119
CDM,174917,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,81.54,61.16,0.98,73.39,119
CDM,175208,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE,829.83,622.38,2.16,3976.57,357
CDM,175242,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,11740.52,8805.39,140.89,10566.47,119
CDM,1755,CLONIDINE HCL 0.1 MG TABLET,1.0350000000000001,0.78,0.01,1.64,238
CDM,1756,CLONIDINE HCL 0.2 MG TABLET,0.35,0.26,0.01,0.32,119
CDM,1759,CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET,7.3149999999999995,5.485,0.07,7.79,238
CDM,1767,CLOTRIMAZOLE 1 % TOPICAL CREAM,65.88,49.41,0.79,59.29,119
CDM,1769,CLOTRIMAZOLE 1 % VAGINAL CREAM,24.3,18.23,0.29,21.87,119
CDM,176971,MORPHINE SULFATE 0.4 MG/ML ORAL SOLUTION,1.63,1.22,0.02,1.47,119
CDM,177895,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,9001.83,6751.37,108.02,8101.65,119
CDM,178041,ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION,4553.6,3415.2,54.64,4098.24,119
CDM,178099,FLORBETAPIR F-18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,10543.81,7907.85,126.53,9489.43,119
CDM,178132,MULTIVITAMIN WITH FOLIC ACID 400 MCG TABLET,0.23,0.17,0.01,0.21,119
CDM,178159,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,19411.12,14558.34,232.93,17470.01,119
CDM,17881,BRIMONIDINE 0.2 % EYE DROPS,100.08,75.055,0.44,147.15,238
CDM,178983,CEFTAZIDIME 2.25 MG/ 0.1ML OPHTHALMIC INJECTION,2.12,1.59,0.03,1.91,119
CDM,179046,"MIRABEGRON ER 25 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
CDM,179099,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,22.46,16.85,0.27,20.21,119
CDM,179549,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",437.34,328.005,1.11,704.16,238
CDM,179606,LINACLOTIDE 145 MCG CAPSULE,85.19,63.9,1.02,76.67,119
CDM,179607,LINACLOTIDE 290 MCG CAPSULE,85.19,63.9,1.02,76.67,119
CDM,179612,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
CDM,179621,ICOSAPENT ETHYL 1 GRAM CAPSULE,21.62,16.21,0.26,19.46,119
CDM,179624,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,124.34,93.25,1.49,111.91,119
CDM,179731,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,73.5,55.12,0.61,88.29,476
CDM,179824,"MICONAZOLE NITRATE 4 % (200 MG)-2 % (9 GRAM)VAGINAL,PREFILL APPL,CREAM",585.575,439.18,0.66,1004.4,238
CDM,179971,"OXCARBAZEPINE ER 300 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
CDM,179972,"OXCARBAZEPINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR",103.35,77.51,1.24,93.02,119
CDM,180086,DARUNAVIR 800 MG TABLET,12.0,9.0,0.14,10.8,119
CDM,1801157097,HC LEAVE OF ABSENCE,0.01,0.01,0.01,0.01,119
CDM,181086,APIXABAN 2.5 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,181121,APIXABAN 5 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,181208,LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,3840.0,2880.0,46.08,3456.0,119
CDM,181807,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,10965.5,8224.12,131.59,9868.95,119
CDM,181808,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,16424.49,12318.37,197.09,14782.04,119
CDM,181849,"ARIPIPRAZOLE ER 400 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",7982.85,5987.14,95.79,7184.56,119
CDM,1820000001,HC LEAVE OF ABSENCE-PATIENT CONVENIENCE,0.01,0.01,0.01,0.01,119
CDM,1821,COLCHICINE 0.6 MG TABLET,4.1,3.07,0.05,3.69,119
CDM,182312,SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,16.99,12.74,0.2,15.29,119
CDM,182407,"DIMETHYL FUMARATE 240 MG CAPSULE,DELAYED RELEASE",11.25,8.44,0.14,10.12,119
CDM,182516,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,84.3,63.22,1.01,75.87,119
CDM,182518,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,168.6,126.45,1.79,432.0,476
CDM,18288,BISOPROLOL FUMARATE 5 MG TABLET,3.73,2.79,0.04,3.36,119
CDM,182893,"LIPASE-PROTEASE-AMYLASE (PORK)36,000-114,000-180K UNIT CAPSULE,DEL REL",60.0,45.0,0.72,54.0,119
CDM,18292,TORSEMIDE 10 MG TABLET,1.84,1.38,0.02,1.66,119
CDM,18293,TORSEMIDE 20 MG TABLET,2.34,1.76,0.03,2.11,119
CDM,18294,TORSEMIDE 100 MG TABLET,2.46,1.84,0.03,2.21,119
CDM,1830000001,HC LEAVE OF ABSENCE- THERAPEUTIC LEAVE,0.01,0.01,0.01,0.01,119
CDM,18307,GABAPENTIN 400 MG CAPSULE,1.23,0.92,0.01,1.11,119
CDM,18308,GABAPENTIN 300 MG CAPSULE,0.875,0.655,0.01,0.88,238
CDM,18309,GABAPENTIN 100 MG CAPSULE,0.725,0.545,0.01,0.68,357
CDM,183096,CEFIXIME 400 MG CAPSULE,60.0,45.0,0.72,54.0,119
CDM,183119,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,765.0,573.75,9.18,688.5,119
CDM,183188,LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,3.28,2.46,0.04,2.95,119
CDM,183256,"RADIUM RA 223 DICHLOR 1,100 KBQ/ML (30 MICROCURIE/ML) INTRAVENOUS SOLN",102892.62,77169.46,1234.71,92603.36,119
CDM,183379,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,48.0,36.0,0.43,48.6,714
CDM,183506,MENTHOL 4 % TOPICAL GEL,45.92,34.44,0.55,41.33,119
CDM,183532,FERRIC SUBSULFATE 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLN AND APPLICATOR,91.54,68.65,1.1,82.39,119
CDM,183558,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,4202.91,3152.18,50.43,3782.62,119
CDM,183560,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,49.5,37.125,0.47,54.0,238
CDM,183617,GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,5689.7,4267.28,68.28,5120.73,119
CDM,183676,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,6111.27,4583.45,73.34,5500.14,119
CDM,183712,PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMENT,15.73,11.8,0.19,14.16,119
CDM,183752,DOLUTEGRAVIR 50 MG TABLET,321.65,241.23,3.86,289.48,119
CDM,18385,"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",0.26,0.2,0.01,0.23,119
CDM,18386,"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",1.62,1.22,0.02,1.46,119
CDM,184629,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,7.4,5.55,0.09,6.66,119
CDM,184630,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
CDM,184632,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
CDM,184668,OXYBUTYNIN 3.9 MG/24 HOUR TRANSDERMAL 4 DAY PATCH,14.89,11.16,0.18,13.4,119
CDM,184676,PROPOFOL 10 MG/ML IV BOLUS (UW),60.6,45.45,0.17,162.0,595
CDM,184725,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,373.75,280.31,4.49,336.38,238
CDM,184804,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,1898.88,1424.16,10.23,2650.75,714
CDM,184809,VORTIOXETINE 5 MG TABLET,77.12,57.84,0.93,69.41,119
CDM,184811,VORTIOXETINE 20 MG TABLET,77.12,57.84,0.93,69.41,119
CDM,184838,RIOCIGUAT 1 MG TABLET,650.64,487.98,7.81,585.58,119
CDM,184839,RIOCIGUAT 1.5 MG TABLET,650.64,487.98,7.81,585.58,119
CDM,184841,RIOCIGUAT 2.5 MG TABLET,650.64,487.98,7.81,585.58,119
CDM,184910,MACITENTAN 10 MG TABLET,1617.32,1212.99,19.41,1455.59,119
CDM,1850000001,HC LEAVE OF ABSENCE- HOSPITAL SERVICES,0.01,0.01,0.01,0.01,119
CDM,185241,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,6.93,5.195,0.08,6.27,357
CDM,185242,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,7.08,5.31,0.08,6.37,238
CDM,185246,"LEVOMILNACIPRAN ER 20 MG CAPSULE,24 HR,EXTENDED RELEASE",78.96,59.22,0.95,71.06,119
CDM,185261,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",24511.8,18383.85,294.14,22060.62,119
CDM,185311,TBO-FILGRASTIM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,711.1,533.33,8.53,639.99,119
CDM,185312,TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1138.09,853.57,13.66,1024.28,119
CDM,185374,"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",45.0,33.75,0.54,40.5,119
CDM,185649,PERAMPANEL 2 MG TABLET,93.15,69.86,1.12,83.84,119
CDM,185650,PERAMPANEL 4 MG TABLET,184.05,138.04,2.21,165.64,119
CDM,185730,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,185731,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,89.96,67.47,1.08,80.96,119
CDM,186014,CYCLOPHOSPHAMIDE 10 MG/ML ORAL SOLUTION - COMPOUND,2727.0,2045.25,32.72,2454.3,119
CDM,186082,ESLICARBAZEPINE 200 MG TABLET,202.06,151.54,2.42,181.85,119
CDM,186084,ESLICARBAZEPINE 400 MG TABLET,202.06,151.54,2.42,181.85,119
CDM,186287,MORPHINE 2 MG/ML PF INTRAVENOUS SYRINGE,12.77,9.58,0.15,11.49,238
CDM,186321,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,1349.995,1012.495,14.58,1336.46,357
CDM,186394,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,99.6,74.7,1.2,89.64,119
CDM,186749,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,13451.91,10088.935,53.81,20177.86,238
CDM,187004,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",5.34,4.0,0.06,4.81,119
CDM,187011,SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,19.91,14.93,0.24,17.92,119
CDM,187043,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,238
CDM,187069,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,24083.05,18062.29,289.0,21674.74,119
CDM,187267,CYCLOPHOSPHAMIDE 25 MG CAPSULE,10.1,7.58,0.12,9.09,119
CDM,187268,CYCLOPHOSPHAMIDE 50 MG CAPSULE,17.57,13.18,0.21,15.81,119
CDM,187269,RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,49.92,37.44,0.6,44.93,238
CDM,187285,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6564.75,4923.5599999999995,78.77,5908.49,238
CDM,187400,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,238
CDM,187778,DROXIDOPA 100 MG CAPSULE,6.67,5.0,0.08,6.0,119
CDM,187942,EMPAGLIFLOZIN 25 MG TABLET,94.42,70.81,1.13,84.98,119
CDM,187943,EMPAGLIFLOZIN 10 MG TABLET,94.42,70.81,1.13,84.98,119
CDM,188236,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,1260.0,945.0,0.07,37996.43,1190
CDM,188300,OXYCHLOROSENE SODIUM TOPICAL POWDER FOR SOLUTION,33.6,25.2,0.4,30.24,119
CDM,188311,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID IN PACKET,6.0,4.5,0.07,5.4,119
CDM,18877,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,81.99,61.49,0.51,381.78,476
CDM,188908,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION,337.5,253.12,4.05,303.75,119
CDM,188913,IPRATROPIUM 20 MCG-ALBUTEROL 100 MCG/ACTUATION MIST FOR INHALATION,2091.68,1568.76,25.1,1882.51,119
CDM,189024,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,19126.0,14344.5,229.51,17213.4,119
CDM,18908,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,120.0,90.0,1.44,108.0,119
CDM,189209,SUVOREXANT 10 MG TABLET,66.64,49.98,0.8,59.98,119
CDM,189258,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,225.0,168.75,1.24,280.12,595
CDM,189270,"N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE",793.22,594.92,9.52,713.9,238
CDM,189298,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,66585.86,49939.4,799.03,59927.27,119
CDM,189386,"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",1178.34,883.76,14.14,1060.51,119
CDM,189430,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,658.4,493.8,7.9,592.56,119
CDM,189450,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,3693.8,2770.35,44.33,3324.42,119
CDM,189451,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,9234.44,6925.83,110.81,8311.0,119
CDM,189756,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE (UW) IV BOLUS,30.0,22.5,0.29,32.4,238
CDM,189762,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",907.68,680.76,10.89,816.91,238
CDM,189764,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",34.9,26.18,0.42,31.41,119
CDM,189765,"OXYCODONE ER 15 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",51.34,38.51,0.62,46.21,119
CDM,189766,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",60.0,45.0,0.72,54.0,119
CDM,189780,DARUNAVIR 800 MG-COBICISTAT 150 MG TABLET,341.23,255.92,4.09,307.11,119
CDM,189792,LISDEXAMFETAMINE 10 MG CAPSULE,60.0,45.0,0.72,54.0,119
CDM,189807,"ARIPIPRAZOLE ER 400 MG SUSPENSION, EXTENDED REL.INTRAMUSCULAR SYRINGE",7982.85,5987.14,95.79,7184.56,119
CDM,189842,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15438.0,11578.5,185.26,13894.2,119
CDM,189864,NALOXEGOL 12.5 MG TABLET,65.46,49.09,0.79,58.91,119
CDM,189865,NALOXEGOL 25 MG TABLET,65.46,49.1,0.79,58.91,119
CDM,189875,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,15892.05,11919.04,190.7,14302.84,119
CDM,189920,DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,157.56,118.17,1.87,143.21,476
CDM,19001,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),7172.25,5379.1849999999995,28.69,17213.4,476
CDM,1901030597,HC RESPITE SUBACUTE ROOM/BOARD,1202.25,901.69,14.43,1082.03,119
CDM,1901031297,HC SWING-SNF BED ROOM/BOARD,2687.48,2015.61,32.25,2418.73,119
CDM,190288,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1595.0,1196.25,19.14,1435.5,238
CDM,190321,"MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION",0.01,0.01,0.01,0.01,119
CDM,190333,ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,1089.7,817.28,13.08,980.73,119
CDM,190336,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,466.36,349.77,5.6,419.72,238
CDM,190425,"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",5.85,4.39,0.07,5.26,119
CDM,190759,DARBEPOETIN ALFA 10 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,235.88,176.91,2.83,212.29,238
CDM,190761,IVABRADINE 5 MG TABLET,48.28,36.21,0.58,43.45,119
CDM,190763,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",12687.9,9515.93,152.25,11419.11,119
CDM,190764,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17786.02,13339.51,213.43,16007.42,119
CDM,190769,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1249.34,937.0,14.99,1124.41,119
CDM,190770,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,780.83,585.62,9.37,702.75,119
CDM,190848,POVIDONE-IODINE 5 % KIT,60.0,45.0,0.72,54.0,119
CDM,191027,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,672.3,504.22,8.07,605.07,238
CDM,191277,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",8577.72,6433.289999999999,34.31,15439.89,476
CDM,191278,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",9249.255000000001,6936.945,37.0,22198.21,476
CDM,191404,CANGRELOR 50 MG INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
CDM,19146,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.6,0.45,0.01,0.54,119
CDM,191659,"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",3128.07,2346.05,37.54,2815.26,119
CDM,191716,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,34.165,25.625,0.1,54.0,238
CDM,191717,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,34.165,25.625,0.1,54.0,238
CDM,191718,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,35.0,26.25,0.12,54.0,238
CDM,191743,BREXPIPRAZOLE 1 MG TABLET,225.0,168.75,2.7,202.5,119
CDM,191744,BREXPIPRAZOLE 2 MG TABLET,225.0,168.75,2.7,202.5,119
CDM,192155,"TACROLIMUS XR 0.75 MG TABLET,EXTENDED RELEASE 24 HR",31.28,23.46,0.38,28.15,119
CDM,192156,"TACROLIMUS XR 1 MG TABLET,EXTENDED RELEASE 24 HR",41.71,31.28,0.5,37.54,119
CDM,192157,"TACROLIMUS XR 4 MG TABLET,EXTENDED RELEASE 24 HR",125.14,93.85,1.5,112.63,119
CDM,19226,CABERGOLINE 0.5 MG TABLET,12.19,9.14,0.15,10.97,119
CDM,192321,TICAGRELOR 60 MG TABLET,43.315,32.485,0.48,41.83,238
CDM,192637,FLUTEMETAMOL F-18 5 MCI (185 MBQ) INTRAVENOUS SOLUTION,180576.0,135432.0,1083.46,243777.6,238
CDM,192700,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,13.52,10.14,0.14,13.48,238
CDM,192994,SODIUM IODIDE-131 (I-131) 250 MCI/0.25 ML ORAL KIT (THERANOSTIC),435.75,326.81,5.23,392.18,119
CDM,193023,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,8187.5,6140.62,98.25,7368.75,119
CDM,193041,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,8270.48,6202.86,99.25,7443.43,119
CDM,193256,FLUCONAZOLE PEDIATRIC IVPB (2 MG/ML)(UW),18.41,13.81,0.22,16.57,119
CDM,193272,MISOPROSTOL 800 MCG (4 X 200 MCG) TABLET KIT,23.16,17.37,0.28,20.84,119
CDM,193325,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,45.17,33.875,0.54,40.66,238
CDM,193326,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,60.0,45.0,0.72,54.0,238
CDM,193356,VANCOMYCIN 750 MG/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,66.0,49.5,0.79,59.4,119
CDM,193359,MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION,9708.2,7281.15,116.5,8737.38,119
CDM,193377,COMPOUNDING VEHICLE SUSPENSION NO.19 ORAL,105.01,78.75,1.26,94.51,119
CDM,193381,COMPOUNDING VEHICLE SUSPENSION SUGAR-FREE NO.20 ORAL,105.01,78.75,1.26,94.51,119
CDM,193612,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,803.4200000000001,602.5649999999999,6.46,961.88,476
CDM,193655,NALOXONE 4 MG/ACTUATION NASAL SPRAY,180.0,135.0,2.16,162.0,238
CDM,193677,PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,162.0,121.5,1.94,145.8,119
CDM,193684,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,7216.45,5412.34,84.49,6653.21,238
CDM,193742,SELEXIPAG 200 MCG TABLET,943.06,707.3,11.32,848.75,119
CDM,193745,SELEXIPAG 800 MCG TABLET,1466.62,1099.96,17.6,1319.96,119
CDM,194258,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML IV FOR CUSTOM RULE,102.6,76.95,1.23,92.34,119
CDM,194262,VANCOMYCIN 25 MG/ML ORAL SOLUTION COMPOUND,3.78,2.84,0.05,3.4,119
CDM,194293,PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,0.19,0.14,0.01,0.17,119
CDM,19433,WARFARIN 3 MG TABLET,1.42,1.06,0.02,1.28,119
CDM,19434,WARFARIN 6 MG TABLET,2.585,1.935,0.02,3.02,238
CDM,194768,CARIPRAZINE 1.5 MG CAPSULE,225.0,168.75,2.7,202.5,119
CDM,19486,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",108.0,81.0,1.3,97.2,119
CDM,19488,"NEOMYCIN 1.75 MG-POLYMYXIN 10,000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS",306.3,229.73,3.68,275.67,119
CDM,195108,AMPICILLIN 500 MG SOLUTION FOR IM INJECTION (UW),16.91,12.69,0.2,15.22,119
CDM,195282,EMTRICITABINE 200 MG-TENOFOVIR ALAFENAMIDE FUMARATE 25 MG TABLET,304.65,228.49,3.66,274.18,119
CDM,19546,"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",108.0,81.0,1.3,97.2,119
CDM,195734,MILTEFOSINE 50 MG CAPSULE,2262.86,1697.14,27.15,2036.57,119
CDM,195900,"SUCCINYLCHOLINE(PF)200 MG/10 ML(20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE",90.0,67.5,1.08,81.0,119
CDM,19636,PHENYLEPHRINE 10 % EYE DROPS,240.0,180.0,2.88,216.0,119
CDM,196434,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,300.0,225.0,3.6,270.0,119
CDM,196435,BRIVARACETAM 10 MG/ML ORAL SOLUTION,4562.7,3422.025,3.45,7954.2,238
CDM,196437,BRIVARACETAM 25 MG TABLET,110.48,82.86,1.33,99.43,119
CDM,196438,BRIVARACETAM 50 MG TABLET,110.48,82.86,1.33,99.43,119
CDM,196482,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,69.3,51.97,0.83,62.37,357
CDM,196494,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",32022.68,24017.01,384.27,28820.41,119
CDM,196542,MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),13.97,10.48,0.17,12.57,119
CDM,196576,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,65.7,49.275,0.57,75.6,238
CDM,196828,CARFILZOMIB 30 MG INTRAVENOUS SOLUTION,4500.92,3375.69,54.01,4050.83,119
CDM,196875,SOFOSBUVIR 400 MG-VELPATASVIR 100 MG TABLET,1097.14,822.86,13.17,987.43,119
CDM,197085,LIFITEGRAST 5 % EYE DROPS IN A DROPPERETTE,60.0,45.0,0.72,54.0,119
CDM,19711,CLINDAMYCIN 1 % LOTION,484.02,363.015,4.32,547.24,238
CDM,19736,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,154.76,116.07,1.86,139.28,119
CDM,197405,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,267.0,200.25,1.87,340.2,238
CDM,197410,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,476
CDM,197417,SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP,148.68,111.51,1.78,133.81,119
CDM,19746,OFLOXACIN 0.3 % EYE DROPS,90.0,67.5,1.08,81.0,119
CDM,197615,SODIUM CHLORIDE 0.45 % (UW) IV BOLUS,27.0,20.25,0.32,24.3,119
CDM,197632,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2693.11,2019.83,32.32,2423.8,119
CDM,197636,KIT FOR THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN,11512.8,8634.6,138.15,10361.52,119
CDM,197731,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
CDM,197771,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,6169.71,4627.28,74.04,5552.74,119
CDM,19805,METRONIDAZOLE 0.75 % TOPICAL CREAM,180.09,135.07,2.16,162.08,119
CDM,198564,NITROGLYCERIN 100 MCG/ML FOR INJECTION (COMPOUND UW),4.92,3.69,0.06,4.43,119
CDM,198777,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,23.25,17.435000000000002,0.26,22.41,357
CDM,198799,LINACLOTIDE 72 MCG CAPSULE,85.19,63.9,1.02,76.67,119
CDM,19882,SERTRALINE 25 MG TABLET,2.09,1.57,0.03,1.88,119
CDM,199041,DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,108.6,81.45,1.3,97.74,119
CDM,199175,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,56731.68,42548.76,680.78,51058.51,119
CDM,199888,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,4283.32,3212.49,51.4,3854.99,119
CDM,200012,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,11982.94,8987.21,143.8,10784.65,119
CDM,2001142197,HC ICU ROOM/BOARD,11859.36,8894.52,142.31,10673.42,119
CDM,200125,UREA 15 GRAM ORAL POWDER PACKET,21.75,16.31,0.26,19.58,119
CDM,2007,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",10.68,8.01,0.13,9.61,238
CDM,2009,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",1.11,0.83,0.01,1.0,119
CDM,200913,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION (REPACKAGED)",61.2,45.9,0.68,58.86,357
CDM,200931,SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,109.83,82.37,1.32,98.85,119
CDM,200999,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,2144.15,1608.11,25.73,1929.74,119
CDM,201063,GLECAPREVIR 100 MG-PIBRENTASVIR 40 MG TABLET,652.14,489.11,7.83,586.93,238
CDM,201303,FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
CDM,201460,NALDEMEDINE 0.2 MG TABLET,72.88,54.66,0.87,65.59,119
CDM,201465,BECLOMETHASONE DIPROP 40 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,985.48,739.11,11.83,886.93,119
CDM,201466,BECLOMETHASONE DIPROP 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,1319.86,989.89,15.84,1187.87,119
CDM,201541,FLUTICASONE FUR. 100 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,1680.0,1260.0,20.16,1512.0,119
CDM,2017,CYCLOBENZAPRINE 10 MG TABLET,0.1,0.07,0.01,0.09,119
CDM,201832,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,14.17,10.625,0.17,12.76,238
CDM,201833,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",830.0,622.5,9.96,747.0,119
CDM,201835,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,830.0,622.5,9.96,747.0,119
CDM,201836,"ADJUVANT AS01B (PF), COMPONENT VIAL 1 OF 2 INTRAMUSCULAR SUSPENSION",827.55,620.66,9.93,744.8,119
CDM,201940,BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRINGE,15044.46,11283.34,180.53,13540.01,119
CDM,202104,CEFAZOLIN 2 GRAM/20 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,35.16,26.37,0.42,31.64,119
CDM,202105,CEFAZOLIN 3 GRAM/30 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,19.98,14.98,0.24,17.98,119
CDM,202114,CEFTRIAXONE 2000 MG IN SWFI 20 ML IV PUSH,42.24,31.68,0.51,38.02,119
CDM,202115,CEFTRIAXONE 1000 MG IN SWFI 10 ML IV PUSH,91.38,68.54,1.1,82.24,119
CDM,202139,LETERMOVIR 480 MG TABLET,1003.47,752.6,12.04,903.12,119
CDM,202142,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,40.08,30.06,0.43,40.12,238
CDM,202209,"LIPASE-PROTEASE-AMYLASE (PORK) 20,000-63,000-84K UNIT CAPSULE, DEL REL",49.52,37.14,0.59,44.57,119
CDM,202243,ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLUTION,3657.0,2742.75,43.88,3291.3,238
CDM,202312,"FIBRINOGEN 1 GRAM (700 MG-1,300 MG) INTRAVENOUS SOLUTION",6.6,4.95,0.08,5.94,119
CDM,202322,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,22162.74,16622.05,265.95,19946.47,119
CDM,202329,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION",1508.38,1131.29,18.1,1357.54,119
CDM,2025,CYCLOPENTOLATE 1 % EYE DROPS,72.6,54.45,0.87,65.34,119
CDM,202657,HYDROMORPHONE (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,502.5,376.88,6.03,452.25,119
CDM,202663,LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION,191164.32,143373.24,2293.97,172047.89,238
CDM,202690,BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET,550.74,413.05,6.61,495.67,119
CDM,203074,INV NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
CDM,203080,INV DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
CDM,203091,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,24822.565000000002,18616.925,255.22,25538.97,476
CDM,203096,ASCORBIC ACID (VITAMIN C) 500 MG/ML INTRAVENOUS SOLUTION,1623.6,1217.7,19.48,1461.24,119
CDM,2032,CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,320.69,240.52,3.85,288.62,119
CDM,2033,CYPROHEPTADINE 4 MG TABLET,2.66,1.99,0.03,2.39,119
CDM,203318,PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION,792.0,594.0,9.5,712.8,119
CDM,203436,COCAINE 4 % NASAL SOLUTION,1016.75,762.56,12.2,915.08,119
CDM,203437,IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,122.11,91.58,1.47,109.9,238
CDM,203470,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,5226.225,3919.665,31.36,7055.4,238
CDM,203961,COMPOUNDING VEHICLE SYRUP NO.23,105.01,78.75,1.26,94.51,119
CDM,204135,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,1553.52,1165.14,18.64,1398.17,119
CDM,204157,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,129.23,96.92,1.55,116.31,238
CDM,204163,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,5737.5,4303.12,68.85,5163.75,119
CDM,204236,HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE,598.08,448.56,7.18,538.27,238
CDM,204619,FLUDEOXYGLUCOSE F-18 20 MCI TO 200 MCI/ML INTRAVENOUS SOLUTION,477.25,357.94,5.73,429.52,119
CDM,20472,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,22.89,17.17,0.2,36.29,714
CDM,204930,KIT FOR PREPARATION OF TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLUTION,13528.74,10146.56,162.34,12175.87,119
CDM,204940,OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,1946.1,1459.58,23.35,1751.49,119
CDM,204942,OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE,3892.21,2919.15,46.71,3502.99,119
CDM,204944,RIVAROXABAN 2.5 MG TABLET,56.96,42.72,0.68,51.26,119
CDM,204958,CANNABIDIOL 100 MG/ML ORAL SOLUTION,4414.5,3310.88,52.97,3973.05,119
CDM,204970,DILUENT FOR ALLERGENIC EXTRACTS NO.1 INJECTION SOLUTION,110.4,82.8,1.32,99.36,119
CDM,204971,ANTIVENIN CROTALIDAE (EQUINE) SOLUTION FOR INJECTION,3628.02,2721.02,43.54,3265.22,119
CDM,204992,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,29152.67,21864.5,349.83,26237.4,119
CDM,205062,BALSAM PERU-CASTOR OIL TOPICAL OINTMENT,160.56,120.42,1.93,144.5,119
CDM,205096,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1804.8,1353.6,21.66,1624.32,238
CDM,205522,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,10742.28,8056.71,128.91,9668.05,119
CDM,20566,MELOXICAM 7.5 MG TABLET,0.24,0.18,0.01,0.22,119
CDM,20580,MELOXICAM 15 MG TABLET,0.3,0.22,0.01,0.27,119
CDM,205859,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,84.0,63.0,0.67,101.25,238
CDM,205882,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",6871.25,5153.44,82.46,6184.12,119
CDM,205980,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,4129.25,3096.94,49.55,3716.32,238
CDM,206017,ARGININE 25 MG/ML-LYSINE 25 MG/ML IN 0.9 % NACL INTRAVENOUS SOLUTION,510.0,382.5,6.12,459.0,119
CDM,2061146297,HC INTERMEDIATE CARE ROOM/BOARD,11108.0,8331.0,133.3,9997.2,119
CDM,206261,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,22415.88,16811.91,268.99,20174.29,119
CDM,206457,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,3440.76,2580.57,41.29,3096.68,119
CDM,206459,ARTIFICIAL TEARS (HYPROMELLOSE) (PF) 1.7 % EYE DROPS WITH APPLICATOR,150.03,112.52,1.8,135.03,119
CDM,206750,KIT FOR PREPARATION OF TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS SOLUTION,5641.15,4230.87,67.69,5077.04,119
CDM,206794,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,399.1,299.33,4.79,359.19,119
CDM,206941,POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION,42080.4,31560.3,504.96,37872.36,119
CDM,207446,BORTEZOMIB 3.5 MG SOLUTION FOR SUBCUTANEOUS INJECTION (UW),126.08500000000001,94.565,1.38,123.8,238
CDM,207466,KIT FOR TC 99M-LABELED RED BLOOD CELLS INTRAVENOUS SOLUTION,796.8,597.6,9.56,717.12,119
CDM,207469,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,5315.8,3986.845,25.52,7654.73,238
CDM,207470,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,1186.97,890.225,4.3,1814.4,357
CDM,207479,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",124.5,93.375,1.48,113.4,357
CDM,207483,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",11.48,8.61,0.14,10.33,119
CDM,207488,TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION,10466.78,7850.09,125.6,9420.1,119
CDM,207489,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,210.0,157.5,2.52,189.0,238
CDM,207490,MODIFIED LANOLIN 100 % TOPICAL CREAM,13.27,9.95,0.16,11.94,119
CDM,207494,AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,3521.7,2641.27,42.26,3169.53,119
CDM,207501,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE (THERANOSTIC),99.0,74.25,1.19,89.1,119
CDM,207653,KIT FOR PREPARATION OF TC-99M-SODIUM OXIDRONATE 3.15 MG IV SOLUTION,198.0,148.5,2.38,178.2,238
CDM,207984,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,29374.004999999997,22030.5,0.15,77926.1,3094
CDM,208036,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,4384.42,3288.32,6.72,8878.13,595
CDM,208216,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,7214.95,5411.21,86.58,6493.46,119
CDM,208217,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,7730.44,5797.83,30.92,11595.66,238
CDM,208222,TRASTUZUMAB-DKST 150 MG INTRAVENOUS SOLUTION,2676.69,2007.52,32.12,2409.02,119
CDM,208264,ELEXACAFTOR 100 MG-TEZACAF 50MG-IVACAF 75MG(D)/IVACAF 150MG(N) TABLETS,1213.53,910.15,14.56,1092.18,119
CDM,208354,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,11083.3,8312.47,133.0,9974.97,119
CDM,208595,"MINERAL OIL, LIGHT STERILE",119.88,89.91,1.44,107.89,119
CDM,208615,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,4837.52,3628.14,58.05,4353.77,119
CDM,208638,XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) GAS FOR INHALATION,1148.165,861.12,11.76,1185.07,238
CDM,208639,XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) GAS FOR INHALATION,2065.02,1548.7649999999999,23.94,1921.61,238
CDM,208848,DEXTROSE 5 % IN WATER (D5W) (UW) IV BOLUS,29.25,21.939999999999998,0.27,32.4,238
CDM,208866,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,4673.345,3505.005,22.43,6729.62,238
CDM,208868,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 GRAM INTRAVENOUS SOLUTION,1178.61,883.96,14.14,1060.75,119
CDM,20887,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,59.265,44.45,0.18,93.34,476
CDM,208889,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,7720.54,5790.4,92.65,6948.49,119
CDM,208890,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,11580.8,8685.6,138.97,10422.72,119
CDM,208895,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,8066.16,6049.62,96.79,7259.54,119
CDM,2090,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,238
CDM,209077,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,6553.344999999999,4915.01,26.21,9830.02,238
CDM,209082,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,894.11,670.58,10.73,804.7,119
CDM,209087,"FENTANYL (PF) 2,500 MCG/50 ML (50 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE",130.5,97.88,1.57,117.45,119
CDM,2091,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,238
CDM,209100,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,38476.84,28857.63,461.72,34629.16,119
CDM,20919,"MORPHINE ER 100 MG TABLET,EXTENDED RELEASE",9.89,7.42,0.12,8.9,119
CDM,20920,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",14.67,11.0,0.02,24.78,238
CDM,20921,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",9.545,7.155,0.11,8.6,238
CDM,20943,AZITHROMYCIN 250 MG TABLET,7.41,5.56,0.09,6.67,119
CDM,209469,AMIVANTAMAB-VMJW 50 MG/ML INTRAVENOUS SOLUTION,10377.51,7783.13,124.53,9339.76,119
CDM,20952,LEVOCARNITINE 330 MG TABLET,5.27,3.95,0.06,4.74,119
CDM,20954,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,223.635,167.73000000000002,2.57,209.92,357
CDM,209578,EPTINEZUMAB-JJMR 100 MG/ML INTRAVENOUS SOLUTION,5189.58,3892.19,62.27,4670.62,119
CDM,209608,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,7706.62,5779.96,30.83,11559.94,238
CDM,209758,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML (1-80 MCI/ML) IV SOLUTION",17483.22,13112.42,209.8,15734.9,119
CDM,209779,CENOBAMATE 50 MG TABLET,177.0,132.75,2.12,159.3,119
CDM,209780,CENOBAMATE 100 MG TABLET,177.0,132.75,2.12,159.3,119
CDM,209929,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,6772.2,5079.15,81.27,6094.98,119
CDM,210126,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),297.015,222.76,3.53,270.0,238
CDM,210127,NIMODIPINE 60 MG/10 ML ORAL SYRINGE (FOR ORAL USE ONLY),588.06,441.04,7.06,529.25,238
CDM,210135,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",28524.39,21393.29,342.29,25671.95,119
CDM,210288,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,1706.12,1279.59,20.47,1535.51,119
CDM,210528,PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,0.98,0.74,0.01,0.88,238
CDM,21062,CITALOPRAM 20 MG TABLET,0.49,0.36,0.01,0.44,119
CDM,210624,C.I. ACID BLUE 90  0.025 % INTRAOCULAR SYRINGE,447.96,335.97,5.38,403.16,119
CDM,21063,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,16.21,12.155000000000001,0.15,17.98,238
CDM,210658,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,125602.14,94201.6,1507.23,113041.93,119
CDM,210663,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,20661.19,15495.89,247.93,18595.07,119
CDM,210716,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG-10 MCG/ML ORAL DROPS (REPACKAGING),0.735,0.5549999999999999,0.01,0.88,357
CDM,210728,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",39606.46,29704.84,475.28,35645.81,119
CDM,210729,PERTUZUMAB 600 MG-TRASTUZUMAB 600 MG-HYALURONID-ZZXF/10 ML SUBCUT SOLN,26403.25,19802.44,316.84,23762.92,119
CDM,211060,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,3051.045,2288.2799999999997,19.65,4018.13,238
CDM,211278,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,116.19,87.14,1.39,104.57,238
CDM,21135,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),554.08,415.56,6.65,498.67,119
CDM,211381,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
CDM,211384,POTASSIUM CHLORIDE 40 MEQ/500 ML (80 MEQ/L) IN NS IVPB (PERIPHERAL LINE),30.0,22.5,0.36,27.0,119
CDM,211436,POLATUZUMAB VEDOTIN-PIIQ 30 MG INTRAVENOUS SOLUTION,10961.49,8221.11,131.54,9865.34,119
CDM,211709,FLUTICASONE FUR. 200 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,1680.0,1260.0,20.16,1512.0,119
CDM,211928,FAMOTIDINE (PF) 20 MG/2 ML ORAL SOLUTION (UW),5.4,4.05,0.06,4.86,119
CDM,212474,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CDM,212502,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL GEL,95.99,72.0,1.15,86.39,238
CDM,212755,"HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL, ISO-OSM IV PCA SYR",98.1,73.57,1.01,211.41,357
CDM,21300,"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",2.54,1.9,0.03,2.29,119
CDM,2131,DAPSONE 100 MG TABLET,9.3,6.98,0.11,8.37,119
CDM,2132,DAPSONE 25 MG TABLET,5.9,4.42,0.07,5.31,119
CDM,213407,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,5434.44,4075.83,65.21,4891.0,119
CDM,213413,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,13838.88,10379.16,166.07,12454.99,119
CDM,21372,WARFARIN 4 MG TABLET,2.4,1.8,0.03,2.16,119
CDM,213818,FLORBETABEN F-18 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,11439.0,8579.25,123.98,11291.4,238
CDM,213879,DOSTARLIMAB-GXLY 50 MG/ML INTRAVENOUS SOLUTION,32416.85,24312.64,389.0,29175.16,119
CDM,2141264497,HC TELEMETRY ROOM/BOARD,4717.44,3538.08,56.61,4245.7,119
CDM,214170,"OMEGA-3 300 MG-DHA 120 MG-EPA 180 MG-FISH OIL 1,000 MG CAPSULE",0.28,0.21,0.01,0.25,119
CDM,214192,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,556.31,417.235,6.57,508.43,238
CDM,214405,BENZOCAINE 20 %-MENTHOL 0.26 %-ZINC CHLORIDE 0.15 % MUCOSAL GEL,35.27,26.45,0.42,31.74,119
CDM,214438,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,14660.39,10995.29,175.92,13194.35,119
CDM,214697,"TRACE ELEMENTS ZINC 1,000 MCG-CU 60 MCG-MANG 3 MCG-SE 6 MCG/ML IV SOLN",107.32,80.49,1.29,96.59,119
CDM,214709,NIVOLUMAB 120 MG/12 ML INTRAVENOUS SOLUTION,11081.37,8311.03,132.98,9973.23,119
CDM,214761,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,18327.48,13745.61,219.93,16494.73,119
CDM,214856,AZATHIOPRINE 50 MG/ML ORAL SUSPENSION,127.98,95.98,1.54,115.18,119
CDM,214880,RIFAMPIN 25MG/ML ORAL SUSPENSION - COMPOUND,90.72,68.04,1.09,81.65,119
CDM,214944,FENTANYL (PF) 20 MCG/2 ML (10 MCG/ML) IN 0.9 % SOD CHLORIDE IV SYRINGE,35.94,26.96,0.43,32.35,119
CDM,215416,MARIBAVIR 200 MG TABLET,879.32,659.49,10.55,791.39,119
CDM,215478,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,17617.82,13213.37,211.41,15856.04,119
CDM,215481,"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",14853.06,11139.8,178.24,13367.75,119
CDM,215615,INCLISIRAN 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,12603.49,9452.62,151.24,11343.14,119
CDM,215625,"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",864.35,648.27,10.37,777.92,119
CDM,215768,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,18450.0,13837.5,182.43,20407.14,476
CDM,216084,EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,74.1,55.58,0.89,66.69,238
CDM,216126,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,43030.32,32272.74,516.36,38727.29,119
CDM,216332,DARIDOREXANT 50 MG TABLET,76.36,57.27,0.92,68.72,119
CDM,216356,"LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",155669.85,116752.39,1868.04,140102.87,119
CDM,216441,SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,333.46500000000003,250.1,3.75,319.28,238
CDM,216638,AMINO ACID 4.25 % NO.1-DEXTROSE 5 %-ELECTROLYTES NO.39 IV SOLUTION,369.0,276.75,3.1,432.0,238
CDM,217002,KETAMINE 10 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,1371.75,1028.815,2.99,2245.05,238
CDM,217022,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,29222.11,21916.58,350.67,26299.9,119
CDM,217361,INDOMETHACIN 100 MG RECTAL SUPPOSITORY,1152.0,864.0,13.82,1036.8,119
CDM,217565,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",39.66,29.74,0.48,35.69,119
CDM,217904,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6871.25,5153.44,82.46,6184.12,119
CDM,217905,ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,2309.4,1732.05,27.71,2078.46,119
CDM,218328,TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION,111522.04,83641.53,1338.26,100369.84,119
CDM,218331,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,24997.49,18748.12,299.97,22497.74,119
CDM,218728,PIFLUFOLASTAT F 18  296 MBQ TO 370 MBQ (8 MCI TO 10 MCI) IV SYRINGE,18931.48,14198.61,227.18,17038.33,119
CDM,21902,"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
CDM,219076,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 INTRAVENOUS SYRINGE,490.26,367.7,5.88,441.23,119
CDM,219104,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,28783.67,21587.75,345.4,25905.3,119
CDM,219161,LECANEMAB-IRMB 100 MG/ML INTRAVENOUS SOLUTION,1951.04,1463.28,23.41,1755.94,119
CDM,220163,ELEXACAF 100 MG-TEZACAF 50 MG-IVACAF 75 MG(D)/IVACAF 75 MG(N) GRAN PK,1820.3,1365.22,21.84,1638.27,119
CDM,220521,TENECTEPLASE 50 MG KIT FOR ISCHEMIC STROKE (UW),24822.565000000002,18616.925,255.22,25538.97,238
CDM,220743,PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,0.63,0.47,0.01,0.57,119
CDM,220745,"FLOTUFOLASTAT F 18 GALLIUM 296-5,846 MBQ/ML (8-158 MCI/ML) IV SOLUTION",18450.0,13837.5,221.4,16605.0,119
CDM,220845,"EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN",44219.13,33164.35,530.63,39797.22,119
CDM,221264,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1178.11,883.58,14.14,1060.3,119
CDM,22142,CLOPIDOGREL 75 MG TABLET,1.45,1.08,0.02,1.3,119
CDM,221537,NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,1986.065,1489.55,23.04,1846.92,238
CDM,221538,NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE,1995.84,1496.88,23.95,1796.26,119
CDM,221646,RUBIDIUM RB-82 CHLORIDE INTRAVENOUS SOLUTION,754.72,566.04,9.06,679.25,238
CDM,222298,METRONIDAZOLE 500 MG/5 ML ORAL SUSPENSION,3270.0,2452.5,39.24,2943.0,119
CDM,222673,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,24928.54,18696.4,299.14,22435.69,119
CDM,222767,SITAGLIPTIN 50 MG TABLET,16.0,12.0,0.19,14.4,119
CDM,22289,CEFDINIR 300 MG CAPSULE,5.0,3.75,0.06,4.5,119
CDM,223430,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",21.55,16.16,0.26,19.4,119
CDM,223434,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION (SANDIMMUNE),307.87,230.89999999999998,3.69,277.1,238
CDM,223435,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",43.1,32.33,0.52,38.79,119
CDM,223439,CYCLOSPORINE MODIFIED 100 MG CAPSULE (GENGRAF),44.08,33.06,0.53,39.67,119
CDM,223440,CYCLOSPORINE MODIFIED 25 MG CAPSULE (GENGRAF),11.03,8.28,0.13,9.93,119
CDM,223442,CYCLOSPORINE MODIFIED 25 MG CAPSULE (NEORAL),16.07,12.05,0.19,14.46,119
CDM,223710,AZITHROMYCIN 500 MG IN NS 250 ML IVPB BATCH,57.0,42.75,0.68,51.3,119
CDM,223881,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1193.64,895.23,14.32,1074.28,119
CDM,223882,TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,2984.11,2238.08,35.81,2685.7,119
CDM,223883,TOCILIZUMAB-AAZG 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,5968.22,4476.17,71.62,5371.4,119
CDM,223890,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLOR IV SYRINGE,34.5,25.88,0.41,31.05,119
CDM,22472,KETOROLAC 15 MG/ML INJECTION SOLUTION,18.05,13.54,0.22,16.24,119
CDM,22473,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,4.859999999999999,3.6449999999999996,0.05,4.97,476
CDM,225544,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE 1 GRAM OR LESS),142.8,107.1,1.71,128.52,238
CDM,22560,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,134.79999999999998,101.095,0.14,232.43,238
CDM,226085,DOXYCYCLINE 500 MG IN 20 ML NS (25 MG/ML) FOR SCLEROTHERAPY,800.64,600.48,9.61,720.58,119
CDM,226256,PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,574.0,430.5,6.89,516.6,238
CDM,22646,"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",374.62,280.96,4.5,337.16,119
CDM,226641,AMIODARONE 1.8 MG/ML IN D5W FOR BOLUS DOSE CMPD,28.8,21.6,0.35,25.92,119
CDM,226738,ACYCLOVIR IN NS (5 MG/ML) IV SOLUTION NEO/PED,1050.0,787.5,12.6,945.0,119
CDM,227120,HYDROCORTISONE IN NS (1 MG/ML) NEO/PEDS SYRINGE,12.48,9.36,0.15,11.23,119
CDM,227358,GLYCERIN 99.5% RECTAL ENEMA SOLUTION (UW),0.14,0.11,0.01,38.23,357
CDM,227387,METOPROLOL TARTRATE 6.25 MG (1/4 OF 25 MG) TABLET,0.14,0.11,0.01,0.13,119
CDM,227618,GLYCERIN 25 ML IN 500 ML NS ENEMA,28.35,21.26,0.34,25.52,119
CDM,227619,GLYCERIN 50 ML IN 1000 ML NS ENEMA,25.2,18.9,0.3,22.68,119
CDM,227625,AZITHROMYCIN IN NS (2 MG/ML) PEDS/NEO,33.0,24.75,0.4,29.7,119
CDM,227708,CEFTAZIDIME 20 MG/ML IN NS IVPB (NEO/PED) CMPD,828.0,621.0,9.94,745.2,119
CDM,228127,CLONIDINE 20 MCG/ML ORAL SUSPENSION,120.96,90.72,1.45,108.86,119
CDM,2286,DESIPRAMINE 25 MG TABLET,0.9,0.68,0.01,0.81,119
CDM,228673,FOSAPREPITANT 150 MG IN 250ML NS (0.6 MG/ML) IVPB CMPD,690.62,517.97,8.29,621.56,119
CDM,2291,DESONIDE 0.05 % TOPICAL CREAM,216.45,162.34,2.6,194.8,119
CDM,229158,WARFARIN 0.25 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),0.56,0.42,0.01,0.5,119
CDM,229163,WARFARIN 1.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),0.71,0.53,0.01,0.64,119
CDM,229169,WARFARIN 0.75 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),2.22,1.66,0.03,2.0,119
CDM,229330,PANTOPRAZOLE 80 MG IN NS 100 ML IV DRIP BATCHED,63.0,47.25,0.76,56.7,119
CDM,229353,DEXAMETHASONE IN D5W (0.4 MG/ML) NEO/PEDS IV,85.74,64.3,1.03,77.17,119
CDM,229394,IH ADULT CENTRAL PARENTERAL NUTRITION - MINIMUM VOLUME,906.0,679.5,10.87,815.4,119
CDM,229396,GENTAMICIN IN D5W (5 MG/ML) IV SOLUTION (NEO/PEDS) CMPD,7.77,5.83,0.09,6.99,119
CDM,229413,ALTEPLASE IN NS 10 MG/30 ML (CHEST TUBE ONLY),4166.37,3124.78,50.0,3749.73,119
CDM,229418,VORICONAZOLE 4 MG/ML IN NS IVPB (NEO/PED) CMPD,1479.6,1109.7,17.76,1331.64,119
CDM,229510,"PENICILLIN G POTASSIUM/NS 100,000 UNITS/ML (PEDS/NEO/INFANT/NICU)",91.2,68.4,1.09,82.08,119
CDM,229551,ZINC SULFATE 5 MG/ML ORAL LIQUID,187.53,140.65,2.25,168.78,119
CDM,22959,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,2203.5,1652.62,26.44,1983.15,119
CDM,229708,ZOLBETUXIMAB-CLZB 100 MG INTRAVENOUS SOLUTION,4397.6,3298.2,52.77,3957.84,119
CDM,229900,ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION - COMPOUNDED,50.4,37.8,0.6,45.36,119
CDM,229920,FOLIC ACID 1 MG/ML ORAL SUSPENSION - COMPOUNDED,73.44,55.08,0.88,66.1,119
CDM,229924,MISOPROSTOL 25 MCG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.0,0.75,0.01,0.9,119
CDM,229926,SPIRONOLACTONE 12.5 MG (1/2 OF 25 MG) TABLET,0.54,0.4,0.01,0.49,119
CDM,230269,PHYTONADIONE 1 MG/ML CMPD NEO/PED ORAL SOLUTION,26.28,19.71,0.32,23.65,119
CDM,230286,CENOBAMATE 12.5 MG (1/4 OF 50 MG) TABLET,59.0,44.25,0.71,53.1,119
CDM,230287,CENOBAMATE 25 MG (1/2 OF 50 MG) TABLET,88.5,66.38,1.06,79.65,119
CDM,230291,METOPROLOL TARTRATE 12.5 MG (1/2 OF 25 MG) TABLET,0.14,0.11,0.01,0.13,119
CDM,230338,POTASSIUM & SODIUM PHOSPHATE 640 MG-1120 MG-1000 MG/300 ML (PHOS-NAK) COMPOUNDED ORAL SUSPENSION,1.8,1.35,0.02,1.62,119
CDM,230344,POTASSIUM PHOSPHATE 0.12 MMOL/ML IN NS (CENTRAL LINE ONLY) IVPB (NEO/PED) CMPD,31.5,23.62,0.38,28.35,119
CDM,230457,ETHANOL 95% INJECTABLE SOLUTION 50 ML COMPOUNDED,2878.2,2158.65,34.54,2590.38,119
CDM,230461,FENTANYL 300 MCG/30 ML (10 MCG/ML) IN D5W IV DRIP NEO/PED,90.0,67.5,1.08,81.0,119
CDM,230463,"FENTANYL 1,500 MCG/30 ML (50 MCG/ML) IV DRIP NEO/PED CMPD",95.58000000000001,71.685,1.14,86.18,238
CDM,230488,HIV POST-EXPOSURE KIT STARTER PACK,81.0,60.75,0.97,72.9,119
CDM,230497,KETAMINE IN NS 500 MG/250 ML IV DRIP,58.5,43.88,0.7,52.65,119
CDM,230738,"HEPARIN (PORCINE) 15,000 UNIT/500 ML IN 0.9% SODIUM CHLORIDE",33.0,24.75,0.4,29.7,119
CDM,230740,MOXIFLOXACIN 1.5 MG/0.3 ML INTRACAMERAL INJECTION (OR ONLY),32.67,24.5,0.39,29.4,119
CDM,230742,FINASTERIDE 5 MG/15 ML ORAL SUSPENSION COMPOUNDED,4.5,3.38,0.05,4.05,119
CDM,230746,DEXTROSE 5% IN WATER 10 ML FLUSH SYRINGE,0.36,0.27,0.01,0.32,119
CDM,230747,SODIUM ACETATE 0.154 MEQ/ML (NORMAL) IV BOLUS (NEO/PED) CMPD,35.1,26.33,0.42,31.59,119
CDM,230945,DEXTROSE 10% SPN WITHOUT HEPARIN (DEXTROSE 10% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,202.5,151.88,2.43,182.25,119
CDM,231033,POTASSIUM CHLORIDE 0.4 MEQ/ML IN SW IVPB NEO/PED (CENTRAL LINE ONLY) (UW),0.34,0.26,0.01,0.31,119
CDM,231034,POTASSIUM CHLORIDE 1.2 MEQ/30 ML (0.04 MEQ/ML) IN D5-1/2NS IV DRIP NEO/PED (PERIPHERAL LINE) (UW),60.0,45.0,0.72,54.0,119
CDM,231053,FENTANYL (PF) 2 MCG/ML NEONATAL IV SYRINGE,0.41,0.31,0.01,0.37,119
CDM,231064,MORPHINE 0.2 MG/ML NEONATAL IV SYRINGE,0.07,0.05,0.01,0.06,119
CDM,23128,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,142.44,106.83,0.81,189.0,714
CDM,23150,"VERAPAMIL ER 180 MG 24 HR CAPSULE,EXTENDED RELEASE",9.14,6.86,0.11,8.23,119
CDM,231743,MEROPENEM 10 MG/ML IN NS IVPB NEO/PED CMPD,180.0,135.0,2.16,162.0,119
CDM,231799,IH ADULT PERIPHERAL PARENTERAL NUTRITION - MINIMUM VOLUME,906.0,679.5,10.87,815.4,119
CDM,231805,CEFTRIAXONE 2000 MG IN SWFI 20 ML (100 MG/ML) NEO/PEDS IVPB,42.24,31.68,0.51,38.02,119
CDM,231835,SIMETHICONE 0.27 MG/ML CMPD ORAL SUSP,19.5,14.62,0.22,32.4,357
CDM,231836,CLINDAMYCIN 18 MG/ML IN D5W IVPB NEO/PED,54.15,40.61,0.36,70.47,238
CDM,231878,INSULIN REGULAR HUMAN 0.25 UNIT/ML *DILUTED* INJECTION (NEO) CMPD,11.52,8.64,0.14,10.37,119
CDM,2319,DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR,264.49,198.37,3.17,238.04,119
CDM,231981,NAFCILLIN 40 MG/ML IN NS IVPB (NEO/PED),2.68,2.01,0.03,2.41,119
CDM,2320,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,305.28,228.96,3.66,274.75,119
CDM,232003,IH ADULT PERIPHERAL PARENTERAL NUTRITION - STANDARD,906.0,679.5,10.87,815.4,119
CDM,232017,MELATONIN 1 MG/ML ORAL LIQUID SYRINGE,0.53,0.4,0.01,0.48,119
CDM,232023,INV DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,0.01,0.01,0.01,0.01,119
CDM,232031,IH ADULT CENTRAL PARENTERAL NUTRITION - STANDARD,906.0,679.5,10.87,815.4,119
CDM,232035,IH ADULT CENTRAL PARENTERAL NUTRITION - CYCLIC,906.0,679.5,10.87,815.4,119
CDM,232036,IH ADULT PERIPHERAL PARENTERAL NUTRITION - CYCLIC,906.0,679.5,10.87,815.4,119
CDM,2322,DEXAMETHASONE 0.5 MG TABLET,0.69,0.52,0.01,0.62,119
CDM,232568,EPINEPHRINE HCL 50 MCG/5 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,53.88,40.41,0.65,48.49,119
CDM,2326,DEXAMETHASONE 2 MG TABLET,3.71,2.78,0.04,3.34,119
CDM,232665,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,84.0,63.0,0.61,211.41,714
CDM,232695,REMDESIVIR 1.25 MG/ML IN NS IVPB (NEO/PED) CMPD,2698.24,2023.68,32.38,2428.42,119
CDM,2327,DEXAMETHASONE 4 MG TABLET,6.02,4.52,0.07,5.42,119
CDM,232701,ALTEPLASE IN NS 5 MG/15 ML (CHEST TUBE ONLY),1615.95,1211.96,19.39,1454.36,119
CDM,232943,MORPHINE 30 MG/30 ML (1 MG/ML) IN D5W IV DRIP (NEO/PED),72.0,54.0,0.86,64.8,119
CDM,232944,MORPHINE 6 MG/30 ML (0.2 MG/ML) IN NS IV DRIP (NEO/PED),2.04,1.53,0.02,1.84,119
CDM,233167,IH TOTAL PARENTERAL NUTRITION NEO 2-IN-1 PN,350.0,262.5,4.2,315.0,119
CDM,233176,NIFEDIPINE 4 MG/ML ORAL SUSPENSION CMPD,61.56,46.17,0.74,55.4,119
CDM,233187,PHENYLEPHRINE 20 MG/100 ML (0.2 MG/ML) IN NS IV DRIP CMPD,225.0,168.75,2.7,202.5,119
CDM,2332,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,5.03,3.77,0.06,4.86,357
CDM,233277,SODIUM CHLORIDE 3 % HYPERTONIC IV BOLUS (UW),33.0,24.75,0.29,35.1,357
CDM,233307,MITOMYCIN 0.02% (0.1 MG/0.5 ML) OPHTHALMIC SOLUTION COMPOUNDED,148.26,111.2,1.78,133.43,119
CDM,233327,BUMETANIDE 0.25 MG/ML ORAL SOLUTION (FROM INJECTION) (UW),0.2,0.15,0.01,0.18,119
CDM,233329,MEXILETINE 10 MG/ML ORAL SUSPENSION - COMPOUNDED,61.92,46.44,0.74,55.73,119
CDM,2335,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,300.0,225.0,3.6,270.0,119
CDM,233515,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE (UW)",1392.28,1044.21,16.71,1253.05,238
CDM,233637,SUZETRIGINE 50 MG TABLET,69.75,52.31,0.84,62.78,119
CDM,234230,IH TOTAL PARENTERAL NUTRITION PED 3-IN-1 PN,350.0,262.5,4.2,315.0,119
CDM,234283,IH TOTAL PARENTERAL NUTRITION PED 2-IN-1 PN,350.0,262.5,4.2,315.0,119
CDM,234373,FOSPHENYTOIN 25 MG PE/ML IN NS INJECTION NEO/PED CMPD,44.4,33.3,0.53,39.96,119
CDM,234462,SELENIUM 8 MCG/ML INTRAVENOUS SOLUTION (CMPD),1371.9,1028.93,16.46,1234.71,119
CDM,234463,LEVOCARNITINE 25 MG/ML INTRAVENOUS SOLUTION (CMPD),225.12,168.84,2.7,202.61,119
CDM,234465,COPPER CHLORIDE 50 MCG/ML INTRAVENOUS SOLUTION (CMPD),97.44,73.08,1.17,87.7,119
CDM,234570,DEXTROSE 5% SPN WITHOUT HEPARIN (DEXTROSE 5% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,213.0,159.75,2.56,191.7,119
CDM,234571,DEXTROSE 12.5% SPN WITHOUT HEPARIN (DEXTROSE 12.5% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,199.5,149.62,2.39,179.55,119
CDM,23458,AMOXICILLIN 875 MG TABLET,2.62,1.96,0.03,2.36,119
CDM,234635,CAFFEINE CITRATE 10 MG/ML IN D5W IVPB (NEO/PED) CMPD,72.0,54.0,0.86,64.8,119
CDM,234677,ECULIZUMAB-AAGH 300 MG/30 ML INTRAVENOUS SOLUTION,13914.88,10436.16,166.98,12523.39,119
CDM,235471,TBO-FILGRASTIM 30 MCG/ML IN D5W IVPB (NEO/PED) CMPD,820.9,615.67,9.85,738.81,119
CDM,235507,FUROSEMIDE 2 MG/ML IN NS NEO/PEDS CMPD INJECTABLE NEO/PEDS,97.5,73.12,1.17,87.75,119
CDM,235536,"HEPARIN/ELECTROLYTE SOLUTION (PLASMA-LYTE R) 1,000 UNITS/1,000 ML",102.0,76.5,1.22,91.8,119
CDM,235800,ROPIVACAIN 0.2% 50 ML NERVE BLOCK SYRINGE,33.6,25.2,0.4,30.24,119
CDM,235850,"HEPARIN (PORCINE) 12,500 UNIT/250 ML IN NS (OR ONLY)",225.0,168.75,2.7,202.5,119
CDM,235855,"LACTULOSE/NS 200 G/1,000 ML ENEMA COMPOUNDED",48.0,36.0,0.58,43.2,119
CDM,235856,"LACTULOSE/STERILE WATER 200 G/1,000 ML ENEMA COMPOUNDED",42.0,31.5,0.5,37.8,119
CDM,235877,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),11.38,8.54,0.1,12.81,1071
CDM,236088,DAPTOMYCIN 50 MG/ML IN NS IV SYRINGE,180.0,135.0,2.16,162.0,119
CDM,2361,DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,112.26,84.2,1.35,101.03,119
CDM,2364,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,23.25,17.439999999999998,0.18,32.4,714
CDM,236430,DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE,4408.95,3306.71,52.91,3968.06,119
CDM,2365,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,110.4,82.8,1.32,99.36,119
CDM,2367,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,120.0,90.0,1.44,108.0,119
CDM,237487,"HEPARIN 20,000 UNITS IN 20 ML (1,000 UNIT/ML) SYRINGE FOR CRRT",40.44,30.33,0.49,36.4,119
CDM,237598,"HEPARIN 20,000 UNITS IN NS 500 ML IRRIGATION (OR ONLY) CMPD",6060.0,4545.0,72.72,5454.0,119
CDM,237599,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE GREATER THAN 1 GRAM),142.8,107.1,1.71,128.52,238
CDM,237618,MORPHINE 20 MG/20 ML (1 MG/ML) IN NS IV DRIP (NEO/PED),43.08,32.31,0.52,38.77,119
CDM,237760,HEPARIN (PORCINE) 100 UNIT/ML IN 0.45 % SODIUM CHLORIDE IV BOLUS (UW),63.75,47.81,0.76,57.38,119
CDM,237761,HEPARIN (PORCINE) 100 UNIT/ML IN DEXTROSE 5 % IV BOLUS (UW),65.25,48.94,0.77,59.4,238
CDM,237784,PIPERACILLIN-TAZOBACTAM 40 MG PIPERACILLIN/ML IN NS IVPB (NEO/PED) CMPD,0.74,0.56,0.01,0.67,119
CDM,237807,POTASSIUM PHOSPHATE 0.05 MMOL/ML IN NS (PERIPHERAL) IVPB (NEO/PED) CMPD,0.13,0.1,0.01,0.12,119
CDM,237906,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,156.84,117.63,1.88,141.16,119
CDM,237913,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,39.48,29.61,0.47,35.53,238
CDM,238225,INV GENERIC NON-CHEMOTHERAPY,0.01,0.01,0.01,0.01,119
CDM,238243,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (4 GM PIP NEO/PED)(UW),36.33,27.244999999999997,0.4,35.1,357
CDM,238507,DEXMEDETOMIDINE 100 MCG/25 ML (4 MCG/ML) IN NS SYRINGE (NEO/PED) CMPD,42.15,31.61,0.51,37.94,119
CDM,238530,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV DRIP,158.85000000000002,119.14,1.41,179.82,357
CDM,238571,INV SIGVOTATUG VEDOTIN 10 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
CDM,238573,INV AMG 509 0.1 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
CDM,238574,INV AMG 509 0.5 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
CDM,238716,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV DRIP,58.5,43.88,0.7,52.65,119
CDM,238717,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV DRIP,47.4,35.55,0.57,42.66,119
CDM,23872,LEFLUNOMIDE 10 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,23873,LEFLUNOMIDE 20 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,238794,NOREPINEPHRINE 48 MCG/3 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,2.66,2.0,0.03,2.39,119
CDM,238795,NOREPINEPHRINE 480 MCG/30 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,26.64,19.98,0.32,23.98,119
CDM,238799,FOSAPREPITANT 150 MG/5 ML (30 MG/ML) INTRAVENOUS SOLUTION (UW),224.265,168.2,2.38,225.4,238
CDM,239665,"EPOPROSTENOL 90,000 NG/30 ML (3,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",49.68,37.26,0.6,44.71,119
CDM,239666,"EPOPROSTENOL 750,000 NG/50 ML (15,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",144.0,108.0,1.73,129.6,119
CDM,240028,INV TOVORAFENIB 100 MG TABLET,0.01,0.01,0.01,0.01,119
CDM,240029,INV TOVORAFENIB 25 MG/ML ORAL SUSPENSION,0.01,0.01,0.01,0.01,119
CDM,240123,DEXMEDETOMIDINE 12 MCG/3 ML (4 MCG/ML) IN NS IV DRIP SYRINGE,16.11,12.08,0.19,14.5,119
CDM,2404,DIAZEPAM 2 MG TABLET,0.38,0.29,0.01,0.34,119
CDM,240492,"FENTANYL 2,500 MCG IN NS 50 ML (50 MCG/ML) DRIP",141.3,105.975,1.57,136.89,238
CDM,240494,AMPICILLIN-SULBACTAM 20 MG AMPICILLIN/ML IN NS IVPB (NEO/PED) CMPD,0.21,0.16,0.01,0.19,119
CDM,240498,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (2 GM AMP NEO/PED)(UW),31.8,23.85,0.38,28.62,238
CDM,2405,DIAZEPAM 5 MG TABLET,0.4,0.3,0.01,0.36,238
CDM,240511,GANCICLOVIR 10 MG/ML IN NS IVPB (NEO/PED) CMPD,11.98,8.98,0.14,10.78,119
CDM,240515,CEFAZOLIN 100 MG/ML IN SWFI IVPB (NEO/PED) CMPD,0.63,0.47,0.01,0.57,119
CDM,240517,ERYTHROMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD,1200.0,900.0,14.4,1080.0,119
CDM,24060,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,1.11,0.83,0.01,1.0,119
CDM,2412,DIBUCAINE 1 % TOPICAL OINTMENT,24.275,18.205,0.23,26.46,238
CDM,241216,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL SOLUTION 50 ML,66.9,50.175000000000004,0.4,90.18,357
CDM,2414,DICLOXACILLIN 250 MG CAPSULE,3.76,2.82,0.05,3.38,119
CDM,241583,SODIUM CHLORIDE 7% FOR NEBULIZATION (BIO BALANCED),3.79,2.84,0.05,3.41,119
CDM,241667,"LIDOCAINE 0.75%-EPINEPHRINE 1:4,000-BSS 0.5 ML CMPD SYRINGE (OR ONLY)",10.64,7.98,0.13,9.58,119
CDM,24176,MIDAZOLAM 2 MG/ML ORAL SYRUP,33.06,24.8,0.4,29.75,119
CDM,2418,DICYCLOMINE 10 MG CAPSULE,0.96,0.72,0.01,0.86,119
CDM,24188,"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",90.75,68.06,1.09,81.68,119
CDM,241917,COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE,292.49,219.37,3.51,263.24,119
CDM,2420,DICYCLOMINE 20 MG TABLET,1.08,0.81,0.01,0.97,119
CDM,242646,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE (UW),21619.68,16214.76,259.44,19457.71,119
CDM,242647,LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRINGE (UW),13764.97,10323.73,165.18,12388.47,119
CDM,242648,LANREOTIDE 90 MG/0.3 ML SUBCUTANEOUS SYRINGE (UW),18332.19,13749.14,219.99,16498.97,119
CDM,242661,KETAMINE IN NS 200 MG/100 ML IV DRIP,36.6,27.45,0.44,32.94,119
CDM,24268,"ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",0.78,0.58,0.01,0.7,119
CDM,243188,EPINEPHRINE 1 MG/ML (1 ML) ANAPHYLAXIS KIT,60.59,45.44,0.73,54.53,119
CDM,2442,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,33.0,24.75,0.4,29.7,238
CDM,2444,DIGOXIN 125 MCG (0.125 MG) TABLET,7.11,5.33,0.09,6.4,119
CDM,2445,DIGOXIN 250 MCG (0.25 MG) TABLET,7.11,5.33,0.09,6.4,119
CDM,24470,"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",2.08,1.56,0.02,1.87,119
CDM,24473,CILOSTAZOL 50 MG TABLET,1.91,1.43,0.02,1.72,119
CDM,24474,CILOSTAZOL 100 MG TABLET,2.19,1.64,0.03,1.97,119
CDM,24521,"ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",0.72,0.54,0.01,0.65,119
CDM,24576,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,852.26,639.19,10.23,767.03,119
CDM,24678,COENZYME Q10 100 MG CAPSULE,0.82,0.61,0.01,0.74,119
CDM,2475,DILTIAZEM 30 MG TABLET,2.62,1.97,0.03,2.36,119
CDM,2476,DILTIAZEM 60 MG TABLET,0.42,0.32,0.01,0.38,119
CDM,24984,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,44.27,33.2,0.53,39.84,119
CDM,250,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,1.8,1.35,0.02,1.62,119
CDM,2501051797,HC DESFLURANE ANESTHESIA GAS PER MINUTE,4.39,3.29,0.05,3.95,119
CDM,2501149297,HC ISOFLURANE ANESTHESIA GAS PER MINUTE,0.41,0.31,0.01,0.37,119
CDM,2501218297,HC SEVOFLURANE ANESTHESIA GAS PER MINUTE,4.39,3.29,0.05,3.95,119
CDM,2501623097,HC NITRIC OXIDE DAILY,1050.61,787.96,12.61,945.55,119
CDM,2501630001,HC PED/ADULT FORMULA (READY-TO-FEED) PER ML,0.16,0.12,0.01,0.14,119
CDM,2501630101,HC PASTEURIZED HUMAN MILK PER ML,1.43,1.07,0.02,1.29,119
CDM,2501630201,HC PROLACTA PER ML,86.21,64.66,1.03,77.59,119
CDM,2501630301,HC INFANT/PED FORTIFIERS & MODULARS PER FEED,1.88,1.41,0.02,1.69,119
CDM,2501630401,HC ADULT MODULARS PER PACKET,17.54,13.16,0.21,15.79,119
CDM,2501630701,HC INFANT/PED FORMULA MIXED FEED PER ML,0.48,0.36,0.01,0.43,119
CDM,2508,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,7.03,5.27,0.08,6.33,238
CDM,2509,DIPHENHYDRAMINE 25 MG CAPSULE,0.25,0.18,0.01,0.22,119
CDM,251,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,157.5,118.125,0.18,270.0,238
CDM,2510,DIPHENHYDRAMINE 50 MG CAPSULE,0.15,0.11,0.01,0.14,119
CDM,2511,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,24.99,18.74,0.3,22.49,119
CDM,25118,CIPROFLOXACIN 250 MG TABLET,1.35,1.01,0.02,1.22,119
CDM,25119,CIPROFLOXACIN 500 MG TABLET,1.11,0.83,0.01,1.0,119
CDM,25120,CIPROFLOXACIN 750 MG TABLET,1.92,1.44,0.02,1.73,119
CDM,25121,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,19.12,14.34,0.23,17.21,238
CDM,25122,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,42.24,31.68,0.51,38.02,238
CDM,25124,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,162.74,122.05,1.95,146.47,238
CDM,25125,"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",1514.24,1135.68,18.17,1362.82,119
CDM,2516,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.04,0.78,0.01,0.94,119
CDM,25238,"VERAPAMIL ER 120 MG 24 HR CAPSULE,EXTENDED RELEASE",8.73,6.55,0.1,7.86,119
CDM,25246,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,38.4,28.8,0.46,34.56,119
CDM,2536,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,13.48,10.11,0.16,12.13,119
CDM,25424,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,8.02,6.01,0.1,7.22,238
CDM,25471,KETOTIFEN 0.025 % (0.035 %) EYE DROPS,39.0,29.25,0.47,35.1,119
CDM,2566,DOCUSATE SODIUM 100 MG CAPSULE,0.29,0.22,0.01,0.26,119
CDM,2569,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,5.76,4.32,0.01,9.99,238
CDM,259J279001,HC RHO D IMMUNE GLOBULIN INJ 300 MCG,739.05,554.29,8.87,665.14,119
CDM,2608,DOXEPIN 10 MG CAPSULE,1.03,0.77,0.01,0.93,119
CDM,2609636001,HC IV INFUSN HYDRATION INITIAL HR,734.9,551.17,8.82,661.41,119
CDM,2609636101,HC IV INFUSN HYDRATION EACH ADDL HR,455.25,341.44,5.46,409.72,119
CDM,2609636501,HC IV INFUSION THERAP INITIAL HR,695.8,521.85,8.35,626.22,119
CDM,2609636601,HC IV INFUSION THERAP EACH ADDL HR,400.39,300.29,4.8,360.35,119
CDM,2609636701,HC IV INFUSION THERAP SEQ 1 HR,535.84,401.88,6.43,482.26,119
CDM,2609636801,HC IV INFUSION THERAP CONCURRENT,571.19,428.39,6.85,514.07,119
CDM,2609636901,HC SUBCU THER INFUSION UP TO 1 HR INCL PUMP SET UP,722.08,541.56,8.66,649.87,119
CDM,2609637201,HC INJECTION IM/SC THERAPEUTIC,231.12,173.34,2.77,208.01,119
CDM,2609637401,HC IVP INITIAL THERAPEUTIC,350.34,262.76,4.2,315.31,119
CDM,2609637501,HC IVP ADDL DIFF DRUG THERAP,184.65,138.49,2.22,166.18,119
CDM,2609637601,HC IVP ADDL SAME DRUG THERAPEUTIC,154.88,116.16,1.86,139.39,119
CDM,2609637701,HC APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,157.24,117.93,1.89,141.52,119
CDM,260C895701,HC PROLONGED IV INF REQ PUMP>8 HRS NON-CHEMO,832.7,624.52,9.99,749.43,119
CDM,2611,DOXEPIN 25 MG CAPSULE,4.81,3.61,0.06,4.33,119
CDM,2616,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,566.52,424.89,6.78,535.5,357
CDM,2619,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,748.58,561.44,8.98,673.72,119
CDM,2622,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,94.5,70.88,0.94,106.63,476
CDM,2625,DOXYCYCLINE HYCLATE 100 MG TABLET,1.2,0.9,0.01,1.08,119
CDM,26371,"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",3.78,2.84,0.05,3.4,119
CDM,2654,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,46.41,34.81,0.35,57.4,357
CDM,26771,"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",3.6,2.7,0.04,3.24,119
CDM,2701034097,HC NITROUS OXIDE,322.25,241.69,3.87,290.03,119
CDM,2701035797,HC PAD ARCTIC GEL NEONATAL 318-02-02,4315.0,3236.25,51.78,3883.5,119
CDM,2701040301,HC BRAINCOOL COOLING PAD,1760.5,1320.38,21.13,1584.45,119
CDM,2701040401,HC HYDROGEL COOLING KIT - PAD,4423.3,3317.48,53.08,3980.97,119
CDM,2701040501,HC TOTAL BODY COOLING- BLANKETROL,48.3,36.22,0.58,43.47,119
CDM,2701651501,HC PACK LVAD PATIENT CARE IMC,1027.35,770.51,12.33,924.61,119
CDM,2701651601,HC VEST HOLSTER LVAD ALL,1866.8,1400.1,22.4,1680.12,119
CDM,2701651701,HC CASE TRAVEL 1260,746.7,560.02,8.96,672.03,119
CDM,2701651801,HCD KIT VENTRICULAR ASSIST DEVICE LEFT KIT-012,554.87,416.15,6.66,499.38,119
CDM,2701652001,HC PACK SHOULDER FOR CARRYING CASE,1941.75,1456.31,23.3,1747.58,119
CDM,2701652201,HC ADAPTER POWER DC FOR HEARTWARE CONTROLLER,7100.0,5325.0,85.2,6390.0,119
CDM,2701652301,HC BATTERY CIRC HEARTWARE,3236.25,2427.19,38.84,2912.62,119
CDM,2701652801,HC BAG SHOWER FOR CONTROLLER AND BATTERIES,1400.1,1050.08,16.8,1260.09,119
CDM,2702369715,HC NUTRITION LVL 15,911.65,683.74,10.94,820.48,119
CDM,2702369716,HC NUTRITION LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,270Q047741,HC KIT LVAD HEARTMATE 3 MODULAR CABLE REPLACEMENT,18160.35,13620.26,217.92,16344.31,119
CDM,270Q047801,HC ADAPTER ASSIST DC FOR HEARTWARE CONTROLLER,6390.0,4792.5,76.68,5751.0,119
CDM,270Q048101,HC CONTROLLER HEARTMATE 3 LVAD,20178.2,15133.65,242.14,18160.38,119
CDM,270Q048141,HC KIT CONTROLLER HEARTWARE,21740.8,16305.6,260.89,19566.72,119
CDM,270Q049701,HC CLIP BATTERY 14V LI-ION REPLACEMENT,2563.1,1922.32,30.76,2306.79,119
CDM,270Q049801,HC VEST HOLSTER LVAD ALL REPLACEMENT,1866.8,1400.1,22.4,1680.12,119
CDM,270Q049901,HC PACK WAIST FOR CONTROLLER 2050 REPLACEMENT,1866.8,1400.1,22.4,1680.12,119
CDM,270Q049941,HC BAG CONSOLIDATED RIGHT REPLACEMENT,1638.1,1228.58,19.66,1474.29,119
CDM,270Q050101,HC BAG SHOWER HEARTMATE II/3 LVAD REPLACEMENT,2097.1,1572.82,25.17,1887.39,119
CDM,270Q050141,HC CASE TRAVEL 1260 REPLACEMENT,746.7,560.02,8.96,672.03,119
CDM,270Q050641,HC BATTERY LITHIUM ION 11V FOR HE REPLACEMENT,2157.5,1618.12,25.89,1941.75,119
CDM,270Q050642,HC BATTERY 14V LI-ION 4 BATT/SET REPLACEMENT,9585.0,7188.75,115.02,8626.5,119
CDM,270Q050841,HC KIT LVAD HEARTMATE 3 MODULAR CABLE,18160.35,13620.26,217.92,16344.31,119
CDM,270Q050842,HC BATTERY 14V LI-ION 4 BATT/SET,9585.0,7188.75,115.02,8626.5,119
CDM,270Q050843,HC POWER UNIT MOBILE HEARTMATE II,29350.1,22012.58,352.2,26415.09,119
CDM,270Q050844,HC CLIP BATTERY 14V LI-ION,2563.1,1922.32,30.76,2306.79,119
CDM,270Q050845,HC BATTERY LITHIUM ION 11V FOR HE,2157.5,1618.12,25.89,1941.75,119
CDM,270Q050846,HC PACK WAIST FOR CONTROLLER 2050,1866.8,1400.1,22.4,1680.12,119
CDM,270Q050847,HC BAG CONSOLIDATED,1638.1,1228.58,19.66,1474.29,119
CDM,270Q050848,HC BAG SHOWER HEARTMATE II/3 LVAD,2097.1,1572.82,25.17,1887.39,119
CDM,270Q050849,HC KIT VENTRICULAR ASSIST DEVICE DLES,527.85,395.89,6.33,475.07,119
CDM,270Q050850,HC PACK PROCEDURE PATIENT FOR CONTROLLER AND BATTERY,1866.8,1400.1,22.4,1680.12,119
CDM,270Q050851,HC ADAPTER AC HEARTWARE CONTROLLER,4315.0,3236.25,51.78,3883.5,119
CDM,270Q050852,HC CHARGER BATTERY HEARTWARE,20721.7,15541.28,248.66,18649.53,119
CDM,270Q407901,HC POWER UNIT MOBILE HEARTMATE II REPLACEMENT,29350.1,22012.58,352.2,26415.09,119
CDM,270Q508043,HC ADAPTER AC HEARTWARE CONTROLLER 1430US,4315.0,3236.25,51.78,3883.5,119
CDM,270S362001,HC METABOLIC SCREENING TEST KIT,625.36,469.02,7.5,562.82,119
CDM,2711849716,HC DRAINAGE SUPPLY NON STERILE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2711849717,HC DRAINAGE SUPPLY NON STERILE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2711849718,HC DRAINAGE SUPPLY NON STERILE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2711849725,HC DRAINAGE SUPPLY NON STERILE LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2711989713,HC GENERAL NURSING SUPPLY NON STERILE LVL 13,583.4,437.55,7.0,525.06,119
CDM,2711989714,HC GENERAL NURSING SUPPLY NON STERILE LVL 14,729.25,546.94,8.75,656.32,119
CDM,2711989715,HC GENERAL NURSING SUPPLY NON STERILE LVL 15,911.65,683.74,10.94,820.48,119
CDM,2712329713,HC MONITORING SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2712329714,HC MONITORING SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2712329715,HC MONITORING SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2712329717,HC MONITORING SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2712329718,HC MONITORING SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2712329719,HC MONITORING SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2712329724,HC MONITORING SUPPLY LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2712329725,HC MONITORING SUPPLY LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721039801,HC CENTRAL LINE CATHETER (NURSING FLR),840.05,630.04,10.08,756.04,119
CDM,2721039901,HC CATHETER SINGLE LUMEN,536.7,402.52,6.44,483.03,119
CDM,2721040001,HC CATHETER DOUBLE LUMEN,578.7,434.02,6.94,520.83,119
CDM,2721040101,HC CATHETER TRIPLE LUMEN,723.4,542.55,8.68,651.06,119
CDM,2721040201,HC BERLIN HEART PUMP REPLACEMENT,148265.45,111199.09,1779.19,133438.91,119
CDM,2721400014,HC FIBER LASER SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721400016,HC FIBER LASER SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721400017,HC FIBER LASER SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721400018,HC FIBER LASER SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721400021,HC FIBER LASER SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721400022,HC FIBER LASER SUPPLY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2721400023,HC FIBER LASER SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721400024,HC FIBER LASER SUPPLY LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2721400029,HC FIBER LASER SUPPLY LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2721400030,HC FIBER LASER SUPPLY LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2721419713,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721419714,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721419715,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721419716,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721419717,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721419718,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721419719,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721419720,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721419721,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721419722,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2721419723,HC BIOPSY/ASPIRATION SUPPLY NON IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721479718,HC CANNULA NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721489713,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721489714,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721489715,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721489716,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721489717,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721489718,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721489719,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721489721,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721489722,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2721489723,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721489725,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721489726,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721489729,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2721489731,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,2721489733,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,2721489737,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,2721489749,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,2721489750,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,2721489753,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,2721489756,HC CARDIOVASCULAR NON IMPLANT SUPPLY LVL 56,74903.9,56177.92,898.85,67413.51,119
CDM,2721569713,HC CATHETER CVC SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721569714,HC CATHETER CVC SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721569718,HC CATHETER CVC SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721569721,HC CATHETER CVC SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721579713,HC CATHETER DIAGNOSTIC SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721579714,HC CATHETER DIAGNOSTIC SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721579718,HC CATHETER DIAGNOSTIC SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721579719,HC CATHETER DIAGNOSTIC SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721579723,HC CATHETER DIAGNOSTIC SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721579727,HC CATHETER DIAGNOSTIC SUPPLY LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2721633001,HC SET FLUID MANAGEMENT PRISMAFLEX ST150,1055.15,791.36,12.66,949.64,119
CDM,2721633101,HC ELECTRODE SENSR NICOM MON,722.85,542.14,8.67,650.57,119
CDM,2721633201,HC CATH COOL LN HEP 9.3F CL-2295,2222.4,1666.8,26.67,2000.16,119
CDM,2721633301,HC TUBE SECUREMENT DEVICE AMT CIN SIL,1353.45,1015.09,16.24,1218.1,119
CDM,2721633401,HC KIT STARTUP STD TUBING CG-500D,848.6,636.45,10.18,763.74,119
CDM,2721633501,HC CATH SOLEX 7 9.3F 26CM,3919.25,2939.44,47.03,3527.32,119
CDM,2721633601,HC SOAKER EXPAN SILV DBL 10IN KIT,742.05,556.54,8.9,667.84,119
CDM,2721633701,HC POWDER HEMOSTATIC 3GM ARISTA,771.2,578.4,9.25,694.08,119
CDM,2721633801,HC PAD ARCTICGEL COOLING UNIV,5378.25,4033.69,64.54,4840.42,119
CDM,2721633901,HC TUBE MINNESOTA ESOPH NSL 18F,3081.25,2310.94,36.98,2773.12,119
CDM,2721634001,HC CATH QUAT 9.3F 45CM 3L KIT,3968.05,2976.04,47.62,3571.25,119
CDM,2721634101,HC KIT ARCTICGEL SUN COOLING SM,4315.0,3236.25,51.78,3883.5,119
CDM,2721634201,HC KIT ARTICGEL SUN COOLING MD & LG,4423.3,3317.48,53.08,3980.97,119
CDM,2721634401,HC CATH ICY HEP 9.3F 38CM IC-3893,3543.8,2657.85,42.53,3189.42,119
CDM,2721634501,HC CIRCUIT PT SHT FP850 3100A,571.7,428.78,6.86,514.53,119
CDM,2721634601,HC NEEDLE EZ-IO 15G,689.8,517.35,8.28,620.82,119
CDM,2721634701,HC SET WARM FLUD 3SPK BAG 120ML,868.45,651.34,10.42,781.6,119
CDM,2721634801,HC RESERVOIR WARMER FLUD 3000ML,781.15,585.86,9.37,703.04,119
CDM,2721634901,HC KIT TRACTN PIN 1234HTA,2304.2,1728.15,27.65,2073.78,119
CDM,2721635001,HC HEADBAND EEG ADULT/PEDIATRIC,2610.6,1957.95,31.33,2349.54,119
CDM,2721635101,HC KIT FLEXI-SEAL PLUS PROTECT W/ENFIT CONNECTOR,606.7,455.02,7.28,546.03,119
CDM,2721635201,HC VALVE DRAIN CHST PNEUMTHRX WO TUBING,392.35,294.26,4.71,353.12,119
CDM,2721635301,HC PILLOW BALLOON FETAL,3088.8,2316.6,37.07,2779.92,119
CDM,2721635401,HC MONITOR PRES QK COMPRT 18G,680.6,510.45,8.17,612.54,119
CDM,2721635501,HC SET CATH SLIT INDWELLING,698.1,523.58,8.38,628.29,119
CDM,2721635601,HC VEST SMARTVEST ADULT ALL SIZES,560.05,420.04,6.72,504.04,119
CDM,2721635701,HC POSITIONER TURN TORTOISE PRONE,1388.05,1041.04,16.66,1249.24,119
CDM,2721635801,HC POSITIONER Z FLO FLUIDIZED MD,699.2,524.4,8.39,629.28,119
CDM,2721635901,HC KIT PRES MON INTRCRA 1104B,3446.2,2584.65,41.35,3101.58,119
CDM,2721636001,HC KIT PRES MON MCRO VNT 4F 2F,3612.8,2709.6,43.35,3251.52,119
CDM,2721636101,HC DRAINAGE EXT VENTR CATH SET,1282.9,962.18,15.39,1154.61,119
CDM,2721636201,HC BINDER PELVIC TRAUMA YLW,1680.1,1260.08,20.16,1512.09,119
CDM,2721636301,HC DEVICE PELVIC STABILIZATION,592.7,444.52,7.11,533.43,119
CDM,2721636401,HC INSERT V-SIGN MEMBRANE,473.3,354.98,5.68,425.97,119
CDM,2721636501,HC TRACH TU CUF FIXD HF 7MM,507.95,380.96,6.1,457.16,119
CDM,2721636601,HC OVERLAY GEO-MATT 72 SOFTSKIN,486.9,365.18,5.84,438.21,119
CDM,2721636701,HC DRESSING QUIKCLOT CTL+ 3IN,710.25,532.69,8.52,639.22,119
CDM,2721636801,HC DRESSING QUIKCLOT 12X12IN,126.25,94.69,1.52,113.62,119
CDM,2721636901,HC SEALER BIPOLAR AQUAMANTYS 6.0,1610.1,1207.58,19.32,1449.09,119
CDM,2721637001,HC TRACH TU CRICO QK-TRACH 4MM,704.7,528.52,8.46,634.23,119
CDM,2721637101,HC KIT PORT EVAC SUBDURAL SEPS,6559.35,4919.51,78.71,5903.42,119
CDM,2721637201,HC KIT VENTRICULOSTOMY,1509.1,1131.82,18.11,1358.19,119
CDM,2721637301,HC BUR MDSRX VENTRICULOSTY,1491.55,1118.66,17.9,1342.4,119
CDM,2721637401,HC SENSOR ACUMEN IQ,1866.8,1400.1,22.4,1680.12,119
CDM,2721637501,HC CATH SWAN F 90CM,1050.65,787.99,12.61,945.59,119
CDM,2721637601,HC CATHETER EDI ENFIT,985.7,739.28,11.83,887.13,119
CDM,2721637701,HC WOUND SYS PREVENA W/PUMP & DRESS,1922.35,1441.76,23.07,1730.12,119
CDM,2721637801,HC DRESSING PREVENA,1239.1,929.32,14.87,1115.19,119
CDM,2721637901,HC TRAY UMBILICAL VSSL INSERTION,479.85,359.89,5.76,431.86,119
CDM,2721638001,HC KIT HYSTEROLUX HYSTSCP FMS,1283.4,962.55,15.4,1155.06,119
CDM,2721638101,HC SEALER LIG SM-JAW 28D,1726.15,1294.61,20.71,1553.54,119
CDM,2721638201,HC SEALER LIG IMPACT 18CM CURVED,2157.5,1618.12,25.89,1941.75,119
CDM,2721638301,HC KIT WND PREVENA PLUS,2524.3,1893.22,30.29,2271.87,119
CDM,2721638401,HC KIT PREVENA + EXT LIFE 14 DAY,1941.75,1456.31,23.3,1747.58,119
CDM,2721638501,HC DRESSING PREVENA CUSTOMIZABLE,1591.9,1193.92,19.1,1432.71,119
CDM,2721638601,HC DRESSING VERAFLO CLEANSE CHCE,644.05,483.04,7.73,579.64,119
CDM,2721638701,HC DRESSING VAC VERAFLO MD,536.7,402.52,6.44,483.03,119
CDM,2721638801,HC CATH SWAN STD 4L 7F 110CM,727.1,545.33,8.73,654.39,119
CDM,2721638901,HC CATH SWAN VIP TD 7.5FX110CM,536.7,402.52,6.44,483.03,119
CDM,2721639001,HC SENSOR PRESS 84 FLORAC TRUWAVE,1820.15,1365.11,21.84,1638.14,119
CDM,2721639201,HC KIT PRES TRNDCR TRPL,241.4,181.05,2.9,217.26,119
CDM,2721639401,HC KIT PRESSURE MONITOR 84IN,420.5,315.38,5.05,378.45,119
CDM,2721639601,HC SLING TRAN REPOS DISP,490.25,367.69,5.88,441.22,119
CDM,2721639701,HC SENSOR CERELINK ICP BASIC KIT,2943.6,2207.7,35.32,2649.24,119
CDM,2721639713,HC CATHETER FILLIFORM SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721639715,HC CATHETER FILLIFORM SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721639801,HC PROBE CERELINK ICP WITH BOLT,3043.95,2282.96,36.53,2739.56,119
CDM,2721639901,HC KIT ACCESS CRAN,1388.55,1041.41,16.66,1249.7,119
CDM,2721640001,HC SYSTEM EXT CSF DRAIN INS-8401,942.55,706.91,11.31,848.3,119
CDM,2721640101,HC KIT ACC CRAN W/PRP PRPKG 5,1538.05,1153.54,18.46,1384.24,119
CDM,2721640201,HC CAST TCC-EZ 3IN,485.35,364.01,5.82,436.82,119
CDM,2721640301,HC SEALER ENSEAL X1 LARGE JAW,442.1,331.58,5.31,397.89,119
CDM,2721640501,HC HEMOSTAT SURGICEL ABSORB 4X8,308.75,231.56,3.7,277.88,119
CDM,2721640601,HC POWDER SURGICEL 3 GM,785.65,589.24,9.43,707.08,119
CDM,2721640701,HC BARRIER INTERCEED ADHESION 6X5,1737.6,1303.2,20.85,1563.84,119
CDM,2721640801,HC DRESSING VAC ABTHERA SENSATRAC,2064.3,1548.22,24.77,1857.87,119
CDM,2721640901,HC JADA VACUUM INDUCED HEMORRHAGE CONTROL,4315.0,3236.25,51.78,3883.5,119
CDM,2721645401,HC CANNULA ARTERIAL BIOMEDICUS 17FR 31.8CM,1580.6,1185.45,18.97,1422.54,119
CDM,2721645501,HC CANNULA ARTERIAL PED STAGED 9/12MM C60G,13259.25,9944.44,159.11,11933.32,119
CDM,2721645601,HC CANNULA ARTERIAL PED STAGED 9/12MM C85G,12052.25,9039.19,144.63,10847.02,119
CDM,2721645701,HC CANNULA ARTERIAL SM CHILD 6MM C806G,12052.25,9039.19,144.63,10847.02,119
CDM,2721645801,HC CANNULA ARTERIAL SM CHILD 6MM C806G M,13259.25,9944.44,159.11,11933.32,119
CDM,2721645901,HC CANNULA ARTERIAL VENOUS FEMORAL,2053.5,1540.12,24.64,1848.15,119
CDM,2721646001,HC CANNULA FEM ART/VEN 12FR HEPARIN 7.5IN NOVNT,1315.9,986.92,15.79,1184.31,119
CDM,2721646101,HC CANNULA INFLOW/OUTFLOW ATRIAL PEDIATRIC,13259.25,9944.44,159.11,11933.32,119
CDM,2721646201,HC CANNULA PERFUSION APEX PED/SM CHILD,16986.75,12740.06,203.84,15288.08,119
CDM,2721646301,HC CANNULA PERFUSION ARTERIAL SM CHILD 5MM MOLDED/6MM,13259.25,9944.44,159.11,11933.32,119
CDM,2721646401,HC CANNULA PERFUSION ATRIAL PED 45912 STGD W/MND,11700.8,8775.6,140.41,10530.72,119
CDM,2721646501,HC CANNULA PERFUSION FEM/VEIN ART HEPARIN ALL,1315.9,986.92,15.79,1184.31,119
CDM,2721646601,HC CATH MC3 CRESCENT RT ATRIAL DUAL LUMEN ALL,10295.0,7721.25,123.54,9265.5,119
CDM,2721646701,HC CATHETER ACCESS BIOMED ART JUG ALL,1866.8,1400.1,22.4,1680.12,119
CDM,2721646801,HC CATHETER ACCESS BIO-MED VEN,1729.1,1296.82,20.75,1556.19,119
CDM,2721646901,HC CATHETER ANGIOGRAPHIC DUAL LUMEN BI-CAVAL,8697.5,6523.12,104.37,7827.75,119
CDM,2721647001,HC CATHETER CANNULA ATRIAL APEX SM CHILDREN 6MM MOLDED,13259.25,9944.44,159.11,11933.32,119
CDM,2721647101,HC CATHETER CANNULA ATRIAL INFANT 5/6MM,13259.25,9944.44,159.11,11933.32,119
CDM,2721647201,HC CATHETER CANNULA APEX INFANT 5/6MM,14991.65,11243.74,179.9,13492.48,119
CDM,2721647301,HC PUMP CENTRIFUGAL BLOOD CP22 WITH INTEGRATED SENS,15975.0,11981.25,191.7,14377.5,119
CDM,2721647401,HC KIT VASCULAR ACCESS,700.05,525.04,8.4,630.04,119
CDM,2721647501,HC KIT ECMO PERFUSION-PUMP POLYVINYL RECUT STERILE 1/4INX6FT,746.7,560.02,8.96,672.03,119
CDM,2721647601,HC KIT TUBING ECMO PERFUSION PUMP 3/8INX6FT,746.7,560.02,8.96,672.03,119
CDM,2721647701,HC KIT GRAFT CASSETTE PURGE IMPELLA GEN 2,4315.0,3236.25,51.78,3883.5,119
CDM,2721647801,HC KIT CANNULA AORTIC/VENOUS BIO-MEDICUS,1330.1,997.58,15.96,1197.09,119
CDM,2721647901,HC PUMP CENTRIFUGAL W/FLOWPROBE BEQ-RF-32,1498.1,1123.58,17.98,1348.29,119
CDM,2721648001,HC SHEATH INTRODUCER BIO-MED VEN,2152.1,1614.08,25.83,1936.89,119
CDM,2721648101,HC PACK CUSTOM BB9F16R3 CIRCUL 3/8,2269.7,1702.28,27.24,2042.73,119
CDM,2721648201,HC CATHETER GUIDE BIO-MED VEN 21FR 55CM,2295.6,1721.7,27.55,2066.04,119
CDM,2721648301,HC TUBE ASSIST DRIVING VAD BLUE/RED,2524.3,1893.22,30.29,2271.87,119
CDM,2721648401,HC PACK CUSTOM ECMO CIRCUIT,2761.6,2071.2,33.14,2485.44,119
CDM,2721648501,HC SET EXT CANNULA AND CONNECTING FOR VAD,4315.0,3236.25,51.78,3883.5,119
CDM,2721648601,HC OXYGENATOR QUADROX ID ADULT BIOLINE BEQ HMOD 7000,5097.8,3823.35,61.17,4588.02,119
CDM,2721648701,HC OXYGENATOR PERFUSION QUADROX-ID PED BEQ-HMOD30000-USA,7404.95,5553.71,88.86,6664.46,119
CDM,2721648801,HC OXY NAUTILUS ECMO W/BALANCE BIOSURFACE,7632.5,5724.38,91.59,6869.25,119
CDM,2721648901,HC OXYGENATOR NEONATAL PMP,7810.0,5857.5,93.72,7029.0,119
CDM,2721649001,HC CATHETER INFUSE DUAL LUMEN BI-CAVAL,8871.45,6653.59,106.46,7984.31,119
CDM,2721649101,HC SET ACCESSORY VAD PU VALVES,9940.0,7455.0,119.28,8946.0,119
CDM,2721649201,HC PUMP CENTRIFUGAL PEDIMAG BLOOD,33970.0,25477.5,407.64,30573.0,119
CDM,2721649301,HC PUMP BLOOD CENTRIMAG,42802.2,32101.65,513.63,38521.98,119
CDM,2721649401,HC OXYGENATOR PERFUSION SET CARDIOHELP HLS ADV 7,50849.7,38137.28,610.2,45764.73,119
CDM,2721649501,HC SET PUMP IMPELLA CP W/SMART ASSIST,91719.0,68789.25,1100.63,82547.1,119
CDM,2721649601,HC KIT PUMP DEVICE CARDIAC VENTRICULAR SMARTASSIST 5.5 S2,149468.0,112101.0,1793.62,134521.2,119
CDM,2721649701,HC PUMP BLOOD VAD W/ VALVES,148265.45,111199.09,1779.19,133438.91,119
CDM,2721649713,HC CATHETER GI SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721649717,HC CATHETER GI SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721649732,HC CATHETER GI SUPPLY LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,2721649733,HC CATHETER GI SUPPLY LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,2721650601,HC CATHETER ATRIOSEPTOSTOMY BALLOON 5FRX50CM 830705F,3447.7,2585.78,41.37,3102.93,119
CDM,2721650701,HC CATHETER BALLOON ATRIO,1778.15,1333.61,21.34,1600.34,119
CDM,2721650801,HC CASSETTE PURGE IMPELLA,933.4,700.05,11.2,840.06,119
CDM,2721650901,HC KIT UNIT CONTROL ARROW SYS NAVIG CV VPS,514.3,385.72,6.17,462.87,119
CDM,2721651401,HC PACK CUSTOM ECMO CIRCUIT CB9F19R3 CIRCU 1/4,2761.6,2071.2,33.14,2485.44,119
CDM,2721651901,HC TUBE BUTTON BALLOON MINIACE ALL SIZES,1239.1,929.32,14.87,1115.19,119
CDM,2721699721,HC CATHETER IABALLON SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721699723,HC CATHETER IABALLON SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721699724,HC CATHETER IABALLON SUPPLY LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2721699725,HC CATHETER IABALLON SUPPLY LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721699726,HC CATHETER IABALLON SUPPLY LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721699727,HC CATHETER IABALLON SUPPLY LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2721759713,HC CATHETER SWAN-GANZ LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721759715,HC CATHETER SWAN-GANZ LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721759716,HC CATHETER SWAN-GANZ LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721779714,HC CLIP SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721779715,HC CLIP SUPPLY NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721779716,HC CLIP SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721779717,HC CLIP SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721779718,HC CLIP SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721809717,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721809719,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721809720,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721809723,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721809724,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2721809725,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721809726,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721809728,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,2721809729,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2721809730,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2721809732,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,2721809740,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,2721819721,HC DEVICE FIXATION SUPPLY NON IMPLANT 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721819723,HC DEVICE FIXATION SUPPLY NON IMPLANT 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721819725,HC DEVICE FIXATION SUPPLY NON IMPLANT 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721829713,HC DILATOR SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721829714,HC DILATOR SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721829715,HC DILATOR SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721839713,HC DIALYSIS SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721839715,HC DIALYSIS SUPPLY NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721839716,HC DIALYSIS SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721839717,HC DIALYSIS SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721859713,HC DRAINAGE SUPPLY STERILE LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721859714,HC DRAINAGE SUPPLY STERILE LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721859715,HC DRAINAGE SUPPLY STERILE LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721859716,HC DRAINAGE SUPPLY STERILE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721859717,HC DRAINAGE SUPPLY STERILE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721859718,HC DRAINAGE SUPPLY STERILE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721859720,HC DRAINAGE SUPPLY STERILE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721859730,HC DRAINAGE SUPPLY STERILE LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2721859733,HC DRAINAGE SUPPLY STERILE LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,2721869716,HC DRESSING WOUND SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721869717,HC DRESSING WOUND SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721869719,HC DRESSING WOUND SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721869720,HC DRESSING WOUND SUPPLY LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721869722,HC DRESSING WOUND SUPPLY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2721879714,HC ELECTRODE NON IMPLANT SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721879715,HC ELECTRODE NON IMPLANT SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721879717,HC ELECTRODE NON IMPLANT SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721879718,HC ELECTRODE NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721879719,HC ELECTRODE NON IMPLANT SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721879721,HC ELECTRODE NON IMPLANT SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721879726,HC ELECTRODE NON IMPLANT SUPPLY LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721879728,HC ELECTRODE NON IMPLANT SUPPLY LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,2721929714,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721929715,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721929716,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721929717,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721929718,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721929740,HC EMBOLIZATION THROMBECTOMY NON IMPLANT SUPPLY LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,2721939730,HC ENDOANCHOR SUPPLY LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2721939739,HC ENDOANCHOR SUPPLY LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,2721969713,HC FEEDING TUBE SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721969714,HC FEEDING TUBE SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721969715,HC FEEDING TUBE SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721969716,HC FEEDING TUBE SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721969717,HC FEEDING TUBE SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721969718,HC FEEDING TUBE SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721969719,HC FEEDING TUBE SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721969720,HC FEEDING TUBE SUPPLY LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721969721,HC FEEDING TUBE SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721969726,HC FEEDING TUBE SUPPLY LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721969728,HC FEEDING TUBE SUPPLY LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,2721979717,HC GENERAL BRONCHOSCOPY NON IMPLANT SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721979718,HC GENERAL BRONCHOSCOPY NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721979723,HC GENERAL BRONCHOSCOPY NON IMPLANT SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721999713,HC GENERAL NURSING SUPPLY STERILE LVL 13,583.4,437.55,7.0,525.06,119
CDM,2721999714,HC GENERAL NURSING SUPPLY STERILE LVL 14,729.25,546.94,8.75,656.32,119
CDM,2721999715,HC GENERAL NURSING SUPPLY STERILE LVL 15,911.65,683.74,10.94,820.48,119
CDM,2721999716,HC GENERAL NURSING SUPPLY STERILE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2721999717,HC GENERAL NURSING SUPPLY STERILE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2721999718,HC GENERAL NURSING SUPPLY STERILE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2721999719,HC GENERAL NURSING SUPPLY STERILE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2721999720,HC GENERAL NURSING SUPPLY STERILE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2721999721,HC GENERAL NURSING SUPPLY STERILE LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2721999722,HC GENERAL NURSING SUPPLY STERILE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2721999723,HC GENERAL NURSING SUPPLY STERILE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2721999724,HC GENERAL NURSING SUPPLY STERILE LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2721999725,HC GENERAL NURSING SUPPLY STERILE LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2721999726,HC GENERAL NURSING SUPPLY STERILE LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2721999727,HC GENERAL NURSING SUPPLY STERILE LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2722009714,HC GENERAL PROCEDURE TRAY KIT SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722009715,HC GENERAL PROCEDURE TRAY KIT SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722009716,HC GENERAL PROCEDURE TRAY KIT SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722009718,HC GENERAL PROCEDURE TRAY KIT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722029713,HC GENERAL SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722029714,HC GENERAL SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722029715,HC GENERAL SUPPLY NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722029716,HC GENERAL SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722029717,HC GENERAL SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722029718,HC GENERAL SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722029719,HC GENERAL SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722039713,HC GI SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722039714,HC GI SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722039715,HC GI SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722039716,HC GI SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722039717,HC GI SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722039718,HC GI SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722039719,HC GI SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722039720,HC GI SUPPLY LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722039721,HC GI SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2722039722,HC GI SUPPLY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2722039723,HC GI SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2722039730,HC GI SUPPLY LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2722039732,HC GI SUPPLY LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,2722039734,HC GI SUPPLY LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,2722039744,HC GI SUPPLY LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,2722069713,HC HEMOSTATIC SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722069714,HC HEMOSTATIC SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722069715,HC HEMOSTATIC SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722069716,HC HEMOSTATIC SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722069717,HC HEMOSTATIC SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722069718,HC HEMOSTATIC SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722069719,HC HEMOSTATIC SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722069720,HC HEMOSTATIC SUPPLY LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722069721,HC HEMOSTATIC LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2722069729,HC HEMOSTATIC SUPPLY LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2722069730,HC HEMOSTATIC SUPPLY LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2722069827,HC HEMOSTATIC SUPPLY LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2722109757,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 57,78649.1,58986.82,943.79,70784.19,119
CDM,2722109758,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 58,82581.6,61936.2,990.98,74323.44,119
CDM,2722109759,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,2722109760,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 60,91046.3,68284.73,1092.56,81941.67,119
CDM,2722109761,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 61,95598.65,71698.99,1147.18,86038.78,119
CDM,2722109771,HC PERCUTANEOUS VENTRICULAR ASSIST DEVICE LVL 71,155720.6,116790.45,1868.65,140148.54,119
CDM,2722199713,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722199714,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722199716,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722199717,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722199718,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722199719,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722199720,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722199722,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2722199723,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2722199724,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2722199725,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2722199726,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2722199727,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2722199728,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,2722199733,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,2722199734,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,2722199735,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,2722199736,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,2722199737,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,2722219718,HC L&D NON IMPLANT SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722219723,HC L&D NON IMPLANT SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2722219724,HC L&D NON IMPLANT SUPPLY LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2722259713,HC LEAD SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722259716,HC LEAD SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722259717,HC LEAD SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722299714,HC LIGATING DEVICE SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722299716,HC LIGATING DEVICE SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722299717,HC LIGATING DEVICE SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722299718,HC LIGATING DEVICE SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722299719,HC LIGATING DEVICE SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722309718,HC LITHOTRIPSY SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722309734,HC LITHOTRIPSY SUPPLY LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,2722349713,HC NEEDLE LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722349714,HC NEEDLE LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722349717,HC NEEDLE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722359719,HC NEEDLE/PROBE ABLATION SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722359723,HC NEEDLE/PROBE ABLATION SUPPLY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2722359727,HC NEEDLE/PROBE ABLATION SUPPLY LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,2722359729,HC NEEDLE/PROBE ABLATION SUPPLY LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2722359732,HC NEEDLE/PROBE ABLATION SUPPLY LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,2722359735,HC NEEDLE/PROBE ABLATION SUPPLY LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,2722379716,HC ORTHOPEDIC SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722379719,HC ORTHOPEDIC SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722399716,HC PACEMAKER SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722399722,HC PACEMAKER SUPPLY NON IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2722449713,HC PROBE SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722449714,HC PROBE SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722449716,HC PROBE SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722449717,HC PROBE SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722449719,HC PROBE SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722449722,HC PROBE SUPPLY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,2722459713,HC PROCEDURAL NEEDLES LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722459715,HC PROCEDURAL NEEDLES LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722459717,HC PROCEDURAL NEEDLES LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722459719,HC PROCEDURAL NEEDLES LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722459720,HC PROCEDURAL NEEDLES LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722459721,HC PROCEDURAL NEEDLES LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,2722459723,HC PROCEDURAL NEEDLES LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2722469715,HC PUMP PAIN SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722479736,HC RADIATION ONCOLOGY NON IMPLANT SUPPLY LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,2722499713,HC RESPIRATORY SUPPLY LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722499714,HC RESPIRATORY SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722499715,HC RESPIRATORY SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CDM,2722499716,HC RESPIRATORY SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722499718,HC RESPIRATORY SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722499719,HC RESPIRATORY SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722579714,HC STONE REMOVAL SUPPLY LVL 14,729.25,546.94,8.75,656.32,119
CDM,2722579716,HC STONE REMOVAL SUPPLY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2722579717,HC STONE REMOVAL SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722579718,HC STONE REMOVAL SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722579719,HC STONE REMOVAL SUPPLY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722579720,HC STONE REMOVAL SUPPLY LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722639713,HC TUBING SUPPLY STERILE LVL 13,583.4,437.55,7.0,525.06,119
CDM,2722639719,HC TUBING SUPPLY STERILE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,2722639720,HC TUBING SUPPLY STERILE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,2722689717,HC BLADE SUPPLY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2722689718,HC BLADE SUPPLY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2722689721,HC BLADE SUPPLY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,27280,AMPICILLIN 1 GRAM/10 ML SOLUTION FOR INJECTION,41.45,31.09,0.5,37.31,119
CDM,2729907014,HC SPECIAL SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2729907017,HC SPECIAL SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272A464913,HC SURGICAL SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,272A464914,HC SURGICAL SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,272A464916,HC SURGICAL SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272A464917,HC SURGICAL SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272A464918,HC SURGICAL SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272A464919,HC SURGICAL SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272A464920,HC SURGICAL SUPPLY NON IMPLANT LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272A464921,HC SURGICAL SUPPLY NON IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272A464922,HC SURGICAL SUPPLY NON IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272A464925,HC SURGICAL SUPPLY NON IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272A464927,HC SURGICAL SUPPLY IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272A464928,HC SURGICAL SUPPLY NON IMPLANT LVL 28,3281.4,2461.05,39.38,2953.26,119
CDM,272A464929,HC SURGICAL SUPPLY NON IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272A464931,HC SURGICAL SUPPLY NON IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272A464936,HC SURGICAL SUPPLY NON IMPLANT LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272A464938,HC SURGICAL SUPPLY NON IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,272A464947,HC SURGICAL SUPPLY NON IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,272C160335,HC RTRV/INSRT/LASER DEVICE FOR IVC FLTR LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C171435,HC CATHETER ATHERECTOMY DIRECTIONAL LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C171436,HC CATHETER ATHERECTOMY DIRECTIONAL LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C172419,HC CATHETER ATHERECTOMY ROTATIONAL LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C172424,HC CATHETER ATHERECTOMY ROTATIONAL LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C172425,HC CATHETER ATHERECTOMY ROTATIONAL LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C172426,HC CATHETER ATHERECTOMY ROTATIONAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C172427,HC CATHETER ATHERECTOMY ROTATIONAL LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C172432,HC CATHETER ATHERECTOMY ROTATIONAL LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C172433,HC CATHETER ATHERECTOMY ROTATIONAL LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C172434,HC CATHETER ATHERECTOMY ROTATIONAL LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C172435,HC CATHETER ATHERECTOMY ROTATIONAL LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C172436,HC CATHETER ATHERECTOMY ROTATIONAL LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C172437,HC CATHETER ATHERECTOMY ROTATIONAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C172510,HC CATHETER BLLN PTA LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C172511,HC CATHETER BLLN PTA LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C172512,HC CATHETER BLLN PTA LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C172513,HC CATHETER BLLN PTA LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C172514,HC CATHETER BLLN PTA LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C172515,HC CATHETER BLLN PTA LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C172516,HC CATHETER BLLN PTA LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C172517,HC CATHETER BLLN PTA LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C172518,HC CATHETER BLLN PTA LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C172519,HC CATHETER BLLN PTA LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C172520,HC CATHETER BLLN PTA LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C172521,HC CATHETER BLLN PTA LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C172522,HC CATHETER BLLN PTA LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C172523,HC CATHETER BLLN PTA LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C172524,HC CATHETER BLLN PTA LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C172525,HC CATHETER BLLN PTA LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C172526,HC CATHETER BLLN PTA LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C172527,HC CATHETER BLLN PTA LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C172528,HC CATHETER BLLN PTA LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C172530,HC CATHETER BLLN PTA LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C172531,HC CATHETER BLLN PTA LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C172533,HC CATHETER BLLN PTA LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C172534,HC CATHETER BLLN PTA LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C172536,HC CATHETER BLLN PTA LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C172539,HC CATHETER BLLN PTA LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,272C172601,HC CATH BAL CERV RIPEN,341.45,256.09,4.1,307.3,119
CDM,272C172602,HC CATH NASAL EPISTAT,516.5,387.38,6.2,464.85,119
CDM,272C172609,"HC CATHETER BLLN, DILATION, NON-VASC LVL 9",185.45,139.09,2.23,166.9,119
CDM,272C172610,"HC CATHETER BLLN, DILATION, NON-VASC LVL 10",278.25,208.69,3.34,250.42,119
CDM,272C172612,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 12",473.25,354.94,5.68,425.92,119
CDM,272C172614,"HC CATHETER BLLN, DILATION, NON-VASC LVL 14",729.25,546.94,8.75,656.32,119
CDM,272C172615,"HC CATHETER BLLN, DILATION, NON-VASC LVL 15",911.65,683.74,10.94,820.48,119
CDM,272C172616,"HC CATHETER BLLN, DILATION, NON-VASC LVL 16",1139.65,854.74,13.68,1025.69,119
CDM,272C172617,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 17",1424.6,1068.45,17.1,1282.14,119
CDM,272C172618,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 18",1780.8,1335.6,21.37,1602.72,119
CDM,272C172619,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 19",2058.15,1543.61,24.7,1852.34,119
CDM,272C172622,"HC CATHETER BLLN, DILATION, NON-VASC LVL 22",2853.35,2140.01,34.24,2568.02,119
CDM,272C172626,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 26",4315.0,3236.25,51.78,3883.5,119
CDM,272C172628,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 28",5054.65,3790.99,60.66,4549.18,119
CDM,272C172634,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 34",10247.6,7685.7,122.97,9222.84,119
CDM,272C172635,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 35",11528.6,8646.45,138.34,10375.74,119
CDM,272C172636,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 36",12969.7,9727.28,155.64,11672.73,119
CDM,272C172637,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 37",14590.95,10943.21,175.09,13131.86,119
CDM,272C172834,HC CATHETER BRACHYTX SEED ADM LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C172904,HC CATHETER DRAINAGE LVL 4,24.3,18.23,0.29,21.87,119
CDM,272C172905,HC CATHETER DRAINAGE LVL 5,36.55,27.41,0.44,32.89,119
CDM,272C172906,HC CATHETER DRAINAGE LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C172907,HC CATHETER DRAINAGE LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C172908,HC CATHETER DRAINAGE LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C172909,HC CATHETER DRAINAGE LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C172910,HC CATHETER DRAINAGE LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C172911,HC CATHETER DRAINAGE LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C172912,HC CATHETER DRAINAGE LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C172913,HC CATHETER DRAINAGE LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C172914,HC CATHETER DRAINAGE LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C172915,HC CATHETER DRAINAGE LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C172916,HC CATHETER DRAINAGE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C172918,HC CATHETER DRAINAGE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C172919,HC CATHETER DRAINAGE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C172920,HC CATHETER DRAINAGE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C172921,HC CATHETER DRAINAGE LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C172922,HC CATHETER DRAINAGE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C172923,HC CATHETER DRAINAGE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C172924,HC CATHETER DRAINAGE LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C172932,HC CATHETER DRAINAGE LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C172941,HC CATH THORACIC ALL SIZE (ARGYLE/PLEUR),35.95,26.96,0.43,32.36,119
CDM,272C172942,HC TUBE CHEST 8-12FR,83.6,62.7,1.0,75.24,119
CDM,272C172943,HC CATH ARGYLE UVC 3.5F- 5F 15IN SL,67.85,50.89,0.81,61.06,119
CDM,272C172944,HC CATH ARGYLE UVC 3.5F-5FR DL/TL,219.45,164.59,2.63,197.5,119
CDM,272C172945,HC TRAY THORA PARA 5FR DRAIN,267.9,200.92,3.21,241.11,119
CDM,272C172946,HC CATH RESOLVE LOKG 10F 30CM PIG,310.5,232.88,3.73,279.45,119
CDM,272C172947,HC CATH DRAIN DAWSON MUELLER,336.15,252.11,4.03,302.53,119
CDM,272C172948,HC TRAY THORA 6F SFTY,414.0,310.5,4.97,372.6,119
CDM,272C172949,HC KIT PNEUMOTHORAX,499.35,374.51,5.99,449.42,119
CDM,272C172950,HC KIT FUHRMAN PLURAL PNEUMOPERIC,638.0,478.5,7.66,574.2,119
CDM,272C172951,HC CATH VENTRICULAR TRAUMACATH SET,690.25,517.69,8.28,621.22,119
CDM,272C172952,HC CATH HERMETIC LUMBAR CLOSED TIP DRAIN,759.85,569.89,9.12,683.86,119
CDM,272C172953,HC TRAY PERCARDIOCENTESIS LOCK 8.3F 40CM,866.2,649.65,10.39,779.58,119
CDM,272C172954,HC CATH EDM VENTRICULAR 35CM,758.95,569.21,9.11,683.06,119
CDM,272C172955,HC EDM LUMBAR DRAIN KIT 700ML,1302.95,977.21,15.64,1172.66,119
CDM,272C172956,HC CATH EDM LUMBAR 80CM,1035.35,776.51,12.42,931.82,119
CDM,272C172957,HC TRAY THAL-QUICK CHEST TUBE ALL SIZES,1005.75,754.31,12.07,905.18,119
CDM,272C172958,HC TRAY TURKEL PNEUMOTHORAX 8F,509.8,382.35,6.12,458.82,119
CDM,272C172959,HC TRAY PNEUMOTHORAX 9F -10.2,1110.3,832.72,13.32,999.27,119
CDM,272C172960,HC TRAY THORACIC VENT PROCEDURE,1096.75,822.56,13.16,987.08,119
CDM,272C172961,HC KIT EXT DRAIN MONITOR CSF BECKER,982.7,737.02,11.79,884.43,119
CDM,272C172962,HC SET CATH WAYNE PNEUMOTHORAX,1233.95,925.46,14.81,1110.56,119
CDM,272C172963,HC CATH VENTRICLEAR II EVD DRNG (G44130),1355.6,1016.7,16.27,1220.04,119
CDM,272C172964,HC SYSTEM DRAIN LIMITORR VOL 20ML,1617.6,1213.2,19.41,1455.84,119
CDM,272C172965,HC CATH CSF BACTISEAL EVD 1.5MM,2072.05,1554.04,24.86,1864.85,119
CDM,272C172966,HC KIT PERCDTS P-TAIL LF CATH 8F,597.4,448.05,7.17,537.66,119
CDM,272C172967,HC CATH BACTISEAL EVD 1.9MM ID,2419.25,1814.44,29.03,2177.33,119
CDM,272C172968,HC KIT PERICARDIOCENTESIS PC 100,474.85,356.14,5.7,427.36,119
CDM,272C173001,HC CATH PACE VEN TEMP 5F 100CM,402.3,301.73,4.83,362.07,119
CDM,272C173002,HC CATH PACE TEMP 6F,900.75,675.56,10.81,810.68,119
CDM,272C173012,HC CATHETER EP 19-FEWER ELECTRODES LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C173013,HC CATHETER EP 19-FEWER ELECTRODES LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C173014,HC CATHETER EP 19-FEWER ELECTRODES LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C173015,HC CATHETER EP 19-FEWER ELECTRODES LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C173016,HC CATHETER EP 19-FEWER ELECTRODES LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C173017,HC CATHETER EP 19-FEWER ELECTRODES LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C173018,HC CATHETER EP 19-FEWER ELECTRODES LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C173019,HC CATHETER EP 19-FEWER ELECTRODES LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C173020,HC CATHETER EP 19-FEWER ELECTRODES LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C173021,HC CATHETER EP 19-FEWER ELECTRODES LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C173022,HC CATHETER EP 19-FEWER ELECTRODES LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C173023,HC CATHETER EP 19-FEWER ELECTRODES LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C173024,HC CATHETER EP 19-FEWER ELECTRODES LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C173028,HC CATHETER EP 19-FEWER ELECTRODES LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C173029,HC CATHETER EP 19-FEWER ELECTRODES LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C173032,HC CATHETER EP 19-FEWER ELECTRODES LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C173123,HC CATHETER EP 20+ ELECTRODES LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C173124,HC CATHETER EP 20+ ELECTRODES LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C173125,HC CATHETER EP 20+ ELECTRODES LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C173126,HC CATHETER EP 20+ ELECTRODES LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C173225,HC CATHETER EP DIAG/ABL/3D/MAP LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C173226,HC CATHETER EP DIAG/ABL/3D/MAP LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C173227,HC CATHETER EP DIAG/ABL/3D/MAP LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C173228,HC CATHETER EP DIAG/ABL/3D/MAP LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C173229,HC CATHETER EP DIAG/ABL/3D/MAP LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C173230,HC CATHETER EP DIAG/ABL/3D/MAP LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C173231,HC CATHETER EP DIAG/ABL/3D/MAP LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C173232,HC CATHETER EP DIAG/ABL/3D/MAP LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C173233,HC CATHETER EP DIAG/ABL/3D/MAP LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C173234,HC CATHETER EP DIAG/ABL/3D/MAP LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C173235,HC CATHETER EP DIAG/ABL/3D/MAP LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C173236,HC CATHETER EP DIAG/ABL/3D/MAP LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C173237,HC CATHETER EP DIAG/ABL/3D/MAP LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C173238,HC CATHETER EP DIAG/ABL/3D/MAP LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,272C173240,HC CATHETER EP DIAG/ABL/3D/MAP LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,272C173322,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C173324,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C173325,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C173326,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C173327,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C173328,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C173329,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C173330,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C173331,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C173332,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C173334,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C173337,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C173338,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,272C173345,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,272C173347,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,272C174735,HC ENDOSCOPE INSERT SINGLE USE LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C175101,HC CATH MIDLINE 3FR 20CM,699.75,524.81,8.4,629.78,119
CDM,272C175106,HC CATHETER INFUSION LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C175107,HC CATHETER INFUSION LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C175108,HC CATHETER INFUSION LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C175109,HC CATHETER INFUSION LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C175110,HC CATHETER INFUSION LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C175111,HC CATHETER INFUSION LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C175112,HC CATHETER INFUSION LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C175113,HC CATHETER INFUSION LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C175114,HC CATHETER INFUSION LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C175115,HC CATHETER INFUSION LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C175116,HC CATHETER INFUSION LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C175117,HC CATHETER INFUSION LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C175118,HC CATHETER INFUSION LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C175119,HC CATHETER INFUSION LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C175120,HC CATHETER INFUSION LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C175121,HC CATHETER INFUSION LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C175122,HC CATHETER INFUSION LVL 22272C175122,2853.35,2140.01,34.24,2568.02,119
CDM,272C175123,HC CATHETER INFUSION LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C175124,HC CATHETER INFUSION LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C175125,HC CATHETER INFUSION LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C175127,HC CATHETER INFUSION LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C175134,HC CATHETER INFUSION LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C175141,HC CATH PICC 20G W/INTROSYTE-N,418.8,314.1,5.03,376.92,119
CDM,272C175142,HC CATH PICC 1ST SL 1.9F 50CM,191.5,143.62,2.3,172.35,119
CDM,272C175143,HC TRAY TRIALYSIS CATH STRAIGHT,977.8,733.35,11.73,880.02,119
CDM,272C175144,HC TRAY TRIALYSIS POWER CATH CRV TEMP,1030.1,772.58,12.36,927.09,119
CDM,272C175145,HC TRAY POWERPICC CATH 4F 1L MAX,910.05,682.54,10.92,819.04,119
CDM,272C175146,HC TRAY POWERPICC SOLO 4F 1L MAX,1026.45,769.84,12.32,923.8,119
CDM,272C175147,HC TRAY POWERPICC 5F 3L MAX TPS,1089.75,817.31,13.08,980.78,119
CDM,272C175148,HC TRAY CATH POWERGLIDE,509.55,382.16,6.11,458.6,119
CDM,272C175150,HC CATH POWER MIDLINE 4FR,620.7,465.52,7.45,558.63,119
CDM,272C175151,HC CATH PICC 3CG 4F 2-LUMEN,1118.9,839.18,13.43,1007.01,119
CDM,272C175152,HC CATH POWERPICC PROVENA SOLO 5F,1206.25,904.69,14.48,1085.62,119
CDM,272C175154,HC CATH PERCUT EMG CRICO 6MM KIT,1016.45,762.34,12.2,914.8,119
CDM,272C175155,"HC CATH CVC TRAY 1L  4F, 5F 5-12CM",513.35,385.01,6.16,462.02,119
CDM,272C175156,"HC CATH CVC 2L 4F,5F 12-15CM PED",886.75,665.06,10.64,798.08,119
CDM,272C175157,HC CATH SWAN 2L 7F 110CM,485.35,364.01,5.82,436.82,119
CDM,272C175158,HC CATH SWAN SV02&EDV 110CM 8F,2672.7,2004.52,32.07,2405.43,119
CDM,272C175159,HC CATH CVC 1 LUMEN TELEFLEX,121.15,90.86,1.45,109.04,119
CDM,272C175160,HC CATH CVC 2 LUMEN TELEFLEX,164.7,123.52,1.98,148.23,119
CDM,272C175161,HC CATH CVC 3 LUMEN TELEFLEX,262.2,196.65,3.15,235.98,119
CDM,272C175162,HC KIT CVC 3 LUM PRES INJECT 7 FR X 20 CM AGB,519.9,389.92,6.24,467.91,119
CDM,272C175163,HC KIT CVC PRES INJECT 7FR-8.5FR X 16/18/20CM AGB (CDC),595.5,446.62,7.15,535.95,119
CDM,272C175165,HC MAC KIT 2L 9FR DISTAL 11.5 CM AGB,845.65,634.24,10.15,761.08,119
CDM,272C175166,HC CATH CV HANDS-OFF TRPL-LUM 7F,185.55,139.16,2.23,167.0,119
CDM,272C175167,HC KIT ART CATHETERIZATION 18 GA X 16CM,551.3,413.48,6.62,496.17,119
CDM,272C175168,HC CATH INFSN SLIC 1L 7F 6IN,45.45,34.09,0.55,40.9,119
CDM,272C175169,HC CATH NUTRILINE PICC 2F 30CM,348.0,261.0,4.18,313.2,119
CDM,272C175175,HC CATH NUTRILINE TWINFLO 2F 30CM,570.75,428.06,6.85,513.68,119
CDM,272C175176,HC CATH NUTRILINE 2FR 30CM,304.65,228.49,3.66,274.18,119
CDM,272C175177,HC CATH PREMICATH 1F W/STYLT,362.9,272.18,4.35,326.61,119
CDM,272C175178,HC CATH PREMICATH 1.1F 20CM,278.05,208.54,3.34,250.24,119
CDM,272C175179,HC TRAY POWERPICC CATH 4F 1L 3CG BASIC,816.75,612.56,9.8,735.08,119
CDM,272C1751A1,HC CATHETER CV PICC 1.9FR SL 30CM,174.25,130.69,2.09,156.83,119
CDM,272C1751A2,HC CATH VASCULAR W/GW 20CM LEADERFLEX,215.75,161.81,2.59,194.18,119
CDM,272C1751A3,HC CATH PICC POWER 4FR SL NO TECH IR BASIC,378.65,283.99,4.54,340.78,119
CDM,272C1751A4,HC CATH CV PICC 1.9FR DL 30CM,415.3,311.48,4.98,373.77,119
CDM,272C1751A5,HC KIT PI CVC 3-LUMEN 7F X 20CM,463.15,347.36,5.56,416.84,119
CDM,272C1751A6,HC CATH MIDLINE POWER 4FR SL 20CM,515.55,386.66,6.19,463.99,119
CDM,272C1751A7,HC KIT CATH CVC TEMP ANTIMIC 7FR TL 16CM FULL,519.9,389.92,6.24,467.91,119
CDM,272C1751A8,HC CATH PICC PROVENA 3F SL IR W/70CM GW,568.85,426.64,6.83,511.96,119
CDM,272C1751A9,HC CATH PICC PROVENA 4FR DL IR W/135CM GW,612.75,459.56,7.35,551.48,119
CDM,272C1751B1,HC CATH PICC POWER 3FR SL BASIC,620.7,465.52,7.45,558.63,119
CDM,272C1751B2,HC CATH PICC 2.6FR DL 50CM BASIC,630.05,472.54,7.56,567.04,119
CDM,272C1751B3,HC KIT CATH PICC SINGLE LUMEN 4FR 55CM,652.0,489.0,7.82,586.8,119
CDM,272C1751B4,HC TRAY CATH PICC PROVENA 4FR DL IR W/70CM GW,685.5,514.12,8.23,616.95,119
CDM,272C1751B5,HC CATH PICC POWER 5FR DL 3CG BASIC,816.75,612.56,9.8,735.08,119
CDM,272C1751B6,HC CATH PICC POWER 5FR TL SHERLOCK BASIC HF,830.75,623.06,9.97,747.68,119
CDM,272C1751B7,HC CATH PICC POWER 4FR DL 3CG FULL,1053.9,790.42,12.65,948.51,119
CDM,272C1751B8,HC CATH PICC PROVENA 3FR SL 3CG,1202.75,902.06,14.43,1082.48,119
CDM,272C175201,HC KIT TRIALYSIS POWER CATH ST OR CRV,799.9,599.92,9.6,719.91,119
CDM,272C175211,HC CATHETER HEMO/PERIT SHORT-TERM LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C175212,HC CATHETER HEMO/PERIT SHORT-TERM LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C175213,HC CATHETER HEMO/PERIT SHORT-TERM LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C175214,HC CATHETER HEMO/PERIT SHORT-TERM LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C175215,HC CATHETER HEMO/PERIT SHORT-TERM LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C175216,HC CATHETER HEMO/PERIT SHORT-TERM LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C175241,HC TRAY TRIALYSIS POWER ST OR CRV,1030.1,772.58,12.36,927.09,119
CDM,272C175322,HC CATHETER IVUS LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C175323,HC CATHETER IVUS LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C175324,HC CATHETER IVUS LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C175325,HC CATHETER IVUS LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C175326,HC CATHETER IVUS LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C175333,HC CATHETER IVUS LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C175335,HC CATHETER IVUS LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C175336,HC CATHETER IVUS LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C175506,HC CATHETER INTRASPINAL LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C175508,HC CATHETER INTRASPINAL LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C175518,HC CATHETER INTRASPINAL LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C175710,HC CATHETER THROMB/EMBOLECTOMY LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C175711,HC CATHETER THROMB/EMBOLECTOMY LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C175712,HC CATHETER THROMB/EMBOLECTOMY LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C175714,HC CATHETER THROMB/EMBOLECTOMY LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C175715,HC CATHETER THROMB/EMBOLECTOMY LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C175716,HC CATHETER THROMB/EMBOLECTOMY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C175717,HC CATHETER THROMB/EMBOLECTOMY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C175718,HC CATHETER THROMB/EMBOLECTOMY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C175719,HC CATHETER THROMB/EMBOLECTOMY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C175721,HC CATHETER THROMB/EMBOLECTOMY LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C175722,HC CATHETER THROMB/EMBOLECTOMY LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C175723,HC CATHETER THROMB/EMBOLECTOMY LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C175725,HC CATHETER THROMB/EMBOLECTOMY LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C175726,HC CATHETER THROMB/EMBOLECTOMY LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C175727,HC CATHETER THROMB/EMBOLECTOMY LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C175729,HC CATHETER THROMB/EMBOLECTOMY LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C175730,HC CATHETER THROMB/EMBOLECTOMY LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C175731,HC CATHETER THROMB/EMBOLECTOMY LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C175732,HC CATHETER THROMB/EMBOLECTOMY LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C175733,HC CATHETER THROMB/EMBOLECTOMY LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C175734,HC CATHETER THROMB/EMBOLECTOMY LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C175735,HC CATHETER THROMB/EMBOLECTOMY LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C175736,HC CATHETER THROMB/EMBOLECTOMY LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C175738,HC CATHETER THROMB/EMBOLECTOMY LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,272C175739,HC CATHETER THROMB/EMBOLECTOMY LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,272C175740,HC CATHETER THROMB/EMBOLECTOMY LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,272C175741,HC CATHETER THROMB/EMBOLECTOMY LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,272C175742,HC CATHETER THROMB/EMBOLECTOMY LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,272C175743,HC CATHETER THROMB/EMBOLECTOMY LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,272C175744,HC CATHETER THROMB/EMBOLECTOMY LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,272C175745,HC CATHETER THROMB/EMBOLECTOMY LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,272C175746,HC CATHETER THROMB/EMBOLECTOMY LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,272C175747,HC CATHETER THROMB/EMBOLECTOMY LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,272C175748,HC CATHETER THROMB/EMBOLECTOMY LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,272C175749,HC CATHETER THROMB/EMBOLECTOMY LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,272C175750,HC CATHETER THROMB/EMBOLECTOMY LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,272C175923,HC CATHETER INTRACARD ECHO LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C175925,HC CATHETER INTRACARD ECHO LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C175928,HC CATHETER INTRACARD ECHO LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C175930,HC CATHETER INTRACARD ECHO LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C175933,HC CATHETER INTRACARD ECHO LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C175936,HC CATHETER INTRACARD ECHO LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C176015,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C176016,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C176017,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C176018,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C176033,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C176034,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C176139,HC CATH TRANSLUM INTRAVASC LITHO/CORONARY LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,272C176619,HC INTRO-SHEATH STEERABLE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C176621,HC INTRO-SHEATH STEERABLE LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C176622,HC INTRO-SHEATH STEERABLE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C176623,HC INTRO-SHEATH STEERABLE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C176624,HC INTRO-SHEATH STEERABLE LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C176625,HC INTRO-SHEATH STEERABLE LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C176626,HC INTRO-SHEATH STEERABLE LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C176627,HC INTRO-SHEATH STEERABLE LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C176629,HC INTRO-SHEATH STEERABLE LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C176630,HC INTRO-SHEATH STEERABLE LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C176901,HC GUIDEWIRE GLIDE/STIFF ANG 150CM/180CM,293.45,220.09,3.52,264.1,119
CDM,272C176905,HC GUIDEWIRE LVL 5,36.55,27.41,0.44,32.89,119
CDM,272C176906,HC GUIDEWIRE LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C176907,HC GUIDEWIRE LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C176908,HC GUIDEWIRE LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C176909,HC GUIDEWIRE LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C176910,HC GUIDEWIRE LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C176911,HC GUIDEWIRE LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C176912,HC GUIDEWIRE LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C176913,HC GUIDEWIRE LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C176914,HC GUIDEWIRE LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C176915,HC GUIDEWIRE LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C176916,HC GUIDEWIRE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C176917,HC GUIDEWIRE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C176918,HC GUIDEWIRE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C176919,HC GUIDEWIRE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C176920,HC GUIDEWIRE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C176921,HC GUIDEWIRE LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C176922,HC GUIDEWIRE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C176923,HC GUIDEWIRE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C176924,HC GUIDEWIRE LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C176926,HC GUIDEWIRE LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C176928,HC GUIDEWIRE LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C176931,HC GUIDEWIRE LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C176933,HC GUIDEWIRE LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C176941,HC GUIDEWIRE 3MM J .035INX150 STD,34.3,25.72,0.41,30.87,119
CDM,272C176942,HC GUIDEWIRE BMW 190CM J-TIP,340.8,255.6,4.09,306.72,119
CDM,272C176943,HC GUIDEWIRE ZIP ANG .035 150CM,136.0,102.0,1.63,122.4,119
CDM,272C176944,HC GUIDEWIRE COONS / ULTRA 145CM,130.15,97.61,1.56,117.14,119
CDM,272C176945,HC GUIDEWIRE COPE / TORQ FLEX .018 X 60,120.65,90.49,1.45,108.58,119
CDM,272C176946,HC GUIDEWIRE COPE MANDRIL ANGD,152.8,114.6,1.83,137.52,119
CDM,272C176947,HC GUIDEWIRE STIFF .035INX80CM,278.6,208.95,3.34,250.74,119
CDM,272C176948,HC CATH MELKER UNIV 5MMX9CM SET,2613.15,1959.86,31.36,2351.84,119
CDM,272C176949,HC SET INTUB RETRO 11F 70-38J-110-01,899.8,674.85,10.8,809.82,119
CDM,272C176950,HC TRAY CIAGLIA RHINO G2 W/O TU,2207.55,1655.66,26.49,1986.8,119
CDM,272C176951,HC GUIDEWIRE SPRING/DUOFLEX TELEFLEX,52.05,39.04,0.62,46.84,119
CDM,272C176952,HC WIRE RUNTHROUGH NS .014X180CM,641.7,481.28,7.7,577.53,119
CDM,272C176953,HC SET INTRODUCER TRACH BLUE RHINO G2,1893.85,1420.39,22.73,1704.46,119
CDM,272C176954,HC GUIDEWIRE VAS FIXEDCORE CRV .038X80CMX3MM,47.55,35.66,0.57,42.8,119
CDM,272C176955,HC GUIDEWIRE VAS CRVD ROSEN .035X145CMX1.5MM,48.85,36.64,0.59,43.96,119
CDM,272C176956,HC GUIDEWIRE VASC FIXEDCORE STRAIGHT .038X80CM,101.75,76.31,1.22,91.58,119
CDM,272C176957,HC GUIDEWIRE HYDROPHILIC ANGLED 035X150,141.35,106.01,1.7,127.22,119
CDM,272C176958,HC GUIDEWIRE VAS AUSTRALIAN TORQ-FLEX .018/40CM,116.45,87.34,1.4,104.8,119
CDM,272C176959,HC GUIDEWIRE LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,272C176960,HC GUIDEWIRE HI-TORQUE FLEX-T .018X145CM,378.65,283.99,4.54,340.78,119
CDM,272C176961,HC GUIDEWIRE VAS 035/6/75 AMPLATZ SUPER STIFF,126.25,94.69,1.52,113.62,119
CDM,272C176962,HC SPRING WIRE GUIDE .032X 26 13/16 STRAIG,56.8,42.6,0.68,51.12,119
CDM,272C176963,HC GUIDEWIRE ROADRUNNER UNIGLIDE 0.018X150CM HYDROPH STRAIGHT,114.8,86.1,1.38,103.32,119
CDM,272C176964,HC GUIDEWIRE VASC NITINOL MANDREL,172.6,129.45,2.07,155.34,119
CDM,272C176965,HC GUIDEWIRE VASC NIT-VU,167.7,125.78,2.01,150.93,119
CDM,272C176966,HC GUIDEWIRE VASC NITINOL MANDREL 300CM,219.55,164.66,2.63,197.6,119
CDM,272C177313,HC RETRIEVAL DEVICE LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C177317,HC RETRIEVAL DEVICE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C177318,HC RETRIEVAL DEVICE LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C177319,HC RETRIEVAL DEVICE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C177320,HC RETRIEVAL DEVICE LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C177321,HC RETRIEVAL DEVICE LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C177322,HC RETRIEVAL DEVICE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C177323,HC RETRIEVAL DEVICE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C177324,HC RETRIEVAL DEVICE LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C177327,HC RETRIEVAL DEVICE LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C177328,HC RETRIEVAL DEVICE LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C177330,HC RETRIEVAL DEVICE LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C177331,HC RETRIEVAL DEVICE LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C177332,HC RETRIEVAL DEVICE LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C188326,HC ADAPT/EXT PACING NEURO LEAD LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C188425,HC EMBOLIZATION PROTECTION DEVICE LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C188426,HC EMBOLIZATION PROTECTION DEVICE LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C188427,HC EMBOLIZATION PROTECTION DEVICE LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C188428,HC EMBOLIZATION PROTECTION DEVICE LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C188429,HC EMBOLIZATION PROTECTION DEVICE LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C188430,HC EMBOLIZATION PROTECTION DEVICE LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C188435,HC EMBOLIZATION PROTECTION DEVICE LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C188436,HC EMBOLIZATION PROTECTION DEVICE LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,272C188437,HC EMBOLIZATION PROTECTION DEVICE LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C188534,HC CATHETER LASER LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C188535,HC CATHETER LASER LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C188537,HC CATH LASER LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C188631,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C188632,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C188634,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C188637,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C188639,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,272C188640,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,272C188701,HC CATHETER GUIDING LVL 1,7.1,5.32,0.09,6.39,119
CDM,272C188702,HC CATHETER GUIDING LVL 2,10.75,8.06,0.13,9.68,119
CDM,272C188703,HC KIT INTRO MICROPUNCTURE SET BEVEL 5FR,163.35,122.51,1.96,147.01,119
CDM,272C188705,HC CATHETER GUIDING LVL 5,36.55,27.41,0.44,32.89,119
CDM,272C188706,HC CATHETER GUIDING LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C188707,HC CATHETER GUIDING LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C188708,HC CATHETER GUIDING LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C188709,HC CATHETER GUIDING LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C188710,HC CATHETER GUIDING LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C188711,HC CATHETER GUIDING LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C188712,HC CATHETER GUIDING LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C188713,HC CATHETER GUIDING LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C188714,HC CATHETER GUIDING LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C188715,HC CATHETER GUIDING LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C188716,HC CATHETER GUIDING LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C188717,HC CATHETER GUIDING LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C188718,HC CATHETER GUIDING LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C188719,HC CATHETER GUIDING LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C188720,HC CATHETER GUIDING LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C188721,HC CATHETER GUIDING LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C188722,HC CATHETER GUIDING LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C188723,HC CATHETER GUIDING LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C188724,HC CATHETER GUIDING LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C188725,HC CATHETER GUIDING LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C188726,HC CATHETER GUIDING LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C188727,HC CATHETER GUIDING LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C188728,HC CATHETER GUIDING LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C188729,HC CATHETER GUIDING LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C188730,HC CATHETER GUIDING LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C188731,HC CATHETER GUIDING LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C188732,HC CATHETER GUIDING LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C188733,HC CATHETER GUIDING LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C188734,HC CATHETER GUIDING LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C188735,HC CATHETER GUIDING LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C188739,HC CATH-GUIDING LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,272C188750,HC CATHETER GUIDING LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,272C188818,HC CATH-ABLAT NON-CARDIAC ENDOVASC LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C188820,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C188822,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C188823,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C188825,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C188826,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C188827,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C188828,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C188830,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C188832,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C188911,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C188918,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C188921,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C188926,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C188928,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C188941,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,272C188942,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,272C188951,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,272C189207,HC INTRO-SHEATH PEEL-AWAY LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C189209,HC INTRO-SHEATH PEEL-AWAY LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C189210,HC INTRO-SHEATH PEEL-AWAY LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C189211,HC INTRO-SHEATH PEEL-AWAY LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C189212,HC INTRO-SHEATH PEEL-AWAY LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C189213,HC INTRO-SHEATH PEEL-AWAY LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C189214,HC INTRO-SHEATH PEEL-AWAY LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C189216,HC INTRO-SHEATH PEEL-AWAY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C189217,HC INTRO-SHEATH PEEL-AWAY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C189218,HC INTRO-SHEATH PEEL-AWAY LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C189219,HC INTRO-SHEATH PEEL-AWAY LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C189310,HC INTRO-SHEATH EP LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C189311,HC INTRO-SHEATH EP LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C189312,HC INTRO-SHEATH EP LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C189313,HC INTRO-SHEATH EP LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C189314,HC INTRO-SHEATH EP LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C189315,HC INTRO-SHEATH EP LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C189316,HC INTRO-SHEATH EP LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C189317,HC INTRO-SHEATH EP LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C189318,HC INTRO-SHEATH EP LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C189319,HC INTRO-SHEATH EP LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C189322,HC INTRO-SHEATH EP LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C189325,HC INTRO-SHEATH EP LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C189326,HC INTRO-SHEATH EP LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C189401,HC INTRO-SHEATH NON-SPECIAL LVL 1,7.1,5.32,0.09,6.39,119
CDM,272C189404,HC INTRO-SHEATH NON-SPECIAL LVL 4,24.3,18.23,0.29,21.87,119
CDM,272C189405,HC INTRO-SHEATH NON-SPECIAL LVL 5,36.55,27.41,0.44,32.89,119
CDM,272C189406,HC INTRO-SHEATH NON-SPECIAL LVL 6,54.85,41.14,0.66,49.36,119
CDM,272C189407,HC INTRO-SHEATH NON-SPECIAL LVL 7,82.35,61.76,0.99,74.11,119
CDM,272C189408,HC INTRO-SHEATH NON-SPECIAL LVL 8,123.6,92.7,1.48,111.24,119
CDM,272C189409,HC INTRO-SHEATH NON-SPECIAL LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C189410,HC INTRO-SHEATH NON-SPECIAL LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C189411,HC INTRO-SHEATH NON-SPECIAL LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C189412,HC INTRO-SHEATH NON-SPECIAL LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C189413,HC INTRO-SHEATH NON-SPECIAL LVL 13,583.4,437.55,7.0,525.06,119
CDM,272C189414,HC INTRO-SHEATH NON-SPECIAL LVL 14,729.25,546.94,8.75,656.32,119
CDM,272C189415,HC INTRO-SHEATH NON-SPECIAL LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C189416,HC INTRO-SHEATH NON-SPECIAL LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C189417,HC INTRO-SHEATH NON-SPECIAL LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C189418,HC INTRO-SHEATH NON-SPECIAL LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C189419,HC INTRO-SHEATH NON-SPECIAL LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C189420,HC INTRO-SHEATH NON-SPECIAL LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C189421,HC INTRO-SHEATH NON-SPECIAL LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C189422,HC INTRO-SHEATH NON-SPECIAL LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,272C189423,HC INTRO-SHEATH NON-SPECIAL LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,272C189424,HC INTRO-SHEATH NON-SPECIAL LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C189425,HC INTRO-SHEATH NON-SPECIAL LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C189426,HC INTRO-SHEATH NON-SPECIAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,272C189428,HC INTRO-SHEATH NON-SPECIAL LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C189430,HC INTRO-SHEATH NON-SPECIAL LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C189431,HC INTRO-SHEATH NON-SPECIAL LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C189437,HC INTRO-SHEATH NON-SPECIAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C189441,HC INTRODUCER INTROSYTE-N 1.9FR,447.25,335.44,5.37,402.52,119
CDM,272C189442,HC INTRODUCER MIC-PUNC 4.5F 10,356.15,267.11,4.27,320.53,119
CDM,272C189443,HC INTRODUCER MIC EZ 4.5F 5CM,154.6,115.95,1.86,139.14,119
CDM,272C189444,HC KIT MICINTRD 5.0F 5CM MICRO-EZ,157.5,118.12,1.89,141.75,119
CDM,272C189445,HC KIT INTRODUCER MIC 3.5F 5CM,255.95,191.96,3.07,230.36,119
CDM,272C189446,HC SHEATH SUP 4F 11CM .035IN GW,46.35,34.76,0.56,41.72,119
CDM,272C189447,HC INTRODUCER MP 4F 10CM,132.1,99.08,1.59,118.89,119
CDM,272C189448,HC INTRODUCER MP 0.018IN,211.4,158.55,2.54,190.26,119
CDM,272C189449,HC SHEATH BRIT TIP 7F 401-705M,60.0,45.0,0.72,54.0,119
CDM,272C189450,HC INTRODUCER 5F-8F 11CM,34.8,26.1,0.42,31.32,119
CDM,272C189451,HC INTRODUCER INTROFLEX W/5F SH,324.3,243.22,3.89,291.87,119
CDM,272C189452,HC INTRODUCER NIT 4F TUNG KIT,97.05,72.79,1.16,87.34,119
CDM,272C189453,HC INTRODUCER KIT PSI FOR TELEFLEX CATH,244.2,183.15,2.93,219.78,119
CDM,272C189454,HC INTRODUCER PERCUT 8.5F 10CM,359.7,269.77,4.32,323.73,119
CDM,272C189455,HC INTRODUCER PERCUT SHTH 7.5-8F,583.4,437.55,7.0,525.06,119
CDM,272C189456,HC SET INTRD W HEMO VLV 5FX7.5CM,111.25,83.44,1.34,100.12,119
CDM,272C189457,HC INTRODUCER SHEATH PINNACLE,52.05,39.04,0.62,46.84,119
CDM,272C189458,HC INTRODUCER ET TU FLEX-GUIDE,509.65,382.24,6.12,458.68,119
CDM,272C189459,HC CATH REBOA CONVENIENCE KIT,1353.45,1015.09,16.24,1218.1,119
CDM,272C189460,HC SHEATH INTRODUCER PRELUDE,202.8,152.1,2.43,182.52,119
CDM,272C189461,HC INTRODUCER SET MICRO-ACCESS,118.3,88.72,1.42,106.47,119
CDM,272C189462,HC KIT MICROINTROD 4FR STIF 0.018X40CM NITINOL,95.6,71.7,1.15,86.04,119
CDM,272C189463,HC KIT INTRODUCER CATH 6FR NDL 7CM BLUE MICROEZ,154.6,115.95,1.86,139.14,119
CDM,272C189464,HC SET INTRODUCER TEARAWAY 2FR 7CM T0.014IN GW,189.3,141.98,2.27,170.37,119
CDM,272C189465,HC MICROINTRODUCER BEVEL NDL MICROEZ BARD,258.4,193.8,3.1,232.56,119
CDM,272C198244,HC CATH PRESSURE VALVE OCCLU LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,272C261818,HC NEEDLE/PROBE EP CRYO LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,272C261819,HC NEEDLE/PROBE EP CRYO LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C261827,HC NEEDLE/PROBE EP CRYO LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C261829,HC NEEDLE/PROBE EP CRYO LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C261831,HC NEEDLE/PROBE EP CRYO LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C262324,HC CATHETER BLLN PTA DRUG COATED LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C262325,HC CATHETER BLLN PTA DRUG COATED LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C262327,HC CATHETER BLLN PTA DRUG COATED LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C262328,HC CATHETER BLLN PTA DRUG COATED LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C262329,HC CATHETER BLLN PTA DRUG COATED LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C262330,HC CATHETER BLLN PTA DRUG COATED LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C262331,HC CATHETER BLLN PTA DRUG COATED LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C262332,HC CATHETER BLLN PTA DRUG COATED LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C262341,HC CATHETER BLLN PTA DRUG COATED LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,272C262801,HC CATH HSG BAL 7F 30CM 3ML-SYR,189.5,142.12,2.27,170.55,119
CDM,272C262809,HC CATHETER BLLN OCCLUSION LVL 9,185.45,139.09,2.23,166.9,119
CDM,272C262810,HC CATHETER BLLN OCCLUSION LVL 10,278.25,208.69,3.34,250.42,119
CDM,272C262811,HC CATHETER BLLN OCCLUSION LVL 11,417.45,313.09,5.01,375.7,119
CDM,272C262812,HC CATHETER BLLN OCCLUSION LVL 12,473.25,354.94,5.68,425.92,119
CDM,272C262815,HC CATHETER BLLN OCCLUSION LVL 15,911.65,683.74,10.94,820.48,119
CDM,272C262816,HC CATHETER BLLN OCCLUSION LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,272C262817,HC CATHETER BLLN OCCLUSION LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,272C262819,HC CATHETER BLLN OCCLUSION LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,272C262820,HC CATHETER BLLN OCCLUSION LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,272C262821,HC CATHETER BLLN OCCLUSION LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,272C262824,HC CATHETER BLLN OCCLUSION LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,272C262825,HC CATHETER BLLN OCCLUSION LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,272C262827,HC CATHETER BLLN OCCLUSION LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,272C262828,HC CATHETER BLLN OCCLUSION LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C262829,HC CATHETER BLLN OCCLUSION LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C262830,HC CATHETER BLLN OCCLUSION LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C262831,HC CATHETER BLLN OCCLUSION LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C262832,HC CATHETER BLLN OCCLUSION LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C262833,HC CATHETER BLLN OCCLUSION LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C262835,HC CATHETER BLLN OCCLUSION LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C262841,HC POSTPARTUM BALLOON BAKRI,1845.2,1383.9,22.14,1660.68,119
CDM,272C262842,HC CATH REBOA+ TRAUMA,15705.2,11778.9,188.46,14134.68,119
CDM,272C262935,HC SHEATH LASER LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,272C263028,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,272C263029,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,272C263030,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,272C263031,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,272C263032,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,272C263033,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,272C263034,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,272C263037,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,272C961040,HC CATH CORONARY DRUG-DELIVERY TPT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,272C961041,HC CATH CORONARY DRUG-DELIVERY TPT LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,272C961042,HC CATH CORONARY DRUG-DELIVERY TPT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,272L850195,HC TRACHEOSTOMY SPEAKING VALVE,145.8,109.35,1.75,131.22,119
CDM,27327,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,46.29,34.715,0.45,49.57,476
CDM,27390,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,15.29,11.47,0.18,13.76,238
CDM,27430,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,549.025,411.77,4.87,623.33,357
CDM,27462,ESTRADIOL 0.025 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
CDM,27463,ESTRADIOL 0.075 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
CDM,274L011301,HC CRANIAL CERVICAL TORTICOLLIS,260.82,195.62,3.13,234.74,119
CDM,274L012001,HC PREFAB CERV COLLAR FLEXIBLE FOAM NON-ADJUST OTS,21.5,16.12,0.26,19.35,119
CDM,274L014001,HC CERVICAL SEMI RIGID ADJUSTAB,62.9,47.18,0.75,56.61,119
CDM,274L015001,HC MOLDED CERV COLLAR PLAST SEMI-RIG ADJ CHIN CUP W MAND,6.8,5.1,0.08,6.12,119
CDM,274L017201,HC PREFAB CERV COLLAR SEMI-RIGID 2PC THERMOPL FOAM OTS,187.55,140.66,2.25,168.8,119
CDM,274L017401,HC PREFAB CERV COLLAR THOR SEMI RIGID 2PC OTS,282.9,212.18,3.39,254.61,119
CDM,274L018001,HC CERV MULTI POST COLLAR ADJ,1866.8,1400.1,22.4,1680.12,119
CDM,274L020001,HC CERV COLLAR THORAC,1724.0,1293.0,20.69,1551.6,119
CDM,274L045001,HC PREFAB TLSO THOR RIGD OTS,458.95,344.21,5.51,413.06,119
CDM,274L045601,HC PREFAB CUS TSLO FLEX TRNK SJ-SS,3433.85,2575.39,41.21,3090.46,119
CDM,274L045701,HC PREFAB TLSO SCAPULAR OTS,3912.0,2934.0,46.94,3520.8,119
CDM,274L046001,HC PREFAB CUS TLSO POST FRAME,1680.1,1260.08,20.16,1512.09,119
CDM,274L046041,HC PREFAB CUS TLSO POST FRAME,1135.15,851.36,13.62,1021.64,119
CDM,274L046401,HC PREFAB FIT & ADJ TLSO 4 SHELL LINR,1287.0,965.25,15.44,1158.3,119
CDM,274L047201,HC PREFAB FIT & ADJ TLSO ANT HYPTIXT,1594.1,1195.58,19.13,1434.69,119
CDM,274L048401,HC TLSO RIGID PLASTIC CUST FAB,7483.6,5612.7,89.8,6735.24,119
CDM,274L048601,HC CUS TLSO 2SHELLS LINR,7577.05,5682.79,90.92,6819.34,119
CDM,274L062101,HC PREFAB SI BELT OTS,323.35,242.51,3.88,291.02,119
CDM,274L062501,HC LO FLEX L1-BELOW L5 PRE OTS,303.3,227.48,3.64,272.97,119
CDM,274L062701,HC PREFAB CUS LO SAG CONT RIGD ANT/POS,599.4,449.55,7.19,539.46,119
CDM,274L062801,HC PREFAB LUMBOSACRAL SUPP OTS,160.5,120.38,1.93,144.45,119
CDM,274L063001,HC PREFAB CUS LSO POST RIG PANEL,720.65,540.49,8.65,648.58,119
CDM,274L063701,HC PREFAB CUS LSO SAG COR RIG ANT/POST PANEL,888.65,666.49,10.66,799.78,119
CDM,274L063901,HC LUMBAR SACRAL ORTH SHELL PANEL PREFAB,4315.0,3236.25,51.78,3883.5,119
CDM,274L064801,HC PREFAB LSO SAGI CTRL RIGID OTS,4045.85,3034.39,48.55,3641.26,119
CDM,274L065001,HC PREFAB LSO SAG RDG OTS,2689.7,2017.28,32.28,2420.73,119
CDM,274L085901,HC HALO ADD MRI COMPATIBLE SYS INCL RINGS/PINS,454.35,340.76,5.45,408.92,119
CDM,274L098401,HC PREFAB PROTECTIVE BODY SOCK EACH OTS,558.25,418.69,6.7,502.42,119
CDM,274L100101,HC CTLSO INFANT IMMOBILIZER,807.45,605.59,9.69,726.7,119
CDM,274L130001,HC BODY JACKET MOLD TO PATIENT,6486.2,4864.65,77.83,5837.58,119
CDM,274L162001,HC HO FLEX PAVLIK HARNS PRE CST,279.25,209.44,3.35,251.32,119
CDM,274L168601,HC PREFAB POSTOP HIP ORT L1686,1563.75,1172.81,18.76,1407.38,119
CDM,274L181201,HC PREFAB KNEE ELAS JNT OTS,90.15,67.61,1.08,81.14,119
CDM,274L182001,HC PREFAB FIT & ADJ KO,244.45,183.34,2.93,220.0,119
CDM,274L183001,HC PREFAB KNEE BRACE 16 INCHES OTS,108.5,81.38,1.3,97.65,119
CDM,274L183201,HC PREFAB CUS KO ADJ JNT POS R SUP,473.3,354.98,5.68,425.97,119
CDM,274L183301,HC PREFAB RDG KNEE BRAC OTS,473.3,354.98,5.68,425.97,119
CDM,274L190201,HC PREFAB ANKLE GAUNTLET PRE OTS,108.3,81.22,1.3,97.47,119
CDM,274L190601,HC PREFAB ANKLE FOOT ORTHOSIS MULTILIGAMENTUS ANKLE SUPPORT OTS,108.5,81.38,1.3,97.65,119
CDM,274L193001,HC PREFAB FIT & ADJ AFO PLASTIC,808.8,606.6,9.71,727.92,119
CDM,274L194001,HC CUS PLASTIC AFO,3756.45,2817.34,45.08,3380.8,119
CDM,274L197001,HC CUS AFO W/ANK-JNT,2994.65,2245.99,35.94,2695.18,119
CDM,274L222001,HC DORS/PLANTAR FLEX ASSIST L2220,977.0,732.75,11.72,879.3,119
CDM,274L227501,HC VARUS/VALGUS PLSTC CORCTN L2275,624.05,468.04,7.49,561.64,119
CDM,274L228001,HC MOLDED INNER BOOT L2280,2679.6,2009.7,32.16,2411.64,119
CDM,274L234001,HC MOLDED PRE TIBILA PT SHELL L2340,2407.75,1805.81,28.89,2166.98,119
CDM,274L275501,HC CUS ADDL LWR EXT ORTHOS FOR CUS FAB ONLY,611.95,458.96,7.34,550.76,119
CDM,274L279501,HC KNEE CONTROL FULL KNEECAP L2795,67.05,50.29,0.8,60.34,119
CDM,274L282001,HC SOFT INTERFACE BELOW KNEE L2820,658.05,493.54,7.9,592.24,119
CDM,274L301001,"HC MOLDED FOOT, INSERT REMOVABLE, EA",260.67,195.5,3.13,234.6,119
CDM,274L302001,"HC MOLDED, FOOT, INSERT, REMOVABLE W METATARSAL PAD OR BAR, EA",2.2,1.65,0.03,1.98,119
CDM,274L306001,HC PREMOLDED METATARS REMOVBLE ARCH SUPP EA L3060,71.15,53.36,0.85,64.04,119
CDM,274L365001,HC PREFAB SHOULDER ORTHO FIG 8 RESTRAINER OTS,72.65,54.49,0.87,65.39,119
CDM,274L366001,HC PREFAB SHOULDER ORTHOSIS FIGURE 8 ABDUCTION RESTRAINER OTS,26.0,19.5,0.31,23.4,119
CDM,274L367001,HC PREFAB ULTRA SLING OTS,250.55,187.91,3.01,225.5,119
CDM,274L371001,HC PREFAB ELB ELAS BRC W/MET OTS,301.85,226.39,3.62,271.67,119
CDM,274L373001,HC CUS EO DBL UPRT W/FLEX ASST,571.26,428.44,6.86,514.13,119
CDM,274L376001,HC PREFAB FIT & ADJ ELBOW W/JT,407.6,305.7,4.89,366.84,119
CDM,274L376201,"HC PREFAB ELBOW ORTHOSIS, NO JNTS OTS",118.79,89.09,1.43,106.91,119
CDM,274L380701,HC PREFAB CUS RESTING HAND SPLINT,122.15,91.61,1.47,109.94,119
CDM,274L380801,HC CUS FIT& ADJ WHFO RIDGID W/O JNT,270.11,202.58,3.24,243.1,119
CDM,274L380901,HC PREFAB WRS-FNG WO JNT OTS,194.15,145.61,2.33,174.74,119
CDM,274L390601,HC CUS FIT & ADJ WRST/HAND ORTH W/O JNT,36.3,27.22,0.44,32.67,119
CDM,274L390801,HC PREFAB WRIST-HAND ORTHO W EXT CONTR COCK-UP OTS,18.1,13.58,0.22,16.29,119
CDM,274L391301,HC CUS FIT & ADJ H/F ORTHOSIS W/O JOINTS,166.97,125.23,2.0,150.27,119
CDM,274L391901,HC CUS FIT & ADJ HO W/O JOINTS,169.6,127.2,2.04,152.64,119
CDM,274L392101,HC CUS FIT & ADJ HFO W JOINT(S),712.08,534.06,8.54,640.87,119
CDM,274L392301,HC HFO WITHOUTH JOINTS PRE CST,116.95,87.71,1.4,105.26,119
CDM,274L392401,HC PREFAB HFO WO JOINTS OTS,189.3,141.98,2.27,170.37,119
CDM,274L392501,HC FO PIP DIP JNT/SPRNG PRE OTS,82.9,62.18,0.99,74.61,119
CDM,274L392701,HC FO PIP DIP NO JT SPR PRE OTS,128.96,96.72,1.55,116.06,119
CDM,274L393301,HC CUS FIT & ADJ FINGER ORTHOSIS W/O JNTS,90.68,68.01,1.09,81.61,119
CDM,274L393501,HC CUS FIT & ADJ FO NONTORSION JOINT,489.94,367.46,5.88,440.95,119
CDM,274L398001,HC PREFAB FIT & ADJ ORTHOSIS FX HUMERAL,559.8,419.85,6.72,503.82,119
CDM,274L398201,HC PREFAB FIT & ADJ UPPER EXTREM FX ORTHOSIS,22.8,17.1,0.27,20.52,119
CDM,274L398401,"HC PREFAB FIT & ADJ UPPER EXT FRACTURE ORTHOSIS/BRACE, WRIST",427.95,320.96,5.14,385.16,119
CDM,274L435001,HC PREFAB ANKLE AIRCAST; RIGID/STIRRUP OTS,243.6,182.7,2.92,219.24,119
CDM,274L436001,HC PNEUMAT WALKING BOOT PRE CAST,161.55,121.16,1.94,145.4,119
CDM,274L436101,HC PREFAB PNMTIC BOOT OTS,155.0,116.25,1.86,139.5,119
CDM,274L438601,"HC NON-PNEUMATIC WALKING BOOT, PREFAB-CUSTOM FIT",138.5,103.88,1.66,124.65,119
CDM,274L438701,HC PREFAB NON-PNMTC BOOT OTS,266.0,199.5,3.19,239.4,119
CDM,274L439601,HC PREFAB CUS BOOT AFO PODOUS REG,456.75,342.56,5.48,411.08,119
CDM,274L439641,HC PREFAB CUS ANKLE CONTRACTURE BOOT,691.95,518.96,8.3,622.76,119
CDM,274L439701,HC PREFAB ANKLE CONTR BOOT OTS,596.15,447.11,7.15,536.54,119
CDM,274L545001,HC IPOP BK RIGID DRESS L5450,1332.45,999.34,15.99,1199.21,119
CDM,274L569201,HC ADDITION TO LOWER EXTREMETY ABOVE KNEE PELVIC CONTROL BELT LIGHT,962.8,722.1,11.55,866.52,119
CDM,274L569501,HC AK SLEEVE SUSP NEOPRENE OR EQUAL,884.85,663.64,10.62,796.36,119
CDM,274L844001,HC ORTHOTIC SHRNKR BELW KNEE L8440,197.55,148.16,2.37,177.8,119
CDM,274L850109,HC TRACHEOSTOMY SPEAKING VALVE,348.35,261.26,4.18,313.52,119
CDM,2752289716,HC LEAD PACING TEMPORARY LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2752289717,HC LEAD PACING TEMPORARY LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,275C172144,HC ICD DUAL CHAMBER LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,275C172145,HC ICD DUAL CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,275C172146,HC ICD DUAL CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,275C172148,HC ICD DUAL CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,275C172149,HC ICD DUAL CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,275C172150,HC ICD DUAL CHAMBER LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,275C172151,HC ICD DUAL CHAMBER LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,275C172153,HC ICD DUAL CHAMBER LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,275C172159,HC ICD DUAL CHAMBER LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,275C172221,HC ICD SINGLE CHAMBER LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,275C172222,HC ICD SINGLE CHAMBER LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,275C172241,HC ICD SINGLE CHAMBER LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,275C172243,HC ICD SINGLE CHAMBER LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,275C172244,HC ICD SINGLE CHAMBER LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,275C172245,HC ICD SINGLE CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,275C172246,HC ICD SINGLE CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,275C172247,HC ICD SINGLE CHAMBER LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,275C172248,HC ICD SINGLE CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,275C172249,HC ICD SINGLE CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,275C172251,HC ICD SINGLE CHAMBER LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,275C172252,HC ICD SINGLE CHAMBER LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,275C172256,HC ICD SINGLE CHAMBER LVL 56,74903.9,56177.92,898.85,67413.51,119
CDM,275C177732,HC LEAD ICD SINGLE COIL LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,275C177733,HC LEAD ICD SINGLE COIL LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,275C177734,HC LEAD ICD SINGLE COIL LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,275C177735,HC LEAD ICD SINGLE COIL LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C177736,HC LEAD ICD SINGLE COIL LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,275C177737,HC LEAD ICD SINGLE COIL LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C177741,HC LEAD ICD SINGLE COIL LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,275C178531,HC PACEMAKER DUAL CHAMBER LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,275C178532,HC PACEMAKER DUAL CHAMBER LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,275C178533,HC PACEMAKER DUAL CHAMBER LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,275C178534,HC PACEMAKER DUAL CHAMBER LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,275C178535,HC PACEMAKER DUAL CHAMBER LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C178536,HC PACEMAKER DUAL CHAMBER LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,275C178537,HC PACEMAKER DUAL CHAMBER LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C178538,HC PACEMAKER DUAL CHAMBER LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,275C178629,HC PACEMAKER SINGLE CHAMBER LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,275C178630,HC PACEMAKER SINGLE CHAMBER LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,275C178631,HC PACEMAKER SINGLE CHAMBER LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,275C178632,HC PACEMAKER SINGLE CHAMBER LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,275C178633,HC PACEMAKER SINGLE CHAMBER LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,275C178634,HC PACEMAKER SINGLE CHAMBER LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,275C178635,HC PACEMAKER SINGLE CHAMBER LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C178636,HC PACEMAKER SINGLE CHAMBER LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,275C178637,HC PACEMAKER SINGLE CHAMBER LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C178645,HC PACEMAKER SINGLE CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,275C178646,HC PACEMAKER SINGLE CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,275C178647,HC PACEMAKER SINGLE CHAMBER LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,275C178648,HC PACEMAKER SINGLE CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,275C178649,HC PACEMAKER SINGLE CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,275C188246,HC ICD BIV/CRT-D LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,275C188247,HC ICD BIV/CRT-D LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,275C188248,HC ICD BIV/CRT-D LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,275C188249,HC ICD BIV/CRT-D LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,275C188250,HC ICD BIV/CRT-D LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,275C188251,HC ICD BIV/CRT-D LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,275C188252,HC ICD BIV/CRT-D LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,275C188253,HC ICD BIV/CRT-D LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,275C188254,HC ICD BIV/CRT-D LVL 54,67939.95,50954.96,815.28,61145.96,119
CDM,275C188255,HC ICD BIV/CRT-D LVL 55,71337.0,53502.75,856.04,64203.3,119
CDM,275C188256,HC ICD BIV/CRT-D LVL 56,74903.9,56177.92,898.85,67413.51,119
CDM,275C188259,HC ICD BIV/CRT-D LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,275C188267,HC ICD BIV/CRT-D LVL 67,128111.55,96083.66,1537.34,115300.4,119
CDM,275C189502,HC LEAD ICD DUAL COIL LVL 2,10.75,8.06,0.13,9.68,119
CDM,275C189532,HC LEAD ICD DUAL COIL LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,275C189533,HC LEAD ICD DUAL COIL LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,275C189534,HC LEAD ICD DUAL COIL LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,275C189535,HC LEAD ICD DUAL COIL LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C189537,HC LEAD ICD DUAL COIL LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C189538,HC LEAD ICD DUAL COIL LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,275C189540,HC LEAD ICD DUAL COIL LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,275C189626,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,275C189637,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C189640,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,275C189817,HC LEAD PACING LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,275C189818,HC LEAD PACING LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,275C189819,HC LEAD PACING LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,275C189821,HC LEAD PACING LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,275C189822,HC LEAD PACING LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,275C189823,HC LEAD PACING LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,275C189826,HC LEAD PACING LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,275C189835,HC LEAD PACING LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C190013,HC LEAD PACING CS/LV LVL 13,583.4,437.55,7.0,525.06,119
CDM,275C190023,HC LEAD PACING CS/LV LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,275C190024,HC LEAD PACING CS/LV LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,275C190025,HC LEAD PACING CS/LV LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,275C190026,HC LEAD PACING CS/LV LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,275C190027,HC LEAD PACING CS/LV LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,275C190028,HC LEAD PACING CS/LV LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,275C190029,HC LEAD PACING CS/LV LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,275C190030,HC LEAD PACING CS/LV LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,275C190031,HC LEAD PACING CS/LV LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,275C190032,HC LEAD PACING CS/LV LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,275C190035,HC LEAD PACING CS/LV LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,275C190037,HC LEAD PACING CS/LV LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C262137,HC PACEMAKER BIV CRT-P LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,275C262138,HC PACEMAKER BIV CRT-P LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,275C262139,HC PACEMAKER BIV CRT-P LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,275C262140,HC PACEMAKER BIV CRT-P LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,275C262141,HC PACEMAKER BIV CRT-P LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,275C262142,HC PACEMAKER BIV CRT-P LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,275C262143,HC PACEMAKER BIV CRT-P LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,275C262149,HC PACEMAKER BIV CRT-P LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,275C262151,HC PACEMAKER BIV CRT-P LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,27639,LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,2.65,1.98,0.03,2.38,119
CDM,27697,ONDANSETRON 4 MG DISINTEGRATING TABLET,3.5149999999999997,2.635,0.04,3.3,238
CDM,27780,ZONISAMIDE 100 MG CAPSULE,2.21,1.66,0.03,1.99,119
CDM,2781909742,HC EMBOLIZATION DEVICE IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,2781909743,HC EMBOLIZATION DEVICE IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,2781909744,HC EMBOLIZATION DEVICE IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,2781909749,HC EMBOLIZATION DEVICE IMPLANT LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,2781909750,HC EMBOLIZATION DEVICE IMPLANT LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,2781909751,HC EMBOLIZATION DEVICE IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,2781909752,HC EMBOLIZATION DEVICE IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,2781909753,HC EMBOLIZATION DEVICE IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,2781919714,HC EMBOLIZATION SPHERE IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,2781919716,HC EMBOLIZATION SPHERE IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2781919729,HC EMBOLIZATION SPHERE IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2781919730,HC EMBOLIZATION SPHERE IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2781919731,HC EMBOLIZATION SPHERE IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,2781949730,HC ENDOPROSTHESIS IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2781949734,HC ENDOPROSTHESIS IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,2781949737,HC ENDOPROSTHESIS IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,2781949747,HC ENDOPROSTHESIS IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,2781949751,HC ENDOPROSTHESIS IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,2782019716,HC GENERAL SUPPLY IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,2782019717,HC GENERAL SUPPLY IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2782019743,HC GENERAL SUPPLY IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,2782019745,HC GENERAL SUPPLY IMPLANT LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,2782019752,HC GENERAL SUPPLY IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,2782019753,HC GENERAL SUPPLY IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,2782139723,HC INTRACRANIAL MONITOR CATHETER LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2782139724,HC INTRACRANIAL MONITOR CATHETER LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2782209717,HC L&D SUPPLY IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,2782209718,HC L&D SUPPLY IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,2782649751,HC VALVE IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,2782649752,HC VALVE IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,2782649755,HC VALVE IMPLANT LVL 55,71337.0,53502.75,856.04,64203.3,119
CDM,2782649758,HC VALVE IMPLANT LVL 58,82581.6,61936.2,990.98,74323.44,119
CDM,2782649759,HC VALVE IMPLANT LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,2782649761,HC VALVE IMPLANT LVL 61,95598.65,71698.99,1147.18,86038.78,119
CDM,2782649763,HC VALVE IMPLANT LVL 63,105397.55,79048.16,1264.77,94857.8,119
CDM,2782649764,HC VALVE IMPLANT LVL 64,110667.5,83000.62,1328.01,99600.75,119
CDM,2782649765,HC VALVE IMPLANT LVL 65,116200.9,87150.68,1394.41,104580.81,119
CDM,2782649766,HC VALVE IMPLANT LVL 66,122011.0,91508.25,1464.13,109809.9,119
CDM,2782649770,HC VALVE IMPLANT LVL 70,148305.25,111228.94,1779.66,133474.72,119
CDM,2782649771,HC VALVE IMPLANT LVL 71,155720.6,116790.45,1868.65,140148.54,119
CDM,2782659723,HC VASCULAR PLUG IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,2782659724,HC VASCULAR PLUG IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,2782659725,HC VASCULAR PLUG IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,2782659726,HC VASCULAR PLUG IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,2782659729,HC VASCULAR PLUG IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,2782659730,HC VASCULAR PLUG IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,2782669732,HC VASCULAR STENT GRAFT IMPLANT LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,2782669734,HC VASCULAR STENT GRAFT IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,2782669737,HC VASCULAR STENT GRAFT IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,2782669738,HC VASCULAR STENT GRAFT IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,2782669740,HC VASCULAR STENT GRAFT IMPLANT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,2782669741,HC VASCULAR STENT GRAFT IMPLANT LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,2782669743,HC VASCULAR STENT GRAFT IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,2782669744,HC VASCULAR STENT GRAFT IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,2782669746,HC VASCULAR STENT GRAFT IMPLANT LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,2782669747,HC VASCULAR STENT GRAFT IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,2782669748,HC VASCULAR STENT GRAFT IMPLANT LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,2782669749,HC VASCULAR STENT GRAFT IMPLANT LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,2782669750,HC VASCULAR STENT GRAFT IMPLANT LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,2782669751,HC VASCULAR STENT GRAFT IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,2782669753,HC VASCULAR STENT GRAFT IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,2782669754,HC VASCULAR STENT GRAFT IMPLANT LVL 54,67939.95,50954.96,815.28,61145.96,119
CDM,2782669755,HC VASCULAR STENT GRAFT IMPLANT LVL 55,71337.0,53502.75,856.04,64203.3,119
CDM,2782669762,HC VASCULAR STENT GRAFT IMPLANT LVL 62,100378.6,75283.95,1204.54,90340.74,119
CDM,2782669764,HC VASCULAR STENT GRAFT IMPLANT LVL 64,110667.5,83000.62,1328.01,99600.75,119
CDM,2782679752,HC LEFT ATRIAL APPENDAGE IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,27838,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,24.0,18.0,0.18,59.45,1666
CDM,27860,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,10.28,7.71,0.12,9.25,119
CDM,27862,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,10.475,7.855,0.12,9.6,238
CDM,27863,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,9.62,7.21,0.12,8.66,238
CDM,278A464801,HC NEEDLE DELIVERY SAVI SCOUT W REFLEC ALL,1976.25,1482.19,23.72,1778.62,119
CDM,278A464809,HC IMPLANTABLE TISSUE MARKER LVL 9,185.45,139.09,2.23,166.9,119
CDM,278A464810,HC IMPLANTABLE TISSUE MARKER LVL 10,278.25,208.69,3.34,250.42,119
CDM,278A464811,HC IMPLANTABLE TISSUE MARKER LVL 11,417.45,313.09,5.01,375.7,119
CDM,278A464812,HC IMPLANTABLE TISSUE MARKER LVL 12,473.25,354.94,5.68,425.92,119
CDM,278A464813,HC IMPLANTABLE TISSUE MARKER LVL 13,583.4,437.55,7.0,525.06,119
CDM,278A464814,HC IMPLANTABLE TISSUE MARKER LVL 14,729.25,546.94,8.75,656.32,119
CDM,278A464816,HC IMPLANTABLE TISSUE MARKER LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278A464819,HC IMPLANTABLE TISSUE MARKER LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278A464820,HC IMPLANTABLE TISSUE MARKER LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,278A464841,HC MARKER FIDUCIAL .75,759.55,569.66,9.11,683.6,119
CDM,278C171312,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C171316,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C171317,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C171318,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C171321,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,278C171322,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C171324,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C171325,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,278C171326,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C171327,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,278C171338,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,278C171701,HC BRACHYTHERAPY SOURCE HDR IR192,64501.4,48376.05,774.02,58051.26,119
CDM,278C172801,HC SAVI APPLICATOR 6.1-1 MINI,9230.0,6922.5,110.76,8307.0,119
CDM,278C172841,HC SAVI APPLICATOR 6.1,9230.0,6922.5,110.76,8307.0,119
CDM,278C172842,HC SAVI APPLICATOR 8.1,9230.0,6922.5,110.76,8307.0,119
CDM,278C172843,HC SAVI APPLICATOR 10-1,9230.0,6922.5,110.76,8307.0,119
CDM,278C174835,HC ENDOSCOPE SINGLE USE LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,278C175010,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CDM,278C175011,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CDM,278C175012,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C175013,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,278C175014,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,278C175015,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C175016,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C175017,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C175018,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C176015,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C176016,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C176018,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C176315,HC CONNECTIVE TISSUE NON-HUMAN LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C176316,HC CONNECTIVE TISSUE NON-HUMAN LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C176437,HC LOOP RECORDER IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,278C176438,HC LOOP RECORDER IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,278C176439,HC LOOP RECORDER IMPLANT LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,278C176440,HC LOOP RECORDER IMPLANT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,278C176718,HC GENERATOR NEURO NON-RECHARG IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C176819,HC GRAFT VASCULAR IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278C176826,HC GRAFT VASCULAR IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C176830,HC GRAFT VASCULAR IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,278C177824,HC LEAD SPNL CORD STIM KIT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C177832,HC LEAD SPNL CORD STIM KIT LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,278C177833,HC LEAD SPNL CORD STIM KIT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,278C178116,HC MESH IMPLANTABLE LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C178815,HC PORT INDWELLING IMPLANTABLE LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C178817,HC PORT INDWELLING IMPLANTABLE LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C178819,HC PORT INDWELLING IMPLANTABLE LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278C178822,HC PORT INDWELLING IMPLANTABLE LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C178823,HC PORT INDWELLING IMPLANTABLE LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,278C181740,HC IMPLANT-SEPTAL DEFECT LVL 40,22750.0,17062.5,273.0,20475.0,119
CDM,278C181741,HC IMPLANT-SEPTAL DEFECT LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,278C181742,HC SEPTAL DEFECT IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,278C181743,HC SEPTAL DEFECT IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,278C181744,HC IMPLANT-SEPTAL DEFECT LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,278C181745,HC IMPLANT-SEPTAL DEFECT LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,278C181746,HC SEPTAL DEFECT IMPLANT LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,278C181747,HC SEPTAL DEFECT IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,278C181908,HC TISSUE LOCALIZATION-EXCISION DEVICE LVL 08,123.6,92.7,1.48,111.24,119
CDM,278C182016,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C182052,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,278C182053,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,278C182346,HC NEUROSTIM GENERATOR/LEAD LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,278C182359,HC NEUROSTIM GENERATOR/LEAD LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,278C182361,HC NEUROSTIM GENERATOR/LEAD LVL 61,95598.65,71698.99,1147.18,86038.78,119
CDM,278C182366,HC NEUROSTIM GENERATOR/LEAD LVL 66,122011.0,91508.25,1464.13,109809.9,119
CDM,278C182656,HC GEN NEURO RCHG W BAT & LDS & CMPNTS IMPLANT LVL 56,74903.9,56177.92,898.85,67413.51,119
CDM,278C187401,HC STENT COATED/COVERED IMPLANT LVL 1,7.1,5.32,0.09,6.39,119
CDM,278C187417,HC STENT COATED/COVERED IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C187418,HC STENT COATED/COVERED IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C187419,HC STENT COATED/COVERED IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278C187421,HC STENT COATED/COVERED IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,278C187422,HC STENT COATED/COVERED IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C187423,HC STENT COATED/COVERED IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,278C187424,HC STENT COATED/COVERED IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C187425,HC STENT COATED/COVERED IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,278C187426,HC STENT COATED/COVERED IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C187427,HC STENT COATED/COVERED IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,278C187428,HC STENT COATED/COVERED IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,278C187429,HC STENT COATED/COVERED IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,278C187430,HC STENT COATED/COVERED IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,278C187431,HC STENT COATED/COVERED IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,278C187432,HC STENT COATED/COVERED IMPLANT LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,278C187433,HC STENT COATED/COVERED IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,278C187434,HC STENT COATED/COVERED IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,278C187435,HC STENT COATED/COVERED IMPLANT LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,278C187436,HC STENT COATED/COVERED IMPLANT LVL 36,12969.7,9727.28,155.64,11672.73,119
CDM,278C187437,HC STENT COATED/COVERED IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,278C187438,HC STENT COATED/COVERED IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,278C187439,HC STENT COATED/COVERED IMPLANT LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,278C187441,HC STENT COATED/COVERED IMPLANT LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,278C187442,HC STENT COATED/COVERED IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,278C187443,HC STENT COATED/COVERED IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,278C187444,HC STENT COATED/COVERED IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,278C187445,HC STENT COATED/COVERED IMPLANT LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,278C187446,HC STENT COATED/COVERED IMPLANT LVL 46,33099.25,24824.44,397.19,29789.32,119
CDM,278C187447,HC STENT COATED/COVERED IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CDM,278C187448,HC STENT COATED/COVERED IMPLANT LVL 48,40050.15,30037.61,480.6,36045.14,119
CDM,278C187451,HC STENT COATED/COVERED IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,278C187452,HC STENT COATED/COVERED IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,278C187453,HC STENT COATED/COVERED IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,278C187462,HC STENT COATED/COVERED IMPLANT LVL 62,100378.6,75283.95,1204.54,90340.74,119
CDM,278C187498,HC PK PAPYRUS COVERED CORONARY STENT H170004,10247.6,7685.7,122.97,9222.84,119
CDM,278C187611,HC STENT NON COATED/NON COVERED IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CDM,278C187614,HC STENT NON COATED/NON COVERED IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,278C187615,HC STENT NON COATED/NON COVERED IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C187616,HC STENT NON COATED/NON COVERED IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C187618,HC STENT NON COATED/NON COVERED IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C187619,HC STENT NON COATED/NON COVERED IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278C187621,HC STENT NON COATED/NON COVERED IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,278C187622,HC STENT NON COATED/NON COVERED IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C187623,HC STENT NON COATED/NON COVERED IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,278C187624,HC STENT NON COATED/NON COVERED IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C187625,HC STENT NON COATED/NON COVERED IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,278C187626,HC STENT-NON COAT/NON-COV LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C187627,HC STENT NON COATED/NON COVERED IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,278C187629,HC STENT NON COATED/NON COVERED IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,278C187630,HC STENT NON COATED/NON COVERED IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,278C187631,HC STENT NON COATED/NON COVERED IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,278C187632,HC STENT-NON COAT/NON-COV LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,278C187633,HC STENT NON COATED/NON COVERED IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,278C187634,HC STENT NON COATED/NON COVERED IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,278C187642,HC STENT NON COATED/NON COVERED IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CDM,278C187643,HC STENT NON COATED/NON COVERED IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CDM,278C187644,HC STENT NON COATED/NON COVERED IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,278C187649,HC STENT NON COATED/NON COVERED IMPLANT LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,278C187650,HC STENT NON COATED/NON COVERED IMPLANT LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,278C187651,HC STENT NON COATED/NON COVERED IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,278C187728,HC STENT NON CTD/NON CVRD WO/DEL SYS IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,278C187731,HC STENT NON CTD/NON CVRD WO/DEL SYS IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,278C188023,HC IVC FILTER IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,278C188024,HC IVC FILTER IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C188025,HC IVC FILTER IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,278C188026,HC IVC FILTER IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C188027,HC IVC FILTER IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,278C188028,HC IVC FILTER IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,278C188116,HC DIALYSIS ACCESS SYS LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C188308,HC ADAPT/EXT PACING OR NEURO LEAD 08,123.6,92.7,1.48,111.24,119
CDM,278C188311,HC ADAPT/EXT PACING OR NEURO LEAD 11,417.45,313.09,5.01,375.7,119
CDM,278C188313,HC ADAPT/EXT PACING NEURO LEAD LVL 13,583.4,437.55,7.0,525.06,119
CDM,278C188314,HC ADAPT/EXT PACING OR NEURO LEAD 14,729.25,546.94,8.75,656.32,119
CDM,278C188315,HC ADAPT/EXT PACING OR NEURO LEAD 15,911.65,683.74,10.94,820.48,119
CDM,278C188322,HC ADAPT/EXT PACING OR NEURO LEAD 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C188905,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 05,36.55,27.41,0.44,32.89,119
CDM,278C188906,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 06,54.85,41.14,0.66,49.36,119
CDM,278C188907,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 07,82.35,61.76,0.99,74.11,119
CDM,278C188908,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 08,123.6,92.7,1.48,111.24,119
CDM,278C188909,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 09,185.45,139.09,2.23,166.9,119
CDM,278C188910,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 10,278.25,208.69,3.34,250.42,119
CDM,278C188911,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 11,417.45,313.09,5.01,375.7,119
CDM,278C188912,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C188913,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 13,583.4,437.55,7.0,525.06,119
CDM,278C188914,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 14,729.25,546.94,8.75,656.32,119
CDM,278C188915,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C188916,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 16,1139.65,854.74,13.68,1025.69,119
CDM,278C188917,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C188918,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C188919,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 19,2058.15,1543.61,24.7,1852.34,119
CDM,278C188920,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 20,2157.45,1618.09,25.89,1941.7,119
CDM,278C188921,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 21,2481.15,1860.86,29.77,2233.04,119
CDM,278C188922,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 22,2853.35,2140.01,34.24,2568.02,119
CDM,278C188923,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 23,3281.4,2461.05,39.38,2953.26,119
CDM,278C188924,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C188925,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 25,4314.95,3236.21,51.78,3883.46,119
CDM,278C188926,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 26,4315.0,3236.25,51.78,3883.5,119
CDM,278C188927,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 27,4493.0,3369.75,53.92,4043.7,119
CDM,278C188928,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 28,5054.65,3790.99,60.66,4549.18,119
CDM,278C188929,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 29,5686.55,4264.91,68.24,5117.9,119
CDM,278C188930,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 30,6397.4,4798.05,76.77,5757.66,119
CDM,278C188931,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 31,7197.15,5397.86,86.37,6477.44,119
CDM,278C188932,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 32,8096.8,6072.6,97.16,7287.12,119
CDM,278C188933,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,278C188934,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,278C188935,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 35,11528.6,8646.45,138.34,10375.74,119
CDM,278C188936,HC HYDROGEL BARRIER SPACEOAR GEL,12969.7,9727.28,155.64,11672.73,119
CDM,278C188938,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 38,16414.9,12311.18,196.98,14773.41,119
CDM,278C188939,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 39,17749.95,13312.46,213.0,15974.96,119
CDM,278C188941,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 41,22750.0,17062.5,273.0,20475.0,119
CDM,278C188944,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 44,27354.7,20516.03,328.26,24619.23,119
CDM,278C188945,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 45,30090.2,22567.65,361.08,27081.18,119
CDM,278C188949,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 49,44055.2,33041.4,528.66,39649.68,119
CDM,278C188950,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 50,48460.8,36345.6,581.53,43614.72,119
CDM,278C188951,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 51,53306.9,39980.18,639.68,47976.21,119
CDM,278C188952,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 52,58637.6,43978.2,703.65,52773.84,119
CDM,278C188953,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 53,64501.4,48376.05,774.02,58051.26,119
CDM,278C188959,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,278C188962,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 62,100378.6,75283.95,1204.54,90340.74,119
CDM,278C188963,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 63,105397.55,79048.16,1264.77,94857.8,119
CDM,278C188966,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 66,122011.0,91508.25,1464.13,109809.9,119
CDM,278C189712,HC LEAD NEUROSTIM TEST KIT LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C189724,HC LEAD NEUROSTIM TEST KIT LVL 24,3773.65,2830.24,45.28,3396.29,119
CDM,278C189734,HC LEAD NEUROSTIM TEST KIT LVL 34,10247.6,7685.7,122.97,9222.84,119
CDM,278C261601,HC BRACHYTX NON-STR YTTRIUM-90,64501.4,48376.05,774.02,58051.26,119
CDM,278C261710,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CDM,278C261711,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CDM,278C261712,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C261713,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,278C261714,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,278C261715,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C261717,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CDM,278C261718,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C261733,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CDM,278C262437,HC WIRELESS PRESSURE SENSOR IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CDM,278C262459,HC WIRELESS PRESSURE SENSOR LVL 59,86710.75,65033.06,1040.53,78039.68,119
CDM,278C262510,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CDM,278C262511,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CDM,278C262512,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CDM,278C262513,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CDM,278C262514,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CDM,278C262515,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CDM,278C262818,HC CATH BLLN OCCULUSION LVL 18,1780.8,1335.6,21.37,1602.72,119
CDM,278C263801,HC BRACHYTHERAPY IBT I-125 SEED,164.6,123.45,1.98,148.14,119
CDM,278C263901,HC BRACHY SEED NS IODINE 125,218.75,164.06,2.62,196.88,119
CDM,278C264010,"HC BRACHYTX, STRANDED,P-103 LVL 10",278.25,208.69,3.34,250.42,119
CDM,278C264110,"HC BRACHYTX, NON-STRANDED, P-103 LVL",278.25,208.69,3.34,250.42,119
CDM,278L850101,HC KIT DILATOR PROVOX VEGA PUNC SET 17FR 10MM,1893.1,1419.82,22.72,1703.79,119
CDM,278L850141,HC SET CATHETER KIT PROVOX VEGA PUNC 17F 12.5,1764.48,1323.36,21.17,1588.03,119
CDM,278L850901,HC PROSTHESIS VOICE INDWELLING,1274.1,955.58,15.29,1146.69,119
CDM,278L850941,HC VALVE SPEECH PROSTHESIS VOICE PROVOX2 8M,1260.1,945.08,15.12,1134.09,119
CDM,278LIMFW59,HC NTAP LIMFLOW SYSTEM,86710.75,65033.06,1040.53,78039.68,119
CDM,278Q410141,HC GRAFT APLIGRAF PER 1 SQ CM,4526.25,3394.69,54.32,4073.62,119
CDM,278Q410341,HC OASIS 5X7CM TRI-LAYER,41.35,31.01,0.5,37.22,119
CDM,278Q411001,HC MATRIX PRIMATRIX PER 1SQ CM,310.9,233.18,3.73,279.81,119
CDM,278Q411401,HC INTEGRA FLOWABLE WOUND MATRIX 1 CC,6198.8,4649.1,74.39,5578.92,119
CDM,278Q411601,HC ALLODERM PER 1 SQ CM,266.25,199.69,3.2,239.62,119
CDM,278Q411701,HC HYALOMATRIX PER 1 SQ CM,111.05,83.29,1.33,99.94,119
CDM,278Q412401,HC OASIS TRI-LAYER WND MATRIX PER 1 SQ CM,12.5,9.38,0.15,11.25,119
CDM,278Q413301,HC GRAFIX PRIME PER 1SQ CM Q4133 (HIGH),1054.75,791.06,12.66,949.28,119
CDM,278Q413742,HC AMNIOEXCEL 2X3CM PER SQ CM,654.4,490.8,7.85,588.96,119
CDM,278Q413743,HC AMNIOEXCEL 4X4CM PER SQ CM,111.05,83.29,1.33,99.94,119
CDM,278Q413744,HC AMNIOEXCEL 4X8CM PER SQ CM,111.05,83.29,1.33,99.94,119
CDM,278Q413747,HC AMNIOEXCEL 5X5CM PER SQ CM,111.05,83.29,1.33,99.94,119
CDM,278Q415801,HC GRAFTS FISH SKIN PER SQ CM LVL 01 (HIGH),236.65,177.49,2.84,212.98,119
CDM,278Q415802,HC GRAFTS FISH SKIN PER SQ CM LVL 02 (HIGH),359.7,269.77,4.32,323.73,119
CDM,278Q415803,HC GRAFTS FISH SKIN PER SQ CM LVL 03 (HIGH),805.85,604.39,9.67,725.26,119
CDM,278Q415941,HC AFFINITY 1.5X1.5CM 2.25CM PER SQ CM,513.35,385.01,6.16,462.02,119
CDM,278Q415942,HC AFFINITY 2.5X2.5CM 6.25CM PER SQ CM,858.75,644.06,10.3,772.88,119
CDM,278Q416301,"HC WOUNDEX, BIOSKIN, PER SQ CM",494.7,371.02,5.94,445.23,119
CDM,278Q418601,HC EPIFIX PER SQ CM (HIGH),5144.85,3858.64,61.74,4630.37,119
CDM,278Q418642,HC EPIFIX DISK 14MM SQ CM,795.7,596.78,9.55,716.13,119
CDM,278Q418643,HC EPIFIX 7X7CM SQ CM,948.65,711.49,11.38,853.78,119
CDM,278Q418644,HC EPIFIX 3X3CM SQ CM,1034.5,775.88,12.41,931.05,119
CDM,278Q418645,HC EPIFIX DISK 18MM SQ CM,1067.2,800.4,12.81,960.48,119
CDM,278Q418646,HC EPIFIX FEN 6X16CM SQ CM,391.6,293.7,4.7,352.44,119
CDM,278Q418647,HC EPIFIX NON FEN 6X16CM SQ CM,391.6,293.7,4.7,352.44,119
CDM,278Q418648,HC EPIFIX SHEET 3.5X3.5CMSQ CM,728.65,546.49,8.74,655.78,119
CDM,278Q418649,HC EPIFIX SHEET 4.0X4.5CM SQ CM,585.05,438.79,7.02,526.54,119
CDM,278Q418650,HC EPIFIX SHEET 2.0X3.0 SQ CM,1257.0,942.75,15.08,1131.3,119
CDM,278Q418651,HC EPIFIX 3X4CM SQ CM,921.65,691.24,11.06,829.48,119
CDM,278Q418652,HC EPIFIX DISK 24MM SQ CM,723.4,542.55,8.68,651.06,119
CDM,278Q418653,HC EPIFIX SHEET 2.0X3.0CM SQ CM,796.1,597.08,9.55,716.49,119
CDM,278Q418654,HC EPIFIX 5X6CM SQ CM,884.9,663.68,10.62,796.41,119
CDM,278Q418655,HC EPIFIX 4X4CM SQ CM,874.15,655.61,10.49,786.74,119
CDM,278Q418656,HC EPIFIX 2X3CM SQ CM,930.3,697.72,11.16,837.27,119
CDM,278Q418657,HC EPIFIX DISK 16MM SQ CM,805.05,603.79,9.66,724.54,119
CDM,278Q418741,HC EPICORD 2X3CM SQ CM,1005.3,753.98,12.06,904.77,119
CDM,278Q418742,HC EPICORD 3X5CM SQ CM,1005.0,753.75,12.06,904.5,119
CDM,278Q418743,HC EPICORD 1X2CM SQ CM,1954.7,1466.02,23.46,1759.23,119
CDM,278Q419601,HC PURAPLY AM PER 1 SQ CM (HIGH),449.65,337.24,5.4,404.68,119
CDM,278Q419641,HC PURAPLY AM PER 1 SQ CM (HIGH) WITH JW MOD,449.65,337.24,5.4,404.68,119
CDM,278Q419642,HC PURAPLY DISC PER 1 SQ CM,1050.1,787.58,12.6,945.09,119
CDM,278Q419643,HC PURAPLY DISC PER 1 SQ CM WITH JW MOD,1050.1,787.58,12.6,945.09,119
CDM,278TRIG470,HC NTAP TRICLIP G4 VLV RPR SYSTM,148305.25,111228.94,1779.66,133474.72,119
CDM,27905,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,42.78,32.08,0.51,38.5,238
CDM,27906,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,238
CDM,27907,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,90.09,67.57,1.08,81.08,238
CDM,27908,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,124.01,93.01,1.49,111.61,357
CDM,28011,SERTRALINE 20 MG/ML ORAL CONCENTRATE,335.52,251.64,4.03,301.97,119
CDM,2803652201,HC PHOTOPHERESIS,12098.31,9073.73,145.18,10888.48,238
CDM,28188,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,22.66,16.99,0.27,20.39,119
CDM,28228,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,36.3,27.22,0.44,32.67,238
CDM,28264,"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",2.03,1.52,0.02,1.83,119
CDM,28384,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,2.96,2.22,0.04,2.66,238
CDM,28400,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",72.0,54.0,0.86,64.8,119
CDM,28408,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
CDM,28409,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
CDM,28417,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,337.65,253.24,1.59,1317.6,714
CDM,2848,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,75.0,56.25,0.9,67.5,119
CDM,2850,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,1503.36,1127.52,18.04,1353.02,238
CDM,28643,"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",1.05,0.79,0.01,0.94,119
CDM,28809,WHITE PETROLATUM TOPICAL JELLY,14.04,10.53,0.17,12.64,119
CDM,28810,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",503.4,377.55,6.04,453.06,119
CDM,28824,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,420.0,315.0,5.04,378.0,119
CDM,28844,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1414.8,1061.1,16.98,1273.32,119
CDM,2888,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,59.59,44.69,0.72,53.63,119
CDM,28947,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1051.385,788.54,6.95,1371.38,357
CDM,28995,"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",3.11,2.34,0.04,2.8,119
CDM,290E014301,HC PT WALKER,480.65,360.49,5.77,432.58,119
CDM,29270,"DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR",2.79,2.09,0.03,2.51,119
CDM,29272,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",3.07,2.3049999999999997,0.02,4.36,238
CDM,29274,"DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR",1.43,1.08,0.02,1.29,119
CDM,29302,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION (REPACKAGING),238.9,179.17,2.87,215.01,119
CDM,29335,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CDM,29424,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,237.87,178.4,2.85,214.08,119
CDM,29464,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,120.9,90.68,1.45,108.81,238
CDM,29531,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,2.56,1.92,0.03,2.3,119
CDM,29676,SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,5.54,4.16,0.07,4.99,119
CDM,29858,"METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",3.13,2.35,0.04,2.82,119
CDM,3000064U01,HC ANTIBODY TREPONEMA PALLIDUM TOTAL & RPR IA QUAL,68.94,51.7,0.83,62.05,119
CDM,3000065U01,HC SYPHILIS TST NON-TREPONEMAL ANTIBODY IA QUAL RPR,39.81,29.86,0.48,35.83,119
CDM,3000140U01,HC NFCT DS FUNGAL PATHOGEN ID DNA 15 FUNGAL TARGETS,1704.63,1278.47,20.46,1534.17,119
CDM,3000141U01,HC NFCT DS BACT&FNG GRAM POS ORG ID & RX RESIST DNA,1704.8,1278.6,20.46,1534.32,119
CDM,3000142U01,HC NFCT DS BACT&FNG GRAM NEG ORG ID & RX RESIST DNA,1704.8,1278.6,20.46,1534.32,119
CDM,3003641501,HC VENIPUNCTURE,32.49,24.37,0.39,29.24,119
CDM,3003641519,HC VENIPUNCTURE POC,196.91,147.68,2.36,177.22,119
CDM,3003641601,HC CAPILLARY BLOOD DRAW,23.11,17.33,0.28,20.8,119
CDM,3003641619,HC CAPILLARY BLOOD DRAW POC,23.46,17.6,0.28,21.11,119
CDM,3003659101,HC BLOOD COLLECT VENOUS ACESS DEVICE,228.59,171.44,2.74,205.73,119
CDM,3003659119,HC BLD COLLECT VENOUS ACCESS DEVICE POC,247.4,185.55,2.97,222.66,119
CDM,3003659201,HC COLLECT BLOOD FROM PICC,238.3,178.72,2.86,214.47,119
CDM,3003660019,HC ABG DRAW,1342.1,1006.58,16.11,1207.89,119
CDM,30071,"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",0.89,0.67,0.01,0.8,119
CDM,3008007401,HC HEPATITIS ACUTE PROFILE,342.74,257.06,4.11,308.47,119
CDM,3008029901,HC PREDNISOLONE,1506.44,1129.83,18.08,1355.8,119
CDM,3008030781,HC COM CON UMBILICAL CORD TISSUE DOA,1280.89,960.67,15.37,1152.8,119
CDM,3008050301,HC PATH CLIN CONSLT J SF 5-20,294.91,221.18,3.54,265.42,119
CDM,3008120681,HC COM CON P210 BCR ABL1 (REFLEX),567.16,425.37,6.81,510.44,119
CDM,3008135081,HC COM CON  ARUP UGT1A1,806.84,605.13,9.68,726.16,119
CDM,3008140101,HC SPHZ MOLECULAR PATHOLOGY PROC LEVEL 2,6228.35,4671.26,74.74,5605.52,119
CDM,3008147901,HC SPHZ FAMILIAL HYPERSCHOL BY PGS,541.71,406.28,6.5,487.54,119
CDM,3008207701,HC ASSAY OF ALCOHOL UR&BREATH IA,97.24,72.93,1.17,87.52,119
CDM,3008210301,HC ALPHA-1-ANTITRYPSIN,48.06,36.04,0.58,43.25,119
CDM,3008213181,HC COM CON METHYLMALONIC ACID,1238.23,928.67,14.86,1114.41,119
CDM,3008214301,HC AMNIOTIC FLUID SPECTROPH,148.79,111.59,1.79,133.91,119
CDM,3008218001,HC VITAMIN C BLOOD,164.41,123.31,1.97,147.97,119
CDM,3008224881,HC COM CON BILIRUBIN DIRECT,61.03,45.77,0.73,54.93,119
CDM,3008227401,HC OCCULT BLD FHG QUAL 1-3,239.73,179.8,2.88,215.76,119
CDM,3008262701,HC DHEA SULFATE,153.98,115.48,1.85,138.58,119
CDM,3008303701,HC HB GLYCOSYLATED A1C HOME DEV,28.56,21.42,0.34,25.7,119
CDM,3008351682,HC COM CON TISSUE T'GLUTAMINASE IGG,152.65,114.49,1.83,137.39,119
CDM,3008352001,HC HMGCR ANTIBODY IGG,114.03,85.52,1.37,102.63,119
CDM,3008352051,"HC COM CON MAG IGM, 5",408.76,306.57,4.91,367.88,119
CDM,3008352101,HC IMMUNOGLOBULIN LIGHT CHAINS FREE EACH,271.88,203.91,3.26,244.69,119
CDM,3008372101,HC LDL DIRECT MEASURE,79.62,59.72,0.96,71.66,119
CDM,3008427001,HC SEX HORMONE BINDING GLOBULIN,150.72,113.04,1.81,135.65,119
CDM,3008499943,HC COM CON PROMETHEUS ANSER IFX,1752.58,1314.44,21.03,1577.32,119
CDM,3008524081,HC COM CON FACTOR VIII ASSAY,445.1,333.82,5.34,400.59,119
CDM,3008536601,HC FIBRINOGEN DEGRADATION PRODUCTS; PARACOAGULATION,238.43,178.82,2.86,214.59,119
CDM,3008539001,HC SPECIAL COAGULATION INTER,2858.93,2144.2,34.31,2573.04,119
CDM,3008555701,"HC OSMTC FRGLTY,RBC,INCUB",525.76,394.32,6.31,473.18,119
CDM,3008605201,HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,1516.47,1137.35,18.2,1364.82,119
CDM,3008623581,HC COM CON ANTISMOOTH MUSCLE ANTIBODY,416.05,312.04,4.99,374.44,119
CDM,3008625501,"HC COM CONN MUSK ANTIBODY, IGG WITH REFLEX TO TITER",170.45,127.84,2.05,153.4,119
CDM,3008635352,HC WB PWM LYMPH PROLIF,670.1,502.58,8.04,603.09,119
CDM,3008636701,"HC STEM CELLS, TOTAL COUNT",886.13,664.6,10.63,797.52,119
CDM,3008671081,HC COM CON INFLUENZA B VIRUS ANTIBODY,61.79,46.34,0.74,55.61,119
CDM,3008676901,HC SER IA NFCT AB SARSCOV2 COVID19 MULTI-STEP IGG,154.07,115.55,1.85,138.66,119
CDM,3008679081,HC COM CON SIN NOMBRE VIRUS IGM,437.11,327.83,5.25,393.4,119
CDM,3008681781,HC NJH HLA MATCHING FEE,2996.63,2247.47,35.96,2696.97,119
CDM,3008682501,HC HLA X-MATCH NON-CYTOTOXIC,1475.94,1106.96,17.71,1328.35,119
CDM,3008682601,HC HLA X-MATCH ADDL SAMPLE,1475.94,1106.96,17.71,1328.35,119
CDM,3008689001,"HC AUTO BLOOD, PREDEPOSITED",1577.61,1183.21,18.93,1419.85,119
CDM,3008690201,HC BLOOD TYPE SER AN DONOR;EA AN,594.47,445.85,7.13,535.02,119
CDM,3008690601,"HC BLD TYP SER RH PHENO, COMPL",373.49,280.12,4.48,336.14,119
CDM,3008694101,HC COLD AGGLUTININS/HEMOLYSINS SCREEN,147.1,110.32,1.77,132.39,119
CDM,3008697101,HC ARUP 17451 AB IDENT PANEL- ENZYME,247.55,185.66,2.97,222.8,119
CDM,3008715401,"HC ORGANISM ID BY NUCLEIC ACID PROBES, AMPLIFIED PROBE",972.72,729.54,11.67,875.45,119
CDM,3008718645,HC ARUP 3002632 SUSCEPTIBILITY - BROTH DILUTION PANEL 2,128.93,96.7,1.55,116.04,119
CDM,3008718646,HC ARUP 60200 SUSCEPTIBILITY - NOCARDIA BY BROTH DILUTION,128.93,96.7,1.55,116.04,119
CDM,3008718647,HC ARUP 3006422 ERM41 MOLECULAR DETECTION,874.98,656.24,10.5,787.48,119
CDM,3008733701,HC ENTAMOEBA ANTIGEN,129.72,97.29,1.56,116.75,119
CDM,3008734101,HC HEPATITIS B SURF AG EIA NEUT,51.23,38.42,0.61,46.11,119
CDM,3008750581,HC COM CON GASTROINTESTINAL PARASITE PANEL BY PCR,874.4,655.8,10.49,786.96,119
CDM,3008763501,HC COVID-19/SARS-COV-2 CPT 87635 INF AGENT DET W/WO RESP CDC SITE U0001,202.53,151.9,2.43,182.28,119
CDM,3008779801,"HC COM CONN BABESIA SPECIES BY PCR, 87798",593.4,445.05,7.12,534.06,119
CDM,3008818781,HC COM CON FLOWCYTOMETRY/READ 2-8,723.75,542.81,8.68,651.38,119
CDM,3008818981,HC COM CON FLOWCYTOMETRY/READ 16 & >,422.97,317.23,5.08,380.67,119
CDM,3008905041,"HC CELL COUNT, BODY FLUIDS, EXCEPT BLOOD",165.92,124.44,1.99,149.33,119
CDM,3008905042,HC URINE SMEAR FOR EOSINOPHILS,165.92,124.44,1.99,149.33,119
CDM,3008905043,"HC EOSINOPHILS, URINE",12.78,9.59,0.15,11.5,119
CDM,3008905141,HC CELL COUNT OTHER FLUIDS W/DIFF,225.29,168.97,2.7,202.76,119
CDM,3008905142,HC CELL COUNT SPINAL FLUID W/DIF,225.29,168.97,2.7,202.76,119
CDM,3008905501,HC LEUKOCYTE SMEAR FECAL,649.53,487.15,7.79,584.58,119
CDM,3008906001,HC CRYSTALS FLUID,203.92,152.94,2.45,183.53,119
CDM,3008906019,HC CRYSTALS FLUID POC,190.67,143.0,2.29,171.6,119
CDM,3008916001,"HC MEAT FIBERS, FECES",68.26,51.2,0.82,61.43,119
CDM,3008919001,HC NASAL SMEAR FOR EOSINOPHILS,184.98,138.74,2.22,166.48,119
CDM,3008922019,"HC SPUTUM, OBTAINING SPECIMEN AEROSOL INDUCED POC",463.96,347.97,5.57,417.56,119
CDM,3008923001,HC COLLECT SWEAT FOR TEST,922.06,691.54,11.06,829.85,119
CDM,3008926001,HC SPERM ISOLATION SIMPLE PREP,1042.53,781.9,12.51,938.28,119
CDM,3008931001,HC SEMEN MOTILITY/COUNT,191.9,143.93,2.3,172.71,119
CDM,3008932001,HC SEMEN ANALYSIS  COMPLETE,275.05,206.29,3.3,247.54,119
CDM,3008932101,HC SPERM COUNT POST-VASECTOMY,234.51,175.88,2.81,211.06,119
CDM,3008932201,HC SEMEN ANALYSIS WHO 5,401.27,300.95,4.82,361.14,119
CDM,3008932241,HC SEMEN ANL STRICT CRITERIA,540.27,405.2,6.48,486.24,119
CDM,3009900101,HC CLIENT DRUG SCREEN COLLECTION,546.55,409.91,6.56,491.9,119
CDM,3009900116,HC CLIENT CONVEYANCE AND HANDLING FEE,120.72,90.54,1.45,108.65,119
CDM,300P961219,HC CATH FOR SPECIMEN COLLECTION POC,24.62,18.46,0.3,22.16,119
CDM,3018004701,HC BASIC METAB PANEL CALC IONIZED,294.74,221.06,3.54,265.27,119
CDM,3018004719,HC BASIC METABOLIC CALCIUM IONIZ POC,294.74,221.06,3.54,265.27,119
CDM,3018004801,HC BASIC METABOLIC PANEL,64.73,48.55,0.78,58.26,119
CDM,3018005001,HC GENERAL HEALTH PANEL,254.34,190.76,3.05,228.91,119
CDM,3018005101,HC ELECTROLYTE PANEL,56.67,42.5,0.68,51.0,119
CDM,3018005119,HC ELECTROLYTE PANEL POC,269.15,201.86,3.23,242.24,119
CDM,3018005301,HC COMPREHENSIVE METABOLIC PANEL,95.82,71.86,1.15,86.24,119
CDM,3018005501,HC OBSTETRIC PANEL,322.4,241.8,3.87,290.16,119
CDM,3018006101,HC LIPID PANEL,94.57,70.93,1.13,85.11,119
CDM,3018006901,HC RENAL FUNCTION PANEL,67.55,50.66,0.81,60.8,119
CDM,3018007601,HC HEPATIC FUNCTION PANEL,62.89,47.17,0.75,56.6,119
CDM,3018008101,HC OBSTETRIC PANEL W HIV TESTING,562.19,421.64,6.75,505.97,119
CDM,3018014301,HC DRUG ASSAY ACETAMINOPHEN,78.71,59.03,0.94,70.84,119
CDM,3018014501,HC DRUG ASSAY ADALIMUMAB,424.97,318.73,5.1,382.47,119
CDM,3018015001,HC AMIKACIN,85.35,64.01,1.02,76.82,119
CDM,3018015101,HC DRUG ASSAY AMIODARONE,79.06,59.3,0.95,71.15,119
CDM,3018015501,HC DRUG SCREEN QUANT CAFFEINE,184.93,138.7,2.22,166.44,119
CDM,3018015601,HC CARBAMAZEPINE TOTAL,102.45,76.84,1.23,92.2,119
CDM,3018015801,HC CYCLOSPORIN,166.06,124.54,1.99,149.45,119
CDM,3018015901,HC DRUG SCREEN QUANT CLOZAPINE,115.83,86.87,1.39,104.25,119
CDM,3018016101,"HC DRUG ASSAY CARBAMAZEPINE - 10,11 - EPOXIDE",186.66,140.0,2.24,167.99,119
CDM,3018016201,HC DIGOXIN; TOTAL,93.78,70.33,1.13,84.4,119
CDM,3018016401,HC VALPROIC ACID; TOTAL,95.62,71.72,1.15,86.06,119
CDM,3018016501,"HC VALPROIC ACID, FREE",323.21,242.41,3.88,290.89,119
CDM,3018016701,HC DRUG ASSAY FELBAMATE,81.69,61.27,0.98,73.52,119
CDM,3018016801,HC ETHOSUXIMIDE,75.55,56.66,0.91,68.0,119
CDM,3018016901,HC DRUG SCREEN QUANT EVEROLIMUS,582.59,436.94,6.99,524.33,119
CDM,3018017001,HC GENTAMICIN,114.65,85.99,1.38,103.18,119
CDM,3018017101,HC DRUG SCREEN QUANT GABAPENTIN,125.52,94.14,1.51,112.97,119
CDM,3018017301,HC HALOPERIDOL,80.19,60.14,0.96,72.17,119
CDM,3018017501,HC DRUG SCREEN QUAN LAMOTRIGINE,134.77,101.08,1.62,121.29,119
CDM,3018017601,HC LIDOCAIN LEVEL,166.1,124.58,1.99,149.49,119
CDM,3018017701,HC DRUG SCRN QUAN LEVETIRACETAM,341.82,256.36,4.1,307.64,119
CDM,3018017801,HC LITHIUM,77.48,58.11,0.93,69.73,119
CDM,3018017901,HC DRUG ASSAY SALICYLATE,125.4,94.05,1.5,112.86,119
CDM,3018018001,HC DRUG SCRN QUAN MYCOPHENOLATE,187.84,140.88,2.25,169.06,119
CDM,3018018101,HC DRUG ASSAY FLECAINIDE,127.03,95.27,1.52,114.33,119
CDM,3018018301,HC DRUG SCRN QUANT OXCARBAZEPIN,152.49,114.37,1.83,137.24,119
CDM,3018018401,HC PHENOBARBITAL,107.42,80.56,1.29,96.68,119
CDM,3018018501,HC PHENYTOIN TOTAL,83.56,62.67,1.0,75.2,119
CDM,3018018601,HC PHENYTOIN (DILANTIN) FREE,137.71,103.28,1.65,123.94,119
CDM,3018018701,HC POSACONAZOLE,162.99,122.24,1.96,146.69,119
CDM,3018018801,HC PRIMIDONE,54.01,40.51,0.65,48.61,119
CDM,3018018901,HC DRUG ASSAY ITRACONAZOLE,120.84,90.63,1.45,108.76,119
CDM,3018019201,HC PROCAINAMIDE W/METABOLITES,116.67,87.5,1.4,105.0,119
CDM,3018019301,HC LEFLUNOMIDE,309.46,232.1,3.71,278.51,119
CDM,3018019401,HC QUINIDINE,95.36,71.52,1.14,85.82,119
CDM,3018019501,HC SIROLIMUS,273.08,204.81,3.28,245.77,119
CDM,3018019701,HC TACROLIMUS,137.06,102.8,1.64,123.35,119
CDM,3018019801,HC THEOPHYLLINE,99.55,74.66,1.19,89.6,119
CDM,3018020001,HC TOBRAMYCIN,112.92,84.69,1.36,101.63,119
CDM,3018020101,HC TOPIRAMATE LEVEL-RL,241.02,180.76,2.89,216.92,119
CDM,3018020201,HC VANCOMYCIN,95.62,71.72,1.15,86.06,119
CDM,3018020301,HC DRUG SCREEN QUANT ZONISAMIDE,343.96,257.97,4.13,309.56,119
CDM,3018020401,HC DRUG ASSAY  METHOTREXATE,273.76,205.32,3.29,246.38,119
CDM,3018023001,HC DRUG ASSAY INFLIXIMAB,737.26,552.95,8.85,663.53,119
CDM,3018023501,HC LACOSAMIDE,391.57,293.68,4.7,352.41,119
CDM,3018028001,HC DRUG ASSAY VEDLIZUMAB,402.4,301.8,4.83,362.16,119
CDM,3018028501,HC VORICONAZOLE,73.41,55.06,0.88,66.07,119
CDM,3018029957,"HC QUANTITATION OF DRUG, NES",444.18,333.14,5.33,399.76,119
CDM,3018029959,HC THIOPURINE METABOLITES,342.99,257.24,4.12,308.69,119
CDM,3018029963,"HC VORICONAZOLE, SERUM",445.3,333.98,5.34,400.77,119
CDM,3018029965,HC CORTISOL DEXAMETHASONE SUPPRESSION TEST,187.33,140.5,2.25,168.6,119
CDM,3018030601,"HC DRUG SCREEN PRESMPTV,ANY NO. INSTR ASSIST DIR OPT",684.02,513.02,8.21,615.62,119
CDM,3018030741,"HC DRUG SCREEN PRESMPTV,ANY NO. BY INSTR CHEM ANAL",637.3,477.98,7.65,573.57,119
CDM,3018030742,HC PAIN MANAGEMENT PANEL W/REFLEX TO QUANTITATION,199.56,149.67,2.39,179.6,119
CDM,3018032001,HC DRUG SCREEN QUANT ALCOHOLS,65.73,49.3,0.79,59.16,119
CDM,3018032101,HC ALCOHOL BIOMARKERS; 1 OR 2,155.26,116.44,1.86,139.73,119
CDM,3018032301,HC ASSAY OF NICOTINE (ALKALOIDS NOS),436.97,327.73,5.24,393.27,119
CDM,3018032401,HC AMPHETAMINES; 1 OR 2,1188.08,891.06,14.26,1069.27,119
CDM,3018032501,HC AMPHETAMINES 3 OR 4,32.01,24.01,0.38,28.81,119
CDM,3018032601,HC AMPHETAMINES; 5 OR MORE,225.47,169.1,2.71,202.92,119
CDM,3018032801,HC ANABOLIC STEROID 3 OR MORE,640.33,480.25,7.68,576.3,119
CDM,3018032901,"HC ANALGESICS, NON-OPIOD; 1 OR 2",103.94,77.96,1.25,93.55,119
CDM,3018033101,HC ANALGESICS NON-OPIOID 6/MORE,168.74,126.56,2.02,151.87,119
CDM,3018033201,HC ANTIDEPRESSANTS CLASS 1 OR 2; QUAL,143.51,107.63,1.72,129.16,119
CDM,3018033501,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS; 1 OR 2,234.0,175.5,2.81,210.6,119
CDM,3018033701,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS; 6 OR MORE,75.3,56.48,0.9,67.77,119
CDM,3018033841,HC ANTIDEPRESSANT NOT SPECIFIED; NON CHROMO,327.94,245.96,3.94,295.15,119
CDM,3018033842,HC TRAZADONE,49.28,36.96,0.59,44.35,119
CDM,3018033941,"HC ANTIEPILEPTICS, NOS  1-3",204.37,153.28,2.45,183.93,119
CDM,3018034201,HC ANTIPSYCHOTICS NOS 1-3,333.38,250.04,4.0,300.04,119
CDM,3018034501,HC BARBITURATES,224.81,168.61,2.7,202.33,119
CDM,3018034601,HC BENZODIAZEPINES; 1-12,503.68,377.76,6.04,453.31,119
CDM,3018034701,HC BENZODIAZEPINES;  13 OR MORE,226.01,169.51,2.71,203.41,119
CDM,3018034801,HC DRUG SCREENING BUPRENORPHINE,225.47,169.1,2.71,202.92,119
CDM,3018034901,"HC CANNABINOIDS, NATURAL",225.47,169.1,2.71,202.92,119
CDM,3018035201,HC CANNABINOID SYNTHETIC 7/MORE,567.96,425.97,6.82,511.16,119
CDM,3018035301,HC COCAINE,225.22,168.92,2.7,202.7,119
CDM,3018035401,HC DRUG SCREENING FENTANYL,224.87,168.65,2.7,202.38,119
CDM,3018035501,HC GABAPENTIN NON-BLOOD,48.44,36.33,0.58,43.6,119
CDM,3018035601,HC DRUG SCREENING HEROIN METABOLITE,309.82,232.36,3.72,278.84,119
CDM,3018035701,HC KETAMINE AND NORKETAMINE,715.45,536.59,8.59,643.91,119
CDM,3018035801,HC METHADONE,226.93,170.2,2.72,204.24,119
CDM,3018035901,HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES,309.82,232.36,3.72,278.84,119
CDM,3018036001,HC  DRUG SCREENING METHYLPHENIDATE,309.82,232.36,3.72,278.84,119
CDM,3018036101,"HC OPIATES, 1 OR MORE",226.01,169.51,2.71,203.41,119
CDM,3018036201,HC OPIOIDS AND OPIATE ANALOGS; 1 OR 2,273.47,205.1,3.28,246.12,119
CDM,3018036401,HC OPIOIDS AND OPIATE ANALOGS; 5 OR MORE,48.44,36.33,0.58,43.6,119
CDM,3018036501,HC DRUG SCREENING OXYCODONE,232.74,174.56,2.79,209.47,119
CDM,3018036601,HC DRUG SCREENING PREGABALIN,1474.84,1106.13,17.7,1327.36,119
CDM,3018036801,HC SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES),309.82,232.36,3.72,278.84,119
CDM,3018037201,HC DRUG SCREENING TAPENTADOL,309.82,232.36,3.72,278.84,119
CDM,3018037301,HC DRUG SCREENING TRAMADOL,85.55,64.16,1.03,77.0,119
CDM,3018037501,HC DRUG/SUBSTANCE NOS 1-3;QUAL,2195.91,1646.93,26.35,1976.32,119
CDM,3018037741,"HC DEFINITIVE DRUG OR SUBSTANCE, QUAL OR QUAN; NOS",521.37,391.03,6.26,469.23,119
CDM,3018040001,HC ACTH STIM ADRENAL INSUFF,242.55,181.91,2.91,218.3,119
CDM,3018126501,HC CHIMERISM DNR/RECP,942.78,707.08,11.31,848.5,119
CDM,3018126801,HC CHIMERISM POST SORTED,1029.36,772.02,12.35,926.42,119
CDM,3018138342,HC NACROLEPSY GENOTYPE,2020.51,1515.38,24.25,1818.46,119
CDM,3018140141,HC MLHA METHYLATION,2279.31,1709.48,27.35,2051.38,119
CDM,3018200901,HC ACETONE SERUM,110.01,82.51,1.32,99.01,119
CDM,3018201001,HC QUANT SERUM ACETONES/KETONES,147.19,110.39,1.77,132.47,119
CDM,3018201701,HC ACYLCARNITINE PROFILE-RL,838.05,628.54,10.06,754.24,119
CDM,3018202401,HC ACTH HORMONE,142.87,107.15,1.71,128.58,119
CDM,3018204001,HC ALBUMIN SERUM,61.03,45.77,0.73,54.93,119
CDM,3018204201,"HC ALBUMIN; QUANTITATIVE OTHER SOURCE, EA SPECIMEN",61.03,45.77,0.73,54.93,119
CDM,3018204301,"HC MICROALBUMIN, URINE, QUANT",61.01,45.76,0.73,54.91,119
CDM,3018208501,HC ALDOLASE,45.56,34.17,0.55,41.0,119
CDM,3018208801,HC ALDOSTERONE; SERUM,141.57,106.18,1.7,127.41,119
CDM,3018210401,HC ALPHA 1 ANTITRYPSIN PHENOTYPE,144.55,108.41,1.73,130.1,119
CDM,3018210501,HC ALPHA-FETOPROTEIN; SERUM,102.18,76.64,1.23,91.96,119
CDM,3018210601,HC ALPHA FETOPROTEIN; AMNIOTIC FLUID,86.68,65.01,1.04,78.01,119
CDM,3018210801,HC ALUMINUM BLOOD,77.67,58.25,0.93,69.9,119
CDM,3018213501,HC AMNIOLEVULINIC ACID DELTA URINE,223.75,167.81,2.68,201.38,119
CDM,3018213901,HC AMINO ACIDS PLASMA QUANT,789.86,592.4,9.48,710.87,119
CDM,3018214001,HC AMMONIA,102.45,76.84,1.23,92.2,119
CDM,3018215001,HC AMYLASE,63.32,47.49,0.76,56.99,119
CDM,3018215701,HC ANDROSTENEDIONE LEVEL-RL,218.2,163.65,2.62,196.38,119
CDM,3018216401,HC ANGIOTENSIN CONVERTING ENZYME,103.91,77.93,1.25,93.52,119
CDM,3018216601,HC ASSAY ANTI-MULLERIAN HORM,831.99,623.99,9.98,748.79,119
CDM,3018217201,HC APOLIPOPROTEIN EACH,96.51,72.38,1.16,86.86,119
CDM,3018217501,HC ARSENIC,95.03,71.27,1.14,85.53,119
CDM,3018223201,HC BETA 2 MICROGLOBULIN,76.98,57.74,0.92,69.28,119
CDM,3018223901,HC BILE ACIDS LEVEL TOTAL,86.85,65.14,1.04,78.16,119
CDM,3018224701,HC BILIRUBIN TOTAL,61.03,45.77,0.73,54.93,119
CDM,3018224801,HC BILIRUBIN DIRECT,61.03,45.77,0.73,54.93,119
CDM,3018226101,HC BIOTINIDASE LEVEL-RL,130.97,98.23,1.57,117.87,119
CDM,3018227001,HC OCCULT BLOOD SCREENING,88.8,66.6,1.07,79.92,119
CDM,3018227101,HC GASTROCULT,99.68,74.76,1.2,89.71,119
CDM,3018227201,HC OCCULT BLD FECES 1-3 TESTS,79.85,59.89,0.96,71.86,119
CDM,3018227219,HC OCCULT BLD FECES 1-3 TESTS POC,79.85,59.89,0.96,71.86,119
CDM,3018230001,HC CADMIUM,99.96,74.97,1.2,89.96,119
CDM,3018230601,HC VITAMIN D 25 HYDROXY,195.28,146.46,2.34,175.75,119
CDM,3018230801,HC CALCITONIN,166.0,124.5,1.99,149.4,119
CDM,3018231001,HC CALCIUM; TOTAL,60.95,45.71,0.73,54.86,119
CDM,3018233001,HC CALCIUM IONIZED,117.38,88.04,1.41,105.64,119
CDM,3018233019,HC CALCIUM IONIZED POC,230.05,172.54,2.76,207.04,119
CDM,3018234001,HC CALCIUM; URINE QUAN TIMED,60.95,45.71,0.73,54.86,119
CDM,3018236501,HC KIDNEY STONE ANALYSIS,184.76,138.57,2.22,166.28,119
CDM,3018237301,HC CARBOHYDRATE DEFICIENT TRANSFERRIN,579.0,434.25,6.95,521.1,119
CDM,3018237401,HC CARBON DIOXIDE,60.95,45.71,0.73,54.86,119
CDM,3018237419,INACTIVE HC CARBON DIOXIDE POC,127.88,95.91,1.53,115.09,119
CDM,3018237501,HC CARBON MONOXIDE,286.87,215.15,3.44,258.18,119
CDM,3018237801,HC CARCINOEMBRONIC ANTIGEN (CEA),131.95,98.96,1.58,118.76,119
CDM,3018237901,HC CARNITENE FREE & TOTAL,524.17,393.13,6.29,471.75,119
CDM,3018238001,HC CAROTENE,86.92,65.19,1.04,78.23,119
CDM,3018238401,HC UR CATECHOLAMINES FRACTIONAL,204.38,153.28,2.45,183.94,119
CDM,3018239001,HC CERULOPLASMIN,76.74,57.56,0.92,69.07,119
CDM,3018239701,HC PTH RELATED PEPTIDE,130.53,97.9,1.57,117.48,119
CDM,3018243501,HC CHLORIDE; BLOOD,60.95,45.71,0.73,54.86,119
CDM,3018243601,HC CHLORIDE; URINE,60.95,45.71,0.73,54.86,119
CDM,3018243801,HC CHLORIDE SWEAT TEST,204.9,153.68,2.46,184.41,119
CDM,3018244101,HC CHLORINATED HC SCREEN,669.34,502.0,8.03,602.41,119
CDM,3018246501,HC CHOLESTEROL,60.95,45.71,0.73,54.86,119
CDM,3018248001,HC CHOLINESTERASE SERUM,105.09,78.82,1.26,94.58,119
CDM,3018248201,HC CHOLINESTERASE RBC,102.45,76.84,1.23,92.2,119
CDM,3018249501,HC CHROMIUM,96.59,72.44,1.16,86.93,119
CDM,3018250701,HC CITRIC ACID 24 HR URINE,104.47,78.35,1.25,94.02,119
CDM,3018252301,HC COLLAGEN CROSS LINKS,183.83,137.87,2.21,165.45,119
CDM,3018252501,HC QUANTITATIVE COPPER ASSAY,91.68,68.76,1.1,82.51,119
CDM,3018253001,HC CORTISOL FREE,114.32,85.74,1.37,102.89,119
CDM,3018253301,HC CORTISOL TOTAL,114.12,85.59,1.37,102.71,119
CDM,3018254001,HC ASSAY OF CREATINE,467.29,350.47,5.61,420.56,119
CDM,3018254201,HC COLUMN CHROMATOGRAPHY/MASS SPECT (SS/MP) QN  EA SPECIMEN,465.03,348.77,5.58,418.53,119
CDM,3018255001,HC CPK CREATINE PHOSPHOKINASE,61.03,45.77,0.73,54.93,119
CDM,3018255201,HC CPK ELECTROPHORESIS -RL,103.23,77.42,1.24,92.91,119
CDM,3018255301,HC CK MB FRACTION,82.11,61.58,0.99,73.9,119
CDM,3018256501,HC CREATININE BLOOD,63.02,47.26,0.76,56.72,119
CDM,3018256519,HC CREATININE BLOOD POCL/POCBS,410.39,307.79,4.92,369.35,119
CDM,3018257001,HC CREATININE; OTHER SOURCE,62.99,47.24,0.76,56.69,119
CDM,3018257501,HC CREATININE CLEARANCE,232.55,174.41,2.79,209.3,119
CDM,3018258501,HC CRYOFIBRINOGEN,55.74,41.8,0.67,50.17,119
CDM,3018259501,HC CRYOGLOBULIN,90.7,68.03,1.09,81.63,119
CDM,3018260001,HC CYANIDE,219.07,164.3,2.63,197.16,119
CDM,3018260701,HC VITAMIN B-12,105.98,79.48,1.27,95.38,119
CDM,3018261001,HC CYSTATIN C,124.62,93.46,1.5,112.16,119
CDM,3018262601,HC DEHYDROEPIANDROSTERONE (DHEA),221.93,166.45,2.66,199.74,119
CDM,3018263301,HC DESOXYCORTICOSTERONE 11,1253.41,940.06,15.04,1128.07,119
CDM,3018263401,HC DEOXYCORTISOL 11,188.85,141.64,2.27,169.96,119
CDM,3018264201,HC DIHYDROTESTOSTERONE (DHT),84.65,63.49,1.02,76.18,119
CDM,3018265201,HC VITAMIN D 1 25 INCLDNG FRACTN,164.95,123.71,1.98,148.45,119
CDM,3018265301,HC ELASTASE PANCREATIC FECAL QUANTITATIVE,492.35,369.26,5.91,443.12,119
CDM,3018265741,HC ENZYME ACTIVITY; NOT RA EA SPEC,154.87,116.15,1.86,139.38,119
CDM,3018265742,HC PORPHOBILINOGEN DEA RBC,340.42,255.32,4.09,306.38,119
CDM,3018265743,"HC ALPHA GALACTOSIDASE, SERUM",60.03,45.02,0.72,54.03,119
CDM,3018266401,HC ELECTROPHORE TEST,166.51,124.88,2.0,149.86,119
CDM,3018266801,HC ERYTHROPOIETIN,166.0,124.5,1.99,149.4,119
CDM,3018267001,HC ESTRADIOL,192.43,144.32,2.31,173.19,119
CDM,3018267101,HC ESTROGENS FRACTIONATED,182.75,137.06,2.19,164.48,119
CDM,3018267701,HC ESTERIOL,115.61,86.71,1.39,104.05,119
CDM,3018267901,HC ESTRONE,193.13,144.85,2.32,173.82,119
CDM,3018269301,HC ETHYLENE & PROPYLENE GLYCOL,177.44,133.08,2.13,159.7,119
CDM,3018270501,HC FAT/LIPIDS FECES; QUAL,100.29,75.22,1.2,90.26,119
CDM,3018271001,HC FAT FECES QUANTITATIVE,529.45,397.09,6.35,476.51,119
CDM,3018272501,HC FATTY ACIDS NONESTERIFIED,355.93,266.95,4.27,320.34,119
CDM,3018272601,HC FATTY ACIDS  VERY LONG CHAIN-RL,867.97,650.98,10.42,781.17,119
CDM,3018272801,HC FERRITIN,96.15,72.11,1.15,86.54,119
CDM,3018273101,HC FETAL FIBRONECTION CV SEMIQUAN,931.01,698.26,11.17,837.91,119
CDM,3018274601,HC FOLIC ACID; SERUM,103.35,77.51,1.24,93.02,119
CDM,3018274701,HC FOLIC ACID; RBC,96.29,72.22,1.16,86.66,119
CDM,3018277501,HC GALACTOSE 1 PHOSPH URIDYL TRANSFERASE RL,544.59,408.44,6.54,490.13,119
CDM,3018277701,HC GALECTIN 3,218.0,163.5,2.62,196.2,119
CDM,3018278441,HC IMMUNOGLOBULIN; EACH (A/D/G/M),66.36,49.77,0.8,59.72,119
CDM,3018278442,HC IMMUNOGLOBULIN A,66.36,49.77,0.8,59.72,119
CDM,3018278443,HC IMMUNOGLOBULIN D,66.36,49.77,0.8,59.72,119
CDM,3018278444,HC IMMUNOGLOBULIN G,66.36,49.77,0.8,59.72,119
CDM,3018278445,HC IMMUNOGLOBULIN M,66.36,49.77,0.8,59.72,119
CDM,3018278446,HC IGG CEREB SPINAL FLUID,66.36,49.77,0.8,59.72,119
CDM,3018278501,HC IMMUNOGLOBULIN E,118.44,88.83,1.42,106.6,119
CDM,3018278741,HC IMMUNOGLOBULIN G SUBCLASS 1,258.53,193.9,3.1,232.68,119
CDM,3018278742,HC IMMUNOGLOBULIN G SUBCLASS 2,258.53,193.9,3.1,232.68,119
CDM,3018278743,HC IMMUNOGLOBULIN G SUBCLASS 3,258.53,193.9,3.1,232.68,119
CDM,3018278744,HC IMMUNOGLOBULIN G SUBCLASS 4,258.53,193.9,3.1,232.68,119
CDM,3018278745,HC IMMUNOGLOBULIN IGG SUBCLASS; EACH (1-4),39.35,29.51,0.47,35.42,119
CDM,3018280001,HC BLOOD GAS PH ONLY,153.44,115.08,1.84,138.1,119
CDM,3018280019,HC BLOOD GAS PH ONLY POC,153.44,115.08,1.84,138.1,119
CDM,3018280301,HC BLOOD GASES ANY COMBINATION,482.66,362.0,5.79,434.39,119
CDM,3018280319,HC  BLOOD GASES WO 02 SAT POC,655.49,491.62,7.87,589.94,119
CDM,3018280501,HC BLOOD GASES W/02 SATURATION,431.54,323.65,5.18,388.39,119
CDM,3018280519,HC BLOOD GASES W/02 SATURATION POCL/POCBS,434.27,325.7,5.21,390.84,119
CDM,3018281001,HC OXYGEN SATURATION,197.89,148.42,2.37,178.1,119
CDM,3018281019,HC OXYGEN SATURATION POC,221.57,166.18,2.66,199.41,119
CDM,3018294101,HC GASTRIN,86.77,65.08,1.04,78.09,119
CDM,3018294301,HC GLUCAGON,115.74,86.8,1.39,104.17,119
CDM,3018294501,HC GLUCOSE; OTHER BODY FLUID,60.95,45.71,0.73,54.86,119
CDM,3018294701,HC GLUCOSE; QUAN BLOOD,60.95,45.71,0.73,54.86,119
CDM,3018294719,HC GLUCOSE; QUAN BLOOD POC,80.91,60.68,0.97,72.82,119
CDM,3018294819,HC GLUCOSE; BLOOD REAGENT STRIP POC,13.65,10.24,0.16,12.28,119
CDM,3018295001,HC GLUCOSE; POST GLUCOSE DOSE,60.95,45.71,0.73,54.86,119
CDM,3018295101,HC GLUCOSE TOLERANCE 3 SPEC,100.22,75.17,1.2,90.2,119
CDM,3018295201,HC GLUCOSE TOLERANCE EA ADDL,30.96,23.22,0.37,27.86,119
CDM,3018295501,HC G 6-PH DEHYDROGENASE,130.51,97.88,1.57,117.46,119
CDM,3018297701,HC GAMMA GLUTAMYL TRANSFERASE,61.03,45.77,0.73,54.93,119
CDM,3018298501,HC FRUCTOSAMINE -RL,73.13,54.85,0.88,65.82,119
CDM,3018300101,HC GONADOTROPIN FSH,129.45,97.09,1.55,116.5,119
CDM,3018300201,HC LEUTENIZINE HORMONE-LH,129.07,96.8,1.55,116.16,119
CDM,3018300301,HC GROWTH HORMONE HGH,101.1,75.82,1.21,90.99,119
CDM,3018301001,"HC HAPTOGLOBIN, QUANTITATIVE",89.07,66.8,1.07,80.16,119
CDM,3018301301,HC H PYLORI (C13) BREATH TEST,245.53,184.15,2.95,220.98,119
CDM,3018301401,HC H PYLORI DRUG ADMIN,36.65,27.49,0.44,32.98,119
CDM,3018301801,HC HEAVY METAL QUAN EACH NES,135.2,101.4,1.62,121.68,119
CDM,3018302001,HC HEMOGLOBIN ELECTROPHORESIS,78.45,58.84,0.94,70.6,119
CDM,3018302101,HC HGB CHROMATOGRAPHY,211.68,158.76,2.54,190.51,119
CDM,3018303301,HC HGB; FETAL QUAL,254.62,190.96,3.06,229.16,119
CDM,3018303601,HC HEMOGLOBIN A1C,78.83,59.12,0.95,70.95,119
CDM,3018305001,HC METHEMOGLOBIN,180.66,135.5,2.17,162.59,119
CDM,3018305101,HC HEMOGLOBIN PLASMA,94.07,70.55,1.13,84.66,119
CDM,3018306801,"HC UNSTABLE HEMOGLOBIN, B",164.5,123.38,1.97,148.05,119
CDM,3018307001,HC HEMOSIDERIN; QUAL,62.37,46.78,0.75,56.13,119
CDM,3018308801,HC HISTAMINE,174.82,131.12,2.1,157.34,119
CDM,3018309001,HC HOMOCYSTEINE,125.0,93.75,1.5,112.5,119
CDM,3018315001,HC HOMOVANILLIC ACID (HVA),119.58,89.68,1.43,107.62,119
CDM,3018349101,"HC HYDROXYCORTICOSTEROIDS, 17-OHCS",309.75,232.31,3.72,278.78,119
CDM,3018349701,HC 5-HIAA,117.51,88.13,1.41,105.76,119
CDM,3018349801,HC HYDROXYPROGESTERONE 17,133.83,100.37,1.61,120.45,119
CDM,3018351601,"HC CENTROMERE AB, IGG",86.58,64.94,1.04,77.92,119
CDM,3018351643,HC ACETYCHOL MODULATING AB,87.85,65.89,1.05,79.06,119
CDM,3018351645,HC ANTI NEURONAL ANTIBODY HU IMMU,39.35,29.51,0.47,35.42,119
CDM,3018351648,"HC GBM AB,IGG (MAFD)",57.12,42.84,0.69,51.41,119
CDM,3018351649,HC GLIADIN ANTIBODY IGA,22.61,16.96,0.27,20.35,119
CDM,3018351650,HC GLIADIN ANTIBODY IGG,95.63,71.72,1.15,86.07,119
CDM,3018351652,HC IMMUNOASSAY NONANTIBODY,145.27,108.95,1.74,130.74,119
CDM,3018351654,"HC IMMUNOASSAY NONANTIBODY - HSTNAB, CENTG, RPPAB, SMAB",152.65,114.49,1.83,137.39,119
CDM,3018351656,HC MYELOPEROXIDASE AB REFLEX,159.13,119.35,1.91,143.22,119
CDM,3018351657,HC SERINE PROTEASE 3 REFLEX,26.71,20.03,0.32,24.04,119
CDM,3018351658,HC TISSUE T'GLUTAMINASE AB,23.28,17.46,0.28,20.95,119
CDM,3018351901,HC RIA NONANTIBODY,244.9,183.68,2.94,220.41,119
CDM,3018352041,HC IMMUNOASSAY QUANT NOS NONAB,337.78,253.34,4.05,304.0,119
CDM,3018352042,HC 14-3-3 ANTIGEN DETECTION,104.78,78.58,1.26,94.3,119
CDM,3018352045,HC MANNOSE BINDING LECTIN,220.87,165.65,2.65,198.78,119
CDM,3018352046,"HC PANCREATIC ELASTASE, FECAL",677.08,507.81,8.12,609.37,119
CDM,3018352049,HC TRYPTASE,337.78,253.34,4.05,304.0,119
CDM,3018352050,HC TSH RECEPTOR AB,218.51,163.88,2.62,196.66,119
CDM,3018352053,HC INTERLEUKIN 2 RECPTOR,621.44,466.08,7.46,559.3,119
CDM,3018352501,HC INSULIN; TOTAL,81.33,61.0,0.98,73.2,119
CDM,3018352701,HC INSULIN LEVEL FREE,96.41,72.31,1.16,86.77,119
CDM,3018352901,HC ASSAY OF INTERLEUKIN-6 (IL-6),736.57,552.43,8.84,662.91,119
CDM,3018354001,HC IRON,61.16,45.87,0.73,55.04,119
CDM,3018355001,HC IRON BINDING CAPACITY,177.8,133.35,2.13,160.02,119
CDM,3018358601,"HC 17 KETOSTEROIDS, URINE, TOTAL",144.13,108.1,1.73,129.72,119
CDM,3018360501,HC LACTIC ACID,82.25,61.69,0.99,74.03,119
CDM,3018360519,HC LACTIC ACID POC,328.84,246.63,3.95,295.96,119
CDM,3018361501,HC LACTATE DEHYDROGENASE,61.03,45.77,0.73,54.93,119
CDM,3018362501,HC LDH ISOENZYMES,107.43,80.57,1.29,96.69,119
CDM,3018363001,HC LACTOFERRIN FECAL (QUAL),331.08,248.31,3.97,297.97,119
CDM,3018365501,HC LEAD,63.91,47.93,0.77,57.52,119
CDM,3018366401,HC LAMELLAR BODY DENSITY,90.86,68.14,1.09,81.77,119
CDM,3018367001,HC LEUCINE AMINOPEPTIDASE-RL,171.66,128.74,2.06,154.49,119
CDM,3018369001,HC LIPASE,63.32,47.49,0.76,56.99,119
CDM,3018369501,HC APOLIPOPROTEIN LEVEL RL,129.53,97.15,1.55,116.58,119
CDM,3018369801,HC ASSAY LIPOPROTEIN PLA2,154.5,115.88,1.85,139.05,119
CDM,3018370001,HC LIPOPROTEIN ELECTROPHORESIS,332.19,249.14,3.99,298.97,119
CDM,3018370101,HC LIPOPROTEIN BLD HR FRACTION,251.03,188.27,3.01,225.93,119
CDM,3018370401,HC LIPOPROTEIN BLD BY NMR,252.26,189.2,3.03,227.03,119
CDM,3018371801,HC HIGH DENSITY LIPOPROTEIN,63.19,47.39,0.76,56.87,119
CDM,3018373501,"HC MAGNESIUM, BLOOD",61.03,45.77,0.73,54.93,119
CDM,3018373541,"HC MAGNESIUM, BLOOD",61.03,45.77,0.73,54.93,119
CDM,3018373542,HC MAGNESIUM 24HR URINE,62.98,47.24,0.76,56.68,119
CDM,3018373543,HC MAGNESIUM URINE,62.98,47.24,0.76,56.68,119
CDM,3018378501,HC MANGANESE,103.75,77.81,1.25,93.38,119
CDM,3018378941,HC CORTISONE URINE RL,349.15,261.86,4.19,314.24,119
CDM,3018378942,HC HB VARIANT BY MASS SPEC,349.15,261.86,4.19,314.24,119
CDM,3018382501,HC MERCURY; QUANTITATIVE,72.88,54.66,0.87,65.59,119
CDM,3018383501,HC METANEPHRINES URINE,144.62,108.46,1.74,130.16,119
CDM,3018383541,HC METANEPHRINES PLASMA,479.99,359.99,5.76,431.99,119
CDM,3018386401,HC MUCOPOLYSACCH ACID; QUAN,1058.16,793.62,12.7,952.34,119
CDM,3018387301,HC MYELIN BASIC PROTEIN,102.12,76.59,1.23,91.91,119
CDM,3018387401,HC MYOGLOBIN,82.85,62.14,0.99,74.56,119
CDM,3018387601,HC MYELOPEROXIDASE MPO,159.13,119.35,1.91,143.22,119
CDM,3018388001,HC NATRIURETIC PEPTIDE,268.64,201.48,3.22,241.78,119
CDM,3018388341,HC NEPHELOMETRY EA ANALYTE NES,212.76,159.57,2.55,191.48,119
CDM,3018388342,HC KAPPA/LAMBDA RATIO SERUM,95.17,71.38,1.14,85.65,119
CDM,3018388501,HC NICKEL,57.65,43.24,0.69,51.88,119
CDM,3018391501,HC NUCLEOTIDASE 5 ASSAY,103.92,77.94,1.25,93.53,119
CDM,3018391601,HC CSF OLIGOCLONAL BANDS STUDY,208.51,156.38,2.5,187.66,119
CDM,3018391801,HC ORGANIC ACIDS URINE,605.44,454.08,7.27,544.9,119
CDM,3018392101,HC METHYLMALONIC ACID SERUM,556.61,417.46,6.68,500.95,119
CDM,3018393001,HC OSMOLALITY; BLOOD,75.31,56.48,0.9,67.78,119
CDM,3018393501,HC OSMOLALITY URINE,75.23,56.42,0.9,67.71,119
CDM,3018393701,HC OSTEOCALCIN,291.64,218.73,3.5,262.48,119
CDM,3018394501,HC OXALATE BLOOD OR URINE,102.51,76.88,1.23,92.26,119
CDM,3018395101,HC ONCOPROTEIN DCP,232.94,174.7,2.8,209.65,119
CDM,3018397001,HC PARATHORMONE; PTH,291.19,218.39,3.49,262.07,119
CDM,3018398601,HC PH; BODY FLUID,25.42,19.07,0.31,22.88,119
CDM,3018398619,HC PH; BODY FLUID (NITROZENE) POC,25.42,19.07,0.31,22.88,119
CDM,3018398641,HC PH; FECAL,9.69,7.27,0.12,8.72,119
CDM,3018399201,HC PHENCYCLIDINE (PCP),588.57,441.43,7.06,529.71,119
CDM,3018399301,HC ASSAY FOR CALPROTECTIN FECAL,300.08,225.06,3.6,270.07,119
CDM,3018403001,HC NEWBORN PHENYLETONURIA SCREEN,677.26,507.94,8.13,609.53,119
CDM,3018406001,HC ACID PHOSPHATASE,64.46,48.34,0.77,58.01,119
CDM,3018406601,HC PROSTATIC ACID PHOSPHATASE,91.46,68.6,1.1,82.31,119
CDM,3018407501,HC ALKALINE PHOSPHATASE SERUM,61.03,45.77,0.73,54.93,119
CDM,3018408001,HC ALKALINE PHOSPHATASE ISOENZYME,352.4,264.3,4.23,317.16,119
CDM,3018410001,HC PHOSPHORUS,61.03,45.77,0.73,54.93,119
CDM,3018410501,HC PHOSPHORUS; URINE,61.03,45.77,0.73,54.93,119
CDM,3018411001,HC PORPHOBILINOGEN  URINE QUANT,197.99,148.49,2.38,178.19,119
CDM,3018411201,HC PLACENTA ALPHA MICRO IG C/V,682.31,511.73,8.19,614.08,119
CDM,3018411219,HC PLACENTA ALPHA MICRO (AMNISURE) IG C/V POCL/POCBS,682.32,511.74,8.19,614.09,119
CDM,3018412001,HC QUAN URINE PORPHYRINS,188.2,141.15,2.26,169.38,119
CDM,3018412601,HC ASSAY OF FECES PORPHYRINS,380.47,285.35,4.57,342.42,119
CDM,3018413201,HC POTASSIUM; SERUM,60.95,45.71,0.73,54.86,119
CDM,3018413219,HC POTASSIUM; SERUM - POC,199.64,149.73,2.4,179.68,119
CDM,3018413301,HC POTASSIUM; URINE,94.02,70.52,1.13,84.62,119
CDM,3018413401,HC PREALBUMIN,102.58,76.94,1.23,92.32,119
CDM,3018414001,HC ASSAY OF PREGNENOLONE-RL,194.98,146.24,2.34,175.48,119
CDM,3018414301,HC HYDROXYPREGNENOLONE 17,10834.19,8125.64,130.01,9750.77,119
CDM,3018414401,HC PROGESTERONE,144.81,108.61,1.74,130.33,119
CDM,3018414501,HC PROCALCITONIN,183.09,137.32,2.2,164.78,119
CDM,3018414601,HC PROLACTIN,538.34,403.76,6.46,484.51,119
CDM,3018415001,HC PROSTAGLANDIN,637.22,477.92,7.65,573.5,119
CDM,3018415301,HC PROSTATIC SPECIFIC ANTIGEN TOTAL,128.14,96.1,1.54,115.33,119
CDM,3018415341,HC PROSTATE SPECIFIC ANTIGEN COMPLEX,128.14,96.1,1.54,115.33,119
CDM,3018415401,HC PROSTATE SPECIFIC ANTIGEN FREE,128.14,96.1,1.54,115.33,119
CDM,3018415501,HC PROTEIN TOTAL SERUM,61.03,45.77,0.73,54.93,119
CDM,3018415601,HC TOTAL PROTEIN; URINE,63.99,47.99,0.77,57.59,119
CDM,3018415701,HC TOTAL PROTEIN; OTHER BODY FLUID,63.99,47.99,0.77,57.59,119
CDM,3018416501,HC PROTEIN; EP FRACT & QUAN,161.88,121.41,1.94,145.69,119
CDM,3018416601,HC PROTEIN ELECTROPHORESIS; OTHER FLUID,227.97,170.98,2.74,205.17,119
CDM,3018418201,HC PROTEIN WB; IM ID FOR BANDS,253.11,189.83,3.04,227.8,119
CDM,3018420201,HC ZINC PROTOPORPHYRIN BLOOD,344.69,258.52,4.14,310.22,119
CDM,3018420601,HC PROINSULIN,194.16,145.62,2.33,174.74,119
CDM,3018420701,HC VITAMIN B6,118.36,88.77,1.42,106.52,119
CDM,3018421001,HC PYRUVIC ACID TEST,139.43,104.57,1.67,125.49,119
CDM,3018422001,HC ASSAY OF PYRUVATE KINASE,588.29,441.22,7.06,529.46,119
CDM,3018423301,HC ESTROGEN RECEPTOR ASSAY,237.94,178.46,2.86,214.15,119
CDM,3018423801,HC ASSAY NONENDOCRINE RECEPTOR,99.02,74.26,1.19,89.12,119
CDM,3018424401,HC RENIN,91.74,68.81,1.1,82.57,119
CDM,3018425201,HC ASSAY OF RIBOFLAVIN,101.61,76.21,1.22,91.45,119
CDM,3018425501,HC SELENIUM,95.23,71.42,1.14,85.71,119
CDM,3018426001,HC SEROTONIN SERUM,242.68,182.01,2.91,218.41,119
CDM,3018429501,HC SODIUM; SERUM,101.85,76.39,1.22,91.66,119
CDM,3018429519,HC SODIUM; SERUM - POC,212.32,159.24,2.55,191.09,119
CDM,3018430001,HC SODIUM URINE,101.85,76.39,1.22,91.66,119
CDM,3018430201,HC SODIUM OTHER SOURCE,101.85,76.39,1.22,91.66,119
CDM,3018430501,HC SOMATOMEDIN,95.61,71.71,1.15,86.05,119
CDM,3018430701,HC SOMATOSTATIN,1334.36,1000.77,16.01,1200.92,119
CDM,3018431141,"HC CHOLESTEROL,FLUID",149.2,111.9,1.79,134.28,119
CDM,3018431142,HC SPECTROPHOTOMETRY ANALYTE NES,111.52,83.64,1.34,100.37,119
CDM,3018431501,HC SPECIFIC GRAVITY BODY FLUID,56.89,42.67,0.68,51.2,119
CDM,3018437641,HC SUGARS SINGLE QUAL EA,47.72,35.79,0.57,42.95,119
CDM,3018437642,HC REDUCING SUBSTANCE STOOL,47.72,35.79,0.57,42.95,119
CDM,3018437801,"HC SUGARS, SINGLE QUANTITATIVE, EA SPECIMEN",31.22,23.42,0.37,28.1,119
CDM,3018439201,HC SULFATE; URINE,15.24,11.43,0.18,13.72,119
CDM,3018440201,HC TESTOSTERONE FREE,184.81,138.61,2.22,166.33,119
CDM,3018440301,HC TESTOSTERONE TOTAL,182.59,136.94,2.19,164.33,119
CDM,3018442501,HC THIAMINE VITAMIN B-1,136.95,102.71,1.64,123.26,119
CDM,3018443001,HC THIOCYANATE LEVEL,163.44,122.58,1.96,147.1,119
CDM,3018443101,HC THROMBOXANE URINE,95.07,71.3,1.14,85.56,119
CDM,3018443201,HC THYROGLOBULIN,54.33,40.75,0.65,48.9,119
CDM,3018443301,HC ASSAY THIOPURINE S-METHYLTRANSFERASE,559.38,419.54,6.71,503.44,119
CDM,3018443601,HC THYROXINE TOTAL T4,42.83,32.12,0.51,38.55,119
CDM,3018443701,HC THYROXINE T4 NEONATAL-RL,42.83,32.12,0.51,38.55,119
CDM,3018443901,HC FREE THYROXINE,65.2,48.9,0.78,58.68,119
CDM,3018444201,HC THYROXINE BINDING GLOBULIN,93.31,69.98,1.12,83.98,119
CDM,3018444341,HC THYROID STIMULATING HORMONE,117.52,88.14,1.41,105.77,119
CDM,3018444501,HC THYROID STIMULATING IMMUNOGLOB,443.1,332.32,5.32,398.79,119
CDM,3018444601,HC TOCOPHEROL ALPHA VITAMIN E,95.02,71.26,1.14,85.52,119
CDM,3018445001,HC TRANSAMINASE AST/SGOT,61.03,45.77,0.73,54.93,119
CDM,3018446001,HC TRANSAMINASE ALT/SGPT,61.03,45.77,0.73,54.93,119
CDM,3018446601,HC TRANSFERRIN LEVEL,90.38,67.78,1.08,81.34,119
CDM,3018447801,HC TRIGLYCERIDES,61.03,45.77,0.73,54.93,119
CDM,3018447901,HC THYROID HORMONE UPTAKE/BIND RATIO,45.03,33.77,0.54,40.53,119
CDM,3018448001,HC TRIIODOTHYRONINE TOTAL,99.81,74.86,1.2,89.83,119
CDM,3018448101,HC TRIIODOTHYRONINE T3 FREE,118.45,88.84,1.42,106.6,119
CDM,3018448201,HC T3; REVERSE,180.17,135.13,2.16,162.15,119
CDM,3018448401,HC TROPONIN QUANTITATIVE,194.18,145.64,2.33,174.76,119
CDM,3018448419,HC TROPONIN QUANTITATIVE POC,895.08,671.31,10.74,805.57,119
CDM,3018448801,HC TRYPSIN; FECES QUAL,83.59,62.69,1.0,75.23,119
CDM,3018451001,HC TYROSINE,485.53,364.15,5.83,436.98,119
CDM,3018452001,HC UREA NITROGEN QUANT,60.95,45.71,0.73,54.86,119
CDM,3018452019,HC UREA NITROGEN QUANT BLOOD POC,327.13,245.35,3.93,294.42,119
CDM,3018454001,HC UREA NITROGEN URINE,60.95,45.71,0.73,54.86,119
CDM,3018454501,HC UREA NITROGEN CLEARANCE,60.46,45.34,0.73,54.41,119
CDM,3018455001,HC URIC ACID BLOOD,61.03,45.77,0.73,54.93,119
CDM,3018456001,HC URIC ACID; OTHER SOURCE,61.03,45.77,0.73,54.93,119
CDM,3018458501,HC URINE VMA ACID,103.57,77.68,1.24,93.21,119
CDM,3018458601,HC VASOACTIVE INTESTINAL PEPTIDE,183.4,137.55,2.2,165.06,119
CDM,3018458801,HC VASOPRESSIN ANTIDURETIC HORM,202.11,151.58,2.43,181.9,119
CDM,3018459001,HC VITAMIN A;  RETINOL,91.17,68.38,1.09,82.05,119
CDM,3018459141,HC VITAMIN NOS,216.81,162.61,2.6,195.13,119
CDM,3018459701,HC VITAMIN K,355.46,266.6,4.27,319.91,119
CDM,3018460001,HC ASSAY OF VOLATILES (BLOOD),172.48,129.36,2.07,155.23,119
CDM,3018463001,HC ZINC,58.76,44.07,0.71,52.88,119
CDM,3018468101,HC C-PEPTIDE,81.82,61.36,0.98,73.64,119
CDM,3018470201,HC HUMAN CHORIONIC GONADOTROPIN QUANT,125.32,93.99,1.5,112.79,119
CDM,3018470219,"HC GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE POC",125.34,94.0,1.5,112.81,119
CDM,3018470301,HC PREGNANCY TEST QUALITATIVE,67.97,50.98,0.82,61.17,119
CDM,3018470319,HC PREGNANCY TEST QUALITATIVE POC,41.33,31.0,0.5,37.2,119
CDM,3018470401,HC HCG FREE BETACHAIN TEST,69.64,52.23,0.84,62.68,119
CDM,3018672301,HC LISTERIA AB,481.81,361.36,5.78,433.63,119
CDM,3018729981,"HC COM CON  INFECTIOUS AGENT AG, NOT SPEC",260.72,195.54,3.13,234.65,119
CDM,3018872019,HC BILIRUBIN TOTAL TRANSCUTANEOUS POC,65.78,49.34,0.79,59.2,119
CDM,301G010301,HC PROSTATE SPECIFIC ANTIGEN SCREEN,128.14,96.1,1.54,115.33,119
CDM,301G048001,"HC DRUG DEFINITIVE, EA PROCEDURE 1-7 DRUG CLASSES",133.93,100.45,1.61,120.54,119
CDM,301G048101,"HC DRUG DEFINITIVE, EA PROCEDURE 8-14 DRUG CLASSES",521.37,391.03,6.26,469.23,119
CDM,301G048201,"HC DRUG DEFINITIVE, EA PROCEDURE 15-21 DRUG CLASSES",267.07,200.3,3.2,240.36,119
CDM,301G048301,"HC DRUG TESTS, DEFINITIVE 22 OR MORE DRUG CLASSES",323.82,242.86,3.89,291.44,119
CDM,30264,CITALOPRAM 10 MG TABLET,0.34,0.25,0.01,0.31,119
CDM,3028137201,HC HLA 1 TYPING LOW RES COMPLETE,804.0,603.0,9.65,723.6,119
CDM,3028137901,HC HLA 1 TYPING HIGH RES COMPLETE,5429.82,4072.36,65.16,4886.84,119
CDM,3028600041,HC AGGLUTININS FEBRILE EACH ANTIGEN,107.69,80.77,1.29,96.92,119
CDM,3028600101,HC ALLERG SP IGG QUAN OR SEMIQUAN,149.1,111.82,1.79,134.19,119
CDM,3028600301,"HC ALLERGEN SPECIFIC IGE, EACH ALLERGEN",36.57,27.43,0.44,32.91,119
CDM,3028600501,HC QUALITATIVE MULTIALLERGEN SCREEN,76.98,57.74,0.92,69.28,119
CDM,3028600801,HC QUALITATIVE OR SEMIQUANITATIVE IMMUNOASSAY,97.98,73.48,1.18,88.18,119
CDM,3028601501,HC ACTIN SMOOTH MUSCLE ANTIBODY EACH,59.1,44.32,0.71,53.19,119
CDM,3028602101,HC ANTIBODY ID; LEUKOCYTE AB,437.98,328.48,5.26,394.18,119
CDM,3028602201,HC ANTIBODY ID; PLATELET ANTIBODIES,2816.54,2112.41,33.8,2534.89,119
CDM,3028602301,HC AB ID; PLATELET IG ASSAY (G/M),209.22,156.92,2.51,188.3,119
CDM,3028603601,HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,118.18,88.64,1.42,106.36,119
CDM,3028603701,HC COM CON NEUTROPHIL CYTOPLASM AB SCREEN,118.18,88.64,1.42,106.36,119
CDM,3028603801,HC ANTI-NUCLEAR ANTIBODIES,48.91,36.68,0.59,44.02,119
CDM,3028603901,HC ANA TITER,97.46,73.1,1.17,87.71,119
CDM,3028604101,HC ACETYLCHOLN RCPTR BNDNG ANTB,287.88,215.91,3.45,259.09,119
CDM,3028604201,HC ACETYLCHOLN RCPTR BLCKG ANTB,521.57,391.18,6.26,469.41,119
CDM,3028604301,HC ACETYLCHOLN RCPTR MODLG ANTB,622.05,466.54,7.46,559.84,119
CDM,3028605101,HC AQUAPORIN-4 ANTIBODY ELISA,1477.07,1107.8,17.72,1329.36,119
CDM,3028605301,HC AQAPRN-4 ANTB FLO CYTMTRY EA,957.58,718.18,11.49,861.82,119
CDM,3028606001,HC ANTISTREPTOLYSIN O TITER,191.82,143.86,2.3,172.64,119
CDM,3028614001,HC C-REACTIVE PROTEIN,63.32,47.49,0.76,56.99,119
CDM,3028614101,HC CRP-HIGH SENSITIVITY,91.56,68.67,1.1,82.4,119
CDM,3028614601,"HC BETA 2 GLYCOPROTEIN 1 ANTIBODY, EA (A/G/M)",133.18,99.88,1.6,119.86,119
CDM,3028614741,HC ANTICARDIOLIPIN IGG,86.89,65.17,1.04,78.2,119
CDM,3028614742,HC ANTICARDIOLIPIN IGM,86.89,65.17,1.04,78.2,119
CDM,3028614743,HC CARDIOLIPIN AB; EA IG CLASS (A/G/M),86.89,65.17,1.04,78.2,119
CDM,3028614801,HC ANTI-PHOSPHOLIPID ANTIBODIES,125.84,94.38,1.51,113.26,119
CDM,3028615701,HC COLD AGGLUTININS TITER,58.21,43.66,0.7,52.39,119
CDM,3028616041,HC COMPLEMENT ANTIGEN; EACH COMPONENT,85.13,63.85,1.02,76.62,119
CDM,3028616042,HC COMPLEMENT C3,85.13,63.85,1.02,76.62,119
CDM,3028616043,HC COMPLEMENT C4,85.13,63.85,1.02,76.62,119
CDM,3028616101,HC C1 ESTERASE INHIBITOR,188.56,141.42,2.26,169.7,119
CDM,3028616201,HC COMPLEMENT TOTAL,67.02,50.26,0.8,60.32,119
CDM,3028620001,HC CITRULLINATED PEPTIDE IGGCCP ANTIBODY,96.03,72.02,1.15,86.43,119
CDM,3028621501,HC DNASE B ANTIBODY,69.96,52.47,0.84,62.96,119
CDM,3028622501,HC DSDNA AB IGG,60.29,45.22,0.72,54.26,119
CDM,3028622601,HC ANTI SINGLE-STRANDED DNA,131.4,98.55,1.58,118.26,119
CDM,3028623101,HC ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS,231.82,173.86,2.78,208.64,119
CDM,3028623541,HC ANTIBODIES TO NUCLEAR ANTIGENS,84.99,63.74,1.02,76.49,119
CDM,3028623543,"HC ENA, ANY METHOD, EACH ANTIBODY",84.99,63.74,1.02,76.49,119
CDM,3028623545,HC JO-1 ANTIBODY IGG,150.57,112.93,1.81,135.51,119
CDM,3028623547,HC SCLERODERMA (SCL-70) (ENA) AB,416.05,312.04,4.99,374.44,119
CDM,3028623548,HC SMITH (ENA) ANTIBODY,24.26,18.2,0.29,21.83,119
CDM,3028623549,HC SSA (RO) (ENA) AB IGG,19.42,14.56,0.23,17.48,119
CDM,3028623550,HC SSB (LA) (ENA) AB IGG,142.32,106.74,1.71,128.09,119
CDM,3028625542,HC ANTI-NEURONAL CELL ANTIBODY,699.4,524.55,8.39,629.46,119
CDM,3028625544,HC ANTI-SMOOTH MUSCLE ANTIBODY,426.5,319.88,5.12,383.85,119
CDM,3028625545,HC FLUORESCENT AB; SCRN EA AB,379.11,284.33,4.55,341.2,119
CDM,3028625546,HC GBM ANTIBODY IGG,170.45,127.84,2.05,153.4,119
CDM,3028625549,"HC MYELIN OLIGODENDROCYTE GLYCOPROTEIN FLUORESCENCE-ACTIVATED CELL SORTING ASSAY, SERUM",426.5,319.88,5.12,383.85,119
CDM,3028625550,HC NEURONAL NUCLEAR ABS (HU & RI),699.4,524.55,8.39,629.46,119
CDM,3028625556,HC LRP4 AUTOANTIBODY,426.5,319.88,5.12,383.85,119
CDM,3028625641,HC ANTI RETICULIN AB TITER FLUORESCENT,255.78,191.84,3.07,230.2,119
CDM,3028625642,HC ANNA TITER,217.07,162.8,2.6,195.36,119
CDM,3028625643,"HC ENDOMYSIAL AB,IGA TITER",287.75,215.81,3.45,258.98,119
CDM,3028625644,HC FLUORESCENT AB; TITER EA AB,410.83,308.12,4.93,369.75,119
CDM,3028625645,"HC NEUTROPHIL CYTOPLASMIC AB, IGG",32.63,24.47,0.39,29.37,119
CDM,3028625646,HC STRIATED MUSCLE IGG TITER BILL,332.65,249.49,3.99,299.38,119
CDM,3028625801,HC GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS,95.63,71.72,1.15,86.07,119
CDM,3028630001,HC CANCER ANTIGEN 15-3 (27.29),96.54,72.4,1.16,86.89,119
CDM,3028630101,HC CANCER ANTIGEN 19-9,115.82,86.86,1.39,104.24,119
CDM,3028630401,HC CANCER ANTIGEN 125,144.43,108.32,1.73,129.99,119
CDM,3028630801,HC HETEROPHILE SCREEN,66.38,49.78,0.8,59.74,119
CDM,3028631601,HC IMMASY TUMOR AG QUAN,231.32,173.49,2.78,208.19,119
CDM,3028631741,HC IA INFECTIOUS AGENT AB QUAN NOS,71.03,53.27,0.85,63.93,119
CDM,3028631742,"HC PNEUMOCOCCAL, IGG",79.91,59.93,0.96,71.92,119
CDM,3028631752,HC S.PNEUMONIAE ANTIBODIES IGG SEROTYPE 9V,71.03,53.27,0.85,63.93,119
CDM,3028633101,"HC IMMUNODIFFUSION; GEL QUAL, EA AB/AG",39.54,29.66,0.47,35.59,119
CDM,3028633201,HC IMMUNE COMPLEX ASSAY,124.72,93.54,1.5,112.25,119
CDM,3028633441,HC IMMUNOGLOBULIN REFLEX,252.78,189.58,3.03,227.5,119
CDM,3028633442,HC IMMUNOFIXATION ELECTROPHORESIS SERUM,252.78,189.58,3.03,227.5,119
CDM,3028633501,HC BENCE JONES PROT ELEC URINE,287.63,215.72,3.45,258.87,119
CDM,3028633601,HC INHIBIN A ANTIBODY SCREEN-RL,118.17,88.63,1.42,106.35,119
CDM,3028633701,HC ANTI INSULIN ANTIBODIES-RL,271.68,203.76,3.26,244.51,119
CDM,3028634001,HC INTRINSIC FACTOR BLOCKING AB,156.36,117.27,1.88,140.72,119
CDM,3028634101,HC ISLET CELL ANTIBODY-RL,174.89,131.17,2.1,157.4,119
CDM,3028635201,HC CELL FUNCTION ASSAY W/STIM,1333.13,999.85,16.0,1199.82,119
CDM,3028635301,HC LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,595.62,446.72,7.15,536.06,119
CDM,3028635501,HC B CELLS TOTAL COUNT,496.2,372.15,5.95,446.58,119
CDM,3028635641,HC ACTIVATED T IMMUNE STATUS  RL,992.43,744.32,11.91,893.19,119
CDM,3028635642,"HC CD2 IMMUNE STATUS, RL",376.03,282.02,4.51,338.43,119
CDM,3028635643,HC MONONUCLEAR CELL ANTIGEN QUANT NOS EA,376.03,282.02,4.51,338.43,119
CDM,3028635701,HC CD56 (NK CELLS) TOTAL COUNT RL,454.89,341.17,5.46,409.4,119
CDM,3028635901,HC TOTAL T CELL COUNT,454.89,341.17,5.46,409.4,119
CDM,3028636001,HC CD4/CD8 ABSOLUTE AND RATIO,551.68,413.76,6.62,496.51,119
CDM,3028636101,HC T CELLS CD4 COUNT,916.84,687.63,11.0,825.16,119
CDM,3028636201,HC MOG-IGG1 AB CELL-BASED IMFLUOR ASSAY EA,353.16,264.87,4.24,317.84,119
CDM,3028636301,HC MOG-IGG1 ANTB FLO CYTMTRY EA,507.26,380.44,6.09,456.53,119
CDM,3028636401,HC TISS TRNSGLMNASE EA IG CLAS,59.1,44.32,0.71,53.19,119
CDM,3028636601,HC MUSCLE-SPECIFIC KINASE ANTB,4256.27,3192.2,51.08,3830.64,119
CDM,3028637641,HC THYROID PEROXIDASE ANTIBODY,91.04,68.28,1.09,81.94,119
CDM,3028637642,HC LIVER KIDNEY MICROSOMAL ANTIBO,91.04,68.28,1.09,81.94,119
CDM,3028638101,HC MITOCHONDRIAL ANTIBODY EACH,114.62,85.96,1.38,103.16,119
CDM,3028640341,HC BACTERIAL ANTIGEN,297.86,223.4,3.57,268.07,119
CDM,3028643001,HC RHEUMATOID FACTOR QAUL,217.28,162.96,2.61,195.55,119
CDM,3028643101,HC RHEUMATOID FACTOR QUANT,101.54,76.16,1.22,91.39,119
CDM,3028648001,"HC TB TEST, CELL IMMUN MEASURE RL",181.91,136.43,2.18,163.72,119
CDM,3028648101,"HC TB, AG RESPONSE T-CELL SUSP",266.68,200.01,3.2,240.01,119
CDM,3028648519,HC SKIN TEST CANDIDA POC,281.23,210.92,3.37,253.11,119
CDM,3028658019,HC SKIN TEST TUBERCULOSIS POC,139.98,104.98,1.68,125.98,119
CDM,3028659241,HC SYPHILLIS NON-TREPONEMAL,57.25,42.94,0.69,51.52,119
CDM,3028659242,"HC RPR REFLEX TO TITER, FTA & TPPA",57.25,42.94,0.69,51.52,119
CDM,3028659243,HC VDRL  SPINAL FLUID QUAL,37.78,28.34,0.45,34.0,119
CDM,3028659341,HC SYPHILIS TEST NON-TREP QUANT,128.16,96.12,1.54,115.34,119
CDM,3028659342,HC RPR TITER BILL,128.16,96.12,1.54,115.34,119
CDM,3028659343,"HC VDRL TITER, SPINAL FLUID",128.16,96.12,1.54,115.34,119
CDM,3028659601,HC VOLTAGE-GTD CA CHNL ANTB EA,1564.13,1173.1,18.77,1407.72,119
CDM,3028660301,HC ADENOVIRUS ANTIBODY,66.79,50.09,0.8,60.11,119
CDM,3028660601,HC ASPERGILLUS ANTIBODY,77.04,57.78,0.92,69.34,119
CDM,3028660941,HC ANTIBODY BACTERIUM NO ELSEWHERE SPECIFIED,276.28,207.21,3.32,248.65,119
CDM,3028661141,"HC ANTIBODY; BARTONELLA, EACH (A/G/M)",76.08,57.06,0.91,68.47,119
CDM,3028661142,HC BARTONELL QUINTANA IGG TITER,76.08,57.06,0.91,68.47,119
CDM,3028661143,HC BARTONELL QUINTANA IGM TITER,76.08,57.06,0.91,68.47,119
CDM,3028661144,HC BARTONELLA HENSELAE IGG,76.08,57.06,0.91,68.47,119
CDM,3028661145,HC BARTONELLA HENSELAE IGM,76.08,57.06,0.91,68.47,119
CDM,3028661201,HC BLASTOMYCES ANTIBODY CF-RL,80.32,60.24,0.96,72.29,119
CDM,3028661501,HC ANTIBODY; BORDETELLA,211.43,158.57,2.54,190.29,119
CDM,3028661741,HC AB;LYME'S (WB) IGG CONFIRM,133.04,99.78,1.6,119.74,119
CDM,3028661742,HC AB;LYME'S (WB) IGM CONFIRM,133.04,99.78,1.6,119.74,119
CDM,3028661801,HC LYME DISEASE ANTIBODY,61.34,46.0,0.74,55.21,119
CDM,3028662201,HC BRUCELLA ANTIBODY,91.59,68.69,1.1,82.43,119
CDM,3028662801,HC AB; CANDIDA,88.34,66.26,1.06,79.51,119
CDM,3028663141,HC ANTIBODY; CHLAMYDIA IGG,45.66,34.24,0.55,41.09,119
CDM,3028663142,HC C. PNEUMONIAE IGG,45.66,34.24,0.55,41.09,119
CDM,3028663143,HC C. PSITTACI IGG,45.66,34.24,0.55,41.09,119
CDM,3028663144,HC C. TRACHOMATIS IGG,45.66,34.24,0.55,41.09,119
CDM,3028663241,HC ANTIBODY; CHLAMYDIA IGM,70.83,53.12,0.85,63.75,119
CDM,3028663242,HC C. PNEUMONIAE IGM,70.83,53.12,0.85,63.75,119
CDM,3028663243,HC C. PSITTACI IGM,70.83,53.12,0.85,63.75,119
CDM,3028663244,HC C. TRACHOMATIS IGM,70.83,53.12,0.85,63.75,119
CDM,3028663541,"HC ANTIBODY; COCCIDIOIDES, EACH (A/G/M)",77.04,57.78,0.92,69.34,119
CDM,3028663542,HC COCCIDIODES-L.D.A.,77.04,57.78,0.92,69.34,119
CDM,3028663544,"HC COCCIDIOIDES ANTIBODY, IGG",77.04,57.78,0.92,69.34,119
CDM,3028663545,"HC COCCIDIOIDES ANTIBODY, IGM",77.04,57.78,0.92,69.34,119
CDM,3028663801,HC Q FEVER ANTIBODY,115.6,86.7,1.39,104.04,119
CDM,3028664401,HC CYTOMEGALOVIRUS ANTIOBYD,105.73,79.3,1.27,95.16,119
CDM,3028664501,HC CYTOMEGALOVIRUS ANTIBODY IGM,122.38,91.78,1.47,110.14,119
CDM,3028664801,HC DIPHTHERIA ANTIBODY-RL,35.5,26.62,0.43,31.95,119
CDM,3028665101,"HC ENCEPHALITIS, CALIFORNIA- RL",108.27,81.2,1.3,97.44,119
CDM,3028665201,"HC ENCEPHALITIS, EASTERN",108.27,81.2,1.3,97.44,119
CDM,3028665301,"HC ENCEPHALITIS, ST. LOUIS- RL",108.27,81.2,1.3,97.44,119
CDM,3028665401,"HC ENCEPHALITIS, WESTERN- RL",108.27,81.2,1.3,97.44,119
CDM,3028665841,HC COXSAKIE A TYPE A9 ANTIBODY,272.48,204.36,3.27,245.23,119
CDM,3028665842,HC AB; ENTEROVIRUS,168.57,126.43,2.02,151.71,119
CDM,3028665843,"HC ANTIBODY; COXSACKIE VIRUS, EACH",286.17,214.63,3.43,257.55,119
CDM,3028665849,HC COXSACKIE B1 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028665850,HC COXSACKIE B2 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028665851,HC COXSACKIE B3 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028665852,HC COXSACKIE B4 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028665853,HC COXSACKIE B5 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028665854,HC COXSACKIE B6 ANTIBODY,168.57,126.43,2.02,151.71,119
CDM,3028666301,HC EPSTEIN-BARR VIRUS AB EARLY,119.62,89.72,1.44,107.66,119
CDM,3028666401,HC NUCLEAR AG ANTIBODY,125.4,94.05,1.5,112.86,119
CDM,3028666541,"HC ANTIBODY; EPSTEIN-BARR, VIRAL CAPSID, EACH (A/G/M)",144.43,108.32,1.73,129.99,119
CDM,3028666542,HC VIRAL CAPSID IGG,144.43,108.32,1.73,129.99,119
CDM,3028666543,HC VIRAL CAPSID IGM,144.43,108.32,1.73,129.99,119
CDM,3028666601,HC EHRLICHIA CHAFFEENSIS G/M,84.5,63.38,1.01,76.05,119
CDM,3028666801,HC TULAREMIA ANTIBODY,651.41,488.56,7.82,586.27,119
CDM,3028667141,HC AB FUNGUS NES,187.26,140.44,2.25,168.53,119
CDM,3028667142,HC IBD SYNDROME FUNGUS NEC,166.52,124.89,2.0,149.87,119
CDM,3028667401,HC ANTIBODY GIARDIA LAMBLIA,2058.99,1544.24,24.71,1853.09,119
CDM,3028667701,HC H PYLORI ANTIBODY,374.33,280.75,4.49,336.9,119
CDM,3028668201,HC AB; HELMINTH NES,128.25,96.19,1.54,115.42,119
CDM,3028668701,HC HTLV-I AB,43.98,32.98,0.53,39.58,119
CDM,3028668901,HC HTLV WESTERN BLOT TEST DIAGNOSTIC,502.11,376.58,6.03,451.9,119
CDM,3028669201,HC HEPATITIS DELTA AB,86.62,64.96,1.04,77.96,119
CDM,3028669441,"HC ANTIBODY; HERPES SIMPLEX VIRUS, NON-SPEC",82.72,62.04,0.99,74.45,119
CDM,3028669442,HC HERPE SIMPLEX VIRUS IGG & IGM,372.21,279.16,4.47,334.99,119
CDM,3028669541,HC HERPES TYPE I AB IGG,130.46,97.84,1.57,117.41,119
CDM,3028669601,HC AB HSV TYPE 2,140.49,105.37,1.69,126.44,119
CDM,3028669801,HC HISTOPLASMA ANTIBODY,67.21,50.41,0.81,60.49,119
CDM,3028670101,HC AB; HIV-1 DIAGNOSTIC,106.3,79.72,1.28,95.67,119
CDM,3028670201,HC AB; HIV-2 DIAGNOSTIC,422.37,316.78,5.07,380.13,119
CDM,3028670301,HC HIV-1/2 ANTIBODY DIAGNOSTIC,171.95,128.96,2.06,154.76,119
CDM,3028670401,HC AB; HBCAB - TOTAL,89.99,67.49,1.08,80.99,119
CDM,3028670501,HC HEPATITIS B CORE IGM ANTIBODY,88.17,66.13,1.06,79.35,119
CDM,3028670601,HC HEPATITIS B SURFACE ANTIBODY,81.19,60.89,0.97,73.07,119
CDM,3028670701,HC HEPATITIS BE ANTIBODY,103.57,77.68,1.24,93.21,119
CDM,3028670801,HC HEPATITIS A ANTIBODY; TOTAL,296.93,222.7,3.56,267.24,119
CDM,3028670901,HC HEPATITIS A ANTIBODY IGM,84.73,63.55,1.02,76.26,119
CDM,3028671101,HC ANTIBODY; JOHN CUNNINGHAM VIRUS,45.74,34.3,0.55,41.17,119
CDM,3028671301,HC LEGIONELLA PNEUMOPHILA ANTIBODY IGG-RL,161.75,121.31,1.94,145.58,119
CDM,3028672001,HC LEPTOSPIRA ANTIBODIES,577.18,432.88,6.93,519.46,119
CDM,3028672741,HC AB; LCMIGG,234.82,176.12,2.82,211.34,119
CDM,3028672742,HC AB; LCMIGM,234.82,176.12,2.82,211.34,119
CDM,3028672743,HC LYMPHOCYTIC CHORIOMENINGITIS (LCM) VIRUS AN,234.82,176.12,2.82,211.34,119
CDM,3028673501,HC MUMPS AB,119.09,89.32,1.43,107.18,119
CDM,3028673541,HC MUMPS IGG ANTIBODY,119.09,89.32,1.43,107.18,119
CDM,3028673542,HC MUMPS IGM  ANTIBODY,119.09,89.32,1.43,107.18,119
CDM,3028673801,"HC ANTIBODY; MYCOPLASMA, EACH (A/G/M)",67.08,50.31,0.8,60.37,119
CDM,3028674741,"HC ANTIBODY; PARVOVIRUS, EACH (A/G/M)",113.72,85.29,1.36,102.35,119
CDM,3028674742,HC PARVOVIRUS B19 ANTIBODY IGG,113.72,85.29,1.36,102.35,119
CDM,3028674743,HC PARVOVIRUS B19 ANTIBODY IGM,113.72,85.29,1.36,102.35,119
CDM,3028675301,HC ANTIBODY; PROTOZOA NES,82.04,61.53,0.98,73.84,119
CDM,3028675741,"HC ANTIBODY; RICKETTSIA AB, EACH (A/G/M)",100.02,75.02,1.2,90.02,119
CDM,3028675743,HC ROCKY MTN SPOTTED FEVER IGM,100.02,75.02,1.2,90.02,119
CDM,3028675744,HC TYPHUS FEVER IGG TITER,34.91,26.18,0.42,31.42,119
CDM,3028675745,HC TYPHUS FEVER IGM TITER,52.4,39.3,0.63,47.16,119
CDM,3028676201,HC RUBELLA ANTIBODY,108.35,81.26,1.3,97.52,119
CDM,3028676541,HC RUBEOLA ANTIBODIES IGM,109.01,81.76,1.31,98.11,119
CDM,3028676542,HC RUBEOLA IGG ANTIBODY,109.01,81.76,1.31,98.11,119
CDM,3028676801,HC AB; SALMONELLA; EIA,24.13,18.1,0.29,21.72,119
CDM,3028677401,HC TETANUS ANTIBODY-RL,84.0,63.0,1.01,75.6,119
CDM,3028677701,HC AB TOXOPLASMA IGG,182.88,137.16,2.19,164.59,119
CDM,3028677801,HC AB TOXOPLASMA IGM,70.44,52.83,0.85,63.4,119
CDM,3028678001,HC ANTIBODY TREPONEMA PALLIDUM,89.07,66.8,1.07,80.16,119
CDM,3028678041,HC TREPONEMA PALLIDUM AB BY TP-PA,89.07,66.8,1.07,80.16,119
CDM,3028678741,HC VARICELLA ZOSTER ANTIBODY,118.07,88.55,1.42,106.26,119
CDM,3028678742,HC VARICELLA ZOSTER ANTIBODY IGG,118.07,88.55,1.42,106.26,119
CDM,3028678801,"HC ANTIBODY; WEST NILE VIRUS, IGM",144.81,108.61,1.74,130.33,119
CDM,3028678901,"HC ANTIBODY; WEST NILE VIRUS, IGG",128.42,96.32,1.54,115.58,119
CDM,3028679041,"HC ANTIBODY; VIRUS, NES",95.62,71.72,1.15,86.06,119
CDM,3028679043,HC HANTAVIRUS ANTIBODY,95.62,71.72,1.15,86.06,119
CDM,3028679044,HC HTLV I/II ANTIBODIES,53.24,39.93,0.64,47.92,119
CDM,3028679301,HC YERSINIA ANTIBODY,236.48,177.36,2.84,212.83,119
CDM,3028679401,HC ZIKA VIRUS IGM ANTIBODY,45.63,34.22,0.55,41.07,119
CDM,3028680001,HC AB THYROGLOBULIN,55.74,41.8,0.67,50.17,119
CDM,3028680301,HC HCV TEST,104.92,78.69,1.26,94.43,119
CDM,3028680401,HC HCV RIBA REFLEX BILL,935.77,701.83,11.23,842.19,119
CDM,3028681201,HC HLA-B27 ANTIGEN,1423.79,1067.84,17.09,1281.41,119
CDM,3028681301,HC HLA TYPING A/B/C MULTIPLE ANTIGENS,2608.2,1956.15,31.3,2347.38,119
CDM,3028682801,HC HLA CLASS III ANTIBODY QUAL,1028.57,771.43,12.34,925.71,119
CDM,3028683101,HC HLA CLASS II PHENOTYPE QUAL,362.97,272.23,4.36,326.67,119
CDM,3028683201,HC HLA CLASS I IG DEFIN QUAL,980.59,735.44,11.77,882.53,119
CDM,3028683301,HC HLA CLASS II IG DEFIN QUAL,2123.96,1592.97,25.49,1911.56,119
CDM,3028683401,HC HLA CLASS I SEMIQUANT PANEL,4156.43,3117.32,49.88,3740.79,119
CDM,3028683501,HC HLA CLASS II SEMIQUANT PANEL,4207.03,3155.27,50.48,3786.33,119
CDM,3028685001,HC RBC AB SCRN EA TECHNIQUE,98.24,73.68,1.18,88.42,119
CDM,3028686001,HC ANTIBODY ELUTION RBC EACH,599.77,449.83,7.2,539.79,119
CDM,3028687001,HC AB ID RBC EA PANEL EA TECHN,481.06,360.8,5.77,432.95,119
CDM,3028688041,"HC COOMBS; DIRECT, EACH ANTISERUM",135.48,101.61,1.63,121.93,119
CDM,3028688601,HC COOMBS TEST INDIRECT TITER,793.69,595.27,9.52,714.32,119
CDM,3028690001,"HC BLOOD TYPING, SEROLOGIC; ABO",33.46,25.1,0.4,30.11,119
CDM,3028690101,HC BLOOD TYPING; SEROLOGIC; RH D,43.04,32.28,0.52,38.74,119
CDM,3028690401,HC BLD TYP SER; AGN SCRN SERUM;EA,154.17,115.63,1.85,138.75,119
CDM,3028690501,HC BLD TYP SER RBC AN NOT ABO/RHD,173.1,129.82,2.08,155.79,119
CDM,3028692001,HC COMPATIBILITY TEST SPIN EA UNIT,284.16,213.12,3.41,255.74,119
CDM,3028692201,HC COMP TEST EA UNIT AHG TECH,352.28,264.21,4.23,317.05,119
CDM,3028692301,HC ELECTRONIC CROSSMATCH COMPATIBILITY,323.17,242.38,3.88,290.85,119
CDM,3028692701,HC FFP THAWING EACH UNIT,283.64,212.73,3.4,255.28,119
CDM,3028694501,HC IRRADIATION BLOOD COMP EA UNIT,346.81,260.11,4.16,312.13,119
CDM,3028696001,HC VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT,282.98,212.24,3.4,254.68,119
CDM,3028696501,HC POOLING PLATELETS OTHER,329.17,246.88,3.95,296.25,119
CDM,3028697001,HC PRETREAT RBC; CHEM OR DRUGS,1130.24,847.68,13.56,1017.22,119
CDM,3028697201,HC PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP,269.67,202.25,3.24,242.7,119
CDM,3028697701,HC SERUM PRETX; INHIBITOR INCUBATE,346.94,260.2,4.16,312.25,119
CDM,3028697801,HC ANTIBODY ABSORPTION EACH,632.24,474.18,7.59,569.02,119
CDM,3028698501,HC SPLIT BLD PRODUCT EA UNIT,335.19,251.39,4.02,301.67,119
CDM,3028699941,HC BLOOD BANK MISC,1146.88,860.16,13.76,1032.19,119
CDM,302G043201,HC INFECTIOUS AG AB (EIA) HIV-1/HIV-2 CONVENTIONAL SCREENING,165.13,123.85,1.98,148.62,119
CDM,302P910001,HC PATHOGEN(S) TEST FOR PLATELETS,806.48,604.86,9.68,725.83,119
CDM,3037,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,14.040000000000001,10.530000000000001,0.1,116.64,1071
CDM,30510,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,3.89,2.92,0.05,3.5,238
CDM,3058500201,HC BLEEDING TIME,182.83,137.12,2.19,164.55,119
CDM,3058500701,HC DIFFERENTIAL MANUAL WBC COUNT,39.11,29.33,0.47,35.2,119
CDM,3058501301,HC HEMATOCRIT SPUN,226.13,169.6,2.71,203.52,119
CDM,3058501401,HC HEMATOCRIT,48.09,36.07,0.58,43.28,119
CDM,3058501419,HC HEMATOCRIT POC,48.09,36.07,0.58,43.28,119
CDM,3058501801,HC HEMOGLOBIN,127.08,95.31,1.52,114.37,119
CDM,3058501819,HC HEMOGLOBIN POCL/POCBS,127.08,95.31,1.52,114.37,119
CDM,3058502501,HC CBC/PLT AUTO DIFFERENTIAL,91.45,68.59,1.1,82.3,119
CDM,3058502519,HC CBC/PLT AUTO DIFFERENTIAL POC,91.45,68.59,1.1,82.3,119
CDM,3058502701,HC CBC W/O DIFFERENTIAL,68.67,51.5,0.82,61.8,119
CDM,3058504101,HC RBC-RED BLOOD COUNT AUTOMATED,58.18,43.64,0.7,52.36,119
CDM,3058504401,HC MANUAL RETICULOCYTE COUNT,373.49,280.12,4.48,336.14,119
CDM,3058504501,HC RETICULOCYTE COUNT AUTOMATED,46.54,34.9,0.56,41.89,119
CDM,3058504601,HC RETICYTE/HGB CONCENTRATE,94.65,70.99,1.14,85.18,119
CDM,3058504801,HC BLOOD COUNT LEUKOCYTE WBC AUTOMATED,46.47,34.85,0.56,41.82,119
CDM,3058504901,HC PLATELET COUNT AUTOMATED,34.65,25.99,0.42,31.18,119
CDM,3058505501,HC RETICULATED PLATELET ASSAY,27.61,20.71,0.33,24.85,119
CDM,3058513001,HC CHROMGNC SUBSTRT ASSAY,951.76,713.82,11.42,856.58,119
CDM,3058517501,HC BLOOD CLOT LYSIS TIME,55.16,41.37,0.66,49.64,119
CDM,3058521001,HC FACTOR II ASSAY,269.03,201.77,3.23,242.13,119
CDM,3058522001,"HC CLOT FACTOR V (ACG, PROACCELERIN)",153.24,114.93,1.84,137.92,119
CDM,3058523001,HC FACTOR VII ASSAY,181.28,135.96,2.18,163.15,119
CDM,3058524001,HC FACTOR VIII ASSAY,157.22,117.92,1.89,141.5,119
CDM,3058524501,HC VW FACTOR 8 ASSAY /RIST COFACT,204.67,153.5,2.46,184.2,119
CDM,3058524601,HC VW FACTOR 8 ANTIGEN,189.11,141.83,2.27,170.2,119
CDM,3058524701,HC VW FACTOR 8 MULTIMRIC,200.86,150.65,2.41,180.77,119
CDM,3058525001,HC FACTOR IX ASSAY,224.41,168.31,2.69,201.97,119
CDM,3058526001,HC FACTOR X ASSAY,182.56,136.92,2.19,164.3,119
CDM,3058527001,HC FACTOR XI ASSAY,315.56,236.67,3.79,284.0,119
CDM,3058528001,HC FACTOR XII ASSAY,318.63,238.97,3.82,286.77,119
CDM,3058529101,"HC FACTOR XIII, QUALITATIVE",166.98,125.24,2.0,150.28,119
CDM,3058530001,HC ANTITHROMBIN III ACTIVITY,451.28,338.46,5.42,406.15,119
CDM,3058530101,HC ANTITHROMBIN III ANTIGEN ASSAY-RL,163.63,122.72,1.96,147.27,119
CDM,3058530201,HC PROTEIN C ANTIGEN,105.32,78.99,1.26,94.79,119
CDM,3058530301,HC PROTEIN C ACTIVITY,165.1,123.82,1.98,148.59,119
CDM,3058530501,HC PROTEIN S TOTAL ANTIGEN,101.7,76.28,1.22,91.53,119
CDM,3058530601,HC PROTEIN S-FREE,216.51,162.38,2.6,194.86,119
CDM,3058530701,HC ACTIVATED PROTEIN C RESISTANCE,141.63,106.22,1.7,127.47,119
CDM,3058534701,HC COAGULATION TIME ACTIVATED,61.33,46.0,0.74,55.2,119
CDM,3058534719,HC COAGULATION TIME ACTIVATED POCL/POCBS,146.25,109.69,1.76,131.62,119
CDM,3058536201,HC FIBRIN SPLIT PRODUCTS,131.92,98.94,1.58,118.73,119
CDM,3058537801,HC D-DIMER SEMI-QUANTITATIVE,185.44,139.08,2.23,166.9,119
CDM,3058537901,HC D DIMER QUAN,288.88,216.66,3.47,259.99,119
CDM,3058538401,HC FIBRINOGEN ACTIVITY,74.37,55.78,0.89,66.93,119
CDM,3058538501,HC FIBRINOGEN; ANTIGEN,171.02,128.26,2.05,153.92,119
CDM,3058539701,HC CLOTTING FUNCT ACTIVITY,1192.68,894.51,14.31,1073.41,119
CDM,3058541001,HC FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN,233.33,175.0,2.8,210.0,119
CDM,3058541501,HC FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,126.94,95.2,1.52,114.25,119
CDM,3058542001,HC FUNCTIONAL PLASMINOGEN,143.21,107.41,1.72,128.89,119
CDM,3058546041,HC KLEIHAUER FETAL ELUTION,341.78,256.33,4.1,307.6,119
CDM,3058546042,HC KLEIHAUER BETKE STAIN,455.41,341.56,5.46,409.87,119
CDM,3058546101,HC FETAL HGB SCREEN ROSETTE,221.83,166.37,2.66,199.65,119
CDM,3058552001,HC HEPARIN ASSAY,512.61,384.46,6.15,461.35,119
CDM,3058552501,HC HEPARIN ADSORPTION OF PLASMA,58.28,43.71,0.7,52.45,119
CDM,3058554001,HC LEUKOCYTE ALKALINE PHOSPHATASE,386.24,289.68,4.63,347.62,119
CDM,3058554901,HC MURAMIDASE,93.68,70.26,1.12,84.31,119
CDM,3058555501,"HC OSMOTIC FRAGILITY, RBC; UNINCUBATED",48.62,36.47,0.58,43.76,119
CDM,3058557619,HC BLOOD PLATELET AGGREGATION POC,546.58,409.94,6.56,491.92,119
CDM,3058557641,"HC PLATELET AGGREGATION, EACH AGENT",241.49,181.12,2.9,217.34,119
CDM,3058559701,HC PHOSPHOLIPID NEUTRALIZATION; PLTLT,381.21,285.91,4.57,343.09,119
CDM,3058559801,HC HEXAGONAL PHOSPHOLIPID; PLTLT,156.1,117.08,1.87,140.49,119
CDM,3058561001,HC PROTHROMBIN TIME,30.66,23.0,0.37,27.59,119
CDM,3058561019,HC PROTHROMBIN TIME POCL/POCBS,117.71,88.28,1.41,105.94,119
CDM,3058561101,HC PROTHROMBIN TIME CORRECTION,112.56,84.42,1.35,101.3,119
CDM,3058561301,HC RUSSELL VIPER VENOM TIME; DILUTED,69.28,51.96,0.83,62.35,119
CDM,3058563501,HC REPTILASE TIME-RL,188.0,141.0,2.26,169.2,119
CDM,3058565101,HC SED RATE ERYTHROCYTE NONAUTO,90.7,68.03,1.09,81.63,119
CDM,3058565201,HC AUTOM ERYTHROCYTE SED RATE,64.82,48.62,0.78,58.34,119
CDM,3058566001,HC SICKLE CELL SCREEN,88.37,66.28,1.06,79.53,119
CDM,3058567001,HC THROMBIN TIME,151.0,113.25,1.81,135.9,119
CDM,3058573001,HC PARTIAL THROMBOPLASTIN TIME,30.66,23.0,0.37,27.59,119
CDM,3058573201,HC PTT SUBSTITUTION PLASMA FRACTIONS EA,106.43,79.82,1.28,95.79,119
CDM,3058581001,HC VISCOSITY,67.78,50.84,0.81,61.0,119
CDM,3060140U01,HC BLOOD CULTURE ID FUNGAL BY MOLECULAR ASSAY,1704.63,1278.47,20.46,1534.17,119
CDM,3060141U01,HC BLOOD CULTURE ID GRAM POSITIVE BY MOLECULAR ASSAY,1704.8,1278.6,20.46,1534.32,119
CDM,3060142U01,HC BLOOD CULTURE ID GRAM NEGATIVE BY MOLECULAR ASSAY,1704.8,1278.6,20.46,1534.32,119
CDM,3060202U01,HC  BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2,599.96,449.97,7.2,539.96,119
CDM,3060352U01,HCD NFCT DS BCT VAGINOSIS&VAGINITIS MULT AMP PROBE,689.22,516.92,8.27,620.3,119
CDM,3068499981,HC COM CON POTASSIUM,132.33,99.25,1.59,119.1,119
CDM,3068658101,HC STRPTCS PNEUM ANTIBODY IGG SEROTYPES MLT IA QUAN,228.57,171.43,2.74,205.71,119
CDM,3068701541,"HC CONCENTRATE, INF AGENT",317.07,237.8,3.8,285.36,119
CDM,3068701542,HC AFB CONCENTRATE-RL,317.07,237.8,3.8,285.36,119
CDM,3068704001,HC CULTURE BLOOD,171.31,128.48,2.06,154.18,119
CDM,3068704501,HC CULTURE STOOL,240.69,180.52,2.89,216.62,119
CDM,3068704601,"HC CULTURE, STOOL, AEROBIC, ADDL PATHOG, EA PLATE",246.11,184.58,2.95,221.5,119
CDM,3068707041,"HC CULTURE, BACTERIAL, OTHER SOURCE",141.81,106.36,1.7,127.63,119
CDM,3068707042,HC CATHETER TIP CULTURE,141.81,106.36,1.7,127.63,119
CDM,3068707043,HC CSF CULTURE AND GRAM STAIN,141.81,106.36,1.7,127.63,119
CDM,3068707044,HC CULTURE TISSUE,141.81,106.36,1.7,127.63,119
CDM,3068707045,HC EYE CULTURE AND GRAM STAIN,141.81,106.36,1.7,127.63,119
CDM,3068707046,HC GENITAL CULTURE,206.74,155.06,2.48,186.07,119
CDM,3068707047,HC RESPIRATORY CULTURE,141.81,106.36,1.7,127.63,119
CDM,3068707048,HC TISSUE CUL/GRAM W/O ANAEROBE,141.81,106.36,1.7,127.63,119
CDM,3068707049,HC WOUND CULTURE,141.81,106.36,1.7,127.63,119
CDM,3068707050,HC CULTURE BACTERIAL OTHER,141.81,106.36,1.7,127.63,119
CDM,3068707051,HC EAR CULTURE,141.81,106.36,1.7,127.63,119
CDM,3068707101,HC CULTURE WOUND QUANT AEROBIC,357.64,268.23,4.29,321.88,119
CDM,3068707301,HC CULTURE WOUND QUANT ANAEROBIC,26.15,19.61,0.31,23.54,119
CDM,3068707501,HC CULTURE ANAEROBIC,368.34,276.26,4.42,331.51,119
CDM,3068707601,HC ORGANISM ID ANAEROBIC,209.22,156.92,2.51,188.3,119
CDM,3068707701,HC ORGANISM ID AEROBIC,184.5,138.38,2.21,166.05,119
CDM,3068708141,HC CULTURE BETA STREP,148.46,111.34,1.78,133.61,119
CDM,3068708143,"HC CULTURE SCREENING, RAPID STREP OR GENITAL GRP B",100.34,75.26,1.2,90.31,119
CDM,3068708144,"HC CULTURE, PRESUMPTIVE PATHOGENS, SCREENING ONLY",100.34,75.26,1.2,90.31,119
CDM,3068708145,HC SCREEN MRSA,100.34,75.26,1.2,90.31,119
CDM,3068708146,HC SCREEN VRE,148.46,111.34,1.78,133.61,119
CDM,3068708601,HC CULTURE URINE,134.7,101.02,1.62,121.23,119
CDM,3068708843,"HC URINE BACTERIA CULTURE, EACH ISOLATE",142.98,107.24,1.72,128.68,119
CDM,3068710101,HC CULT FUNGUS W P ID SKIN HR NL,261.6,196.2,3.14,235.44,119
CDM,3068710201,HC CULTURE FUNGUS EXCEPT BLOOD,368.9,276.68,4.43,332.01,119
CDM,3068710301,HC CULTURE FUNGUS BLOOD,338.98,254.24,4.07,305.08,119
CDM,3068710641,HC YEAST ID,119.14,89.36,1.43,107.23,119
CDM,3068710701,HC ORGANISM ID FUNGUS MOLD,190.08,142.56,2.28,171.07,119
CDM,3068710901,HC CULTURE MYCOPLASMA,256.27,192.2,3.08,230.64,119
CDM,3068711001,HC CULTURE CHLAMYDIA  ANY,634.58,475.94,7.61,571.12,119
CDM,3068711601,HC AFB CULTURE,528.94,396.7,6.35,476.05,119
CDM,3068714001,HC ORG ID BY IMMUNOFLUORESCENCE,98.98,74.24,1.19,89.08,119
CDM,3068714701,HC ORG ID AGGLUTINATIONS,159.61,119.71,1.92,143.65,119
CDM,3068714901,"HC NUCLEIC ACID PROBE CULTURE TYPING, EACH",303.75,227.81,3.64,273.38,119
CDM,3068715041,"HC BLOOD CULTURE ID, MOLECULAR",595.51,446.63,7.15,535.96,119
CDM,3068715042,HC DNA/RNA AMPLIFIED PROBE,595.51,446.63,7.15,535.96,119
CDM,3068715301,HC DNA/RNA SEQUENCING,269.15,201.86,3.23,242.24,119
CDM,3068715801,HC CULTURE; OTHER METHOD,178.14,133.6,2.14,160.33,119
CDM,3068716901,HC MACROSCOPIC PARASITE,41.08,30.81,0.49,36.97,119
CDM,3068717201,HC PINWORM EXAM,353.03,264.77,4.24,317.73,119
CDM,3068717601,HC HOMOGENATION TISSUE CULTURE,38.62,28.96,0.46,34.76,119
CDM,3068717701,HC OVA AND PARASITE EXAM,235.46,176.6,2.83,211.91,119
CDM,3068718141,"HC MIC GRADIENT STRIP, EACH AGENT",139.47,104.6,1.67,125.52,119
CDM,3068718401,HC SUSCEPTIBILITY DISK METHOD,157.01,117.76,1.88,141.31,119
CDM,3068718541,HC SUSCEPTIBILITY TEST BY ENZYME,431.76,323.82,5.18,388.58,119
CDM,3068718544,"HC SUSCEPTIBILITY TEST BY ENZYME, EACH",431.76,323.82,5.18,388.58,119
CDM,3068718601,HC YEAST MIC PANEL,874.98,656.24,10.5,787.48,119
CDM,3068718641,HC ANTIBIOTIC MIC LEVEL,133.91,100.43,1.61,120.52,119
CDM,3068718642,HC FUNGUS SUSCEPTIBILITY,133.91,100.43,1.61,120.52,119
CDM,3068718643,HC MIC ANAEROBIC,133.91,100.43,1.61,120.52,119
CDM,3068718647,HC SO ARUP 60402 SUSCEPTIBILITY - ANAEAROBE BY BROTH DILUTION,145.72,109.29,1.75,131.15,119
CDM,3068718648,HC SO ARUP 60492 SUSCEPTIBILITY - AFB/NOCARDIA BY BROTH DILUTION,147.55,110.66,1.77,132.8,119
CDM,3068718649,HC SO ARUP 60790 SUSCEPTIBILITY - AUTOMATED BROTH DILUTION,109.63,82.22,1.32,98.67,119
CDM,3068718651,HC SO ARUP 61010 SUSCEPTIBILITY - MOLD BY BROTH DILUTION,229.7,172.28,2.76,206.73,119
CDM,3068718652,HC SO ARUP 65070 SUSCEPTIBILITY BROTH DILUTION PANEL,116.27,87.2,1.4,104.64,119
CDM,3068718801,HC SENSITIVITY MAC DIL EA ANTIBIO,17.98,13.48,0.22,16.18,119
CDM,3068720542,HC SMEAR - GRAM OR GIEMSA,135.12,101.34,1.62,121.61,119
CDM,3068720543,HC SMEAR PRIMARY SOURCE,135.12,101.34,1.62,121.61,119
CDM,3068720641,HC SMEAR FLUORESCENT OR AFB STAIN,299.48,224.61,3.59,269.53,119
CDM,3068720741,HC BLOOD PARASITE SMEAR,495.16,371.37,5.94,445.64,119
CDM,3068720742,HC BLOOD PARASITE THICK SMEAR,495.16,371.37,5.94,445.64,119
CDM,3068720743,HC BLOOD PARASITE THIN SMEAR,495.16,371.37,5.94,445.64,119
CDM,3068720744,HC SMEAR MALARIA/BORRELIA,556.41,417.31,6.68,500.77,119
CDM,3068720747,HC STAIN & CONCENTRATION,557.05,417.79,6.68,501.34,119
CDM,3068720942,HC STAIN MICROSPORIDUM,257.34,193.0,3.09,231.61,119
CDM,3068721001,HC WET PREP,194.0,145.5,2.33,174.6,119
CDM,3068722001,HC WET MOUNT KOH FUNI/YEASTS,193.42,145.06,2.32,174.08,119
CDM,3068723001,HC C DIFFICILE TOXIN CONFIRMATION,173.55,130.16,2.08,156.2,119
CDM,3068725201,HC VIRUS INOCULATION TISSUE,472.42,354.32,5.67,425.18,119
CDM,3068725301,HC VIRAL IDENTIFICATION,33.56,25.17,0.4,30.2,119
CDM,3068725401,HC VIRUS INOCULATION SHELL,619.87,464.9,7.44,557.88,119
CDM,3068725501,HC VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,58.15,43.61,0.7,52.34,119
CDM,3068726001,HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; ADENOVIRUS,72.14,54.1,0.87,64.93,119
CDM,3068726581,HC COM CON BORDETELLA PERTUSSIS,223.15,167.36,2.68,200.84,119
CDM,3068726901,HC GIARDIA AG BY IF,501.62,376.22,6.02,451.46,119
CDM,3068727001,HC SMEAR CHLAMYDIA,238.03,178.52,2.86,214.23,119
CDM,3068727301,HC IAADI HERPES SMPLX VIRUS TYPE 2,155.85,116.89,1.87,140.26,119
CDM,3068727401,HC IAADI HERPES SMPLX VIRUS TYPE 1,363.51,272.63,4.36,327.16,119
CDM,3068727501,HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS,68.25,51.19,0.82,61.42,119
CDM,3068727601,"HC CHG INFLUENZA AG, DFA",68.25,51.19,0.82,61.42,119
CDM,3068727801,HC LEGIONELLA P AG BY DFA,251.06,188.3,3.01,225.95,119
CDM,3068727901,"HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PARAINFLUENZA VIRUS, EA TYPE",70.05,52.54,0.84,63.04,119
CDM,3068728001,HC RESPIRATORY SYNCYTIAL VI,227.79,170.84,2.73,205.01,119
CDM,3068728101,HC PNEUMOCYSTIS C AG BY IF,205.99,154.49,2.47,185.39,119
CDM,3068729001,HC VARICELLA ZOSTER AG IF,1436.82,1077.62,17.24,1293.14,119
CDM,3068730001,"HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT, MULT ORGANISMS, EA POLYVALENT ANTISERUM",289.5,217.12,3.47,260.55,119
CDM,3068730101,HC VAP CHOLESTEROL,32.44,24.33,0.39,29.2,119
CDM,3068730501,HC ASPERGILLUS AG EIA,537.59,403.19,6.45,483.83,119
CDM,3068732401,HC CLOSTRIDIUM AG EIA,192.68,144.51,2.31,173.41,119
CDM,3068732701,HC CRYPTOCOCCAL ANTIGEN,182.97,137.23,2.2,164.67,119
CDM,3068732801,HC CRYPTOSPORIDUM ANTIGEN,166.29,124.72,2.0,149.66,119
CDM,3068732901,HC GIARDIA ANTIGEN,176.41,132.31,2.12,158.77,119
CDM,3068733801,HC H PYLORI STOOL,250.67,188.0,3.01,225.6,119
CDM,3068734001,HC HEPATITIS B SURFACE AG EIA,80.24,60.18,0.96,72.22,119
CDM,3068735001,HC HEPATITIS B E ANTIGEN,97.33,73.0,1.17,87.6,119
CDM,3068738501,HC HISTOPLASMA ANTIGEN,578.85,434.14,6.95,520.96,119
CDM,3068738901,HC HIV-1 AG W/HIV-1 & HIV-2 AB; SINGLE,165.13,123.85,1.98,148.62,119
CDM,3068742001,HC RSV ANTIGEN,81.94,61.46,0.98,73.75,119
CDM,3068742501,HC ROTAVIRUS DIRET ANTIGEN,422.27,316.7,5.07,380.04,119
CDM,3068742601,HC COVID-19/SARS-COV-2 INHOUSE ANTIGEN IA,140.05,105.04,1.68,126.05,119
CDM,3068742701,HC SHIGA LIKE TOXIN AG EIA,155.17,116.38,1.86,139.65,119
CDM,3068742801,HC IAAD IA SARS COV-2 & INFLUENZA VIRUS TYPES A&B,96.39,72.29,1.16,86.75,119
CDM,3068743001,HC RAPID STREP SCREEN EIA,182.97,137.23,2.2,164.67,119
CDM,3068744941,HC LEGIONELLA URINE ANTIGEN,318.14,238.6,3.82,286.33,119
CDM,3068744942,"HC INFECTIOUS ANTIGEN BY EIA, MULTI-STEP, EACH",1114.15,835.61,13.37,1002.74,119
CDM,3068744943,HC STREP PNEUMO URINARY AG,1114.15,835.61,13.37,1002.74,119
CDM,3068746801,HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFED PRB TQ,218.31,163.73,2.62,196.48,119
CDM,3068746901,HC IADNA BABESIA MICROTI AMPLIFIED PROBE TECHNIQUE,95.01,71.26,1.14,85.51,119
CDM,3068747601,"HC BORRELIA BURGDORFERI, AMP PROB TECH-RL",208.5,156.38,2.5,187.65,119
CDM,3068748001,"HC CANDIDA, NA DIRECT PROBE",190.46,142.84,2.29,171.41,119
CDM,3068748101,HC CANDIDA NA AMPLIFIED PROBE,2122.53,1591.9,25.47,1910.28,119
CDM,3068748301,HC CNS DNA AMP PROBE TYPE 12-25,569.64,427.23,6.84,512.68,119
CDM,3068748401,HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TQ,218.31,163.73,2.62,196.48,119
CDM,3068748601,"HC CHLAMYDIA P, AMPLIF NA PROBE",180.21,135.16,2.16,162.19,119
CDM,3068749101,HC CHLAMYDIA TRACH BY AMP DNA,99.4,74.55,1.19,89.46,119
CDM,3068749301,HC C DIFF AMPLIFIED PROBE,720.11,540.08,8.64,648.1,119
CDM,3068749601,HC CYTOMEGALOVIRUS BY PCR,592.02,444.02,7.1,532.82,119
CDM,3068749701,HC CYTOMEGALOVIRUS QUANT PCR,1452.68,1089.51,17.43,1307.41,119
CDM,3068749801,HC ENTEROVIRUS BY PCR,709.08,531.81,8.51,638.17,119
CDM,3068750101,HC H1N1 BY PCR,1085.24,813.93,13.02,976.72,119
CDM,3068750201,HC INFLUENZA DNA AMP PROBE,562.69,422.02,6.75,506.42,119
CDM,3068750501,HC INFECTIOUS AGENT ANTIGEN DETECTION,826.34,619.76,9.92,743.71,119
CDM,3068750601,HC IADNA-DNA/RNA PROBE TQ 6-11; QUAL,968.15,726.11,11.62,871.34,119
CDM,3068750701,HC IADNA-DNA/RNA PROBE TQ 12-25; QUAL,1772.03,1329.02,21.26,1594.83,119
CDM,3068751001,"HC GARDNERELLA, DIR NA PROBE",190.46,142.84,2.29,171.41,119
CDM,3068751701,HC HEPATITIS B DNA QUANT - RL,1633.16,1224.87,19.6,1469.84,119
CDM,3068752101,HC HEP C AMPLIF NA PROBE,523.44,392.58,6.28,471.1,119
CDM,3068752201,HC HEPATITIS C RNA  QUANTITATIVE,1087.1,815.32,13.05,978.39,119
CDM,3068752901,HC HERPES SIMPLEX VIRUS BY PCR,754.21,565.66,9.05,678.79,119
CDM,3068753201,HC HERPES VIRUS 6 AMPLIFIED NA PROBE,606.26,454.7,7.28,545.63,119
CDM,3068753301,HC HERPES 6 NA QUAN,1245.47,934.1,14.95,1120.92,119
CDM,3068753501,HC HIV-1 PROBE&REVERSE TRNSCRP J,253.5,190.12,3.04,228.15,119
CDM,3068753641,HC HIV-1 QUANT&REVRSE TRNSCRP J,756.19,567.14,9.07,680.57,119
CDM,3068753642,HC HIV 1 RNA BY PCR,1540.0,1155.0,18.48,1386.0,119
CDM,3068753801,HC IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIP,253.5,190.12,3.04,228.15,119
CDM,3068754101,"HC LEGIONELLA, AMPLIF NA PROBE",709.62,532.22,8.52,638.66,119
CDM,3068755101,HC MYCOBACTERIA DNA AMP PROBE,733.36,550.02,8.8,660.02,119
CDM,3068755601,HC MYCOBACTERIA T AMPLIF NA PROBE,740.96,555.72,8.89,666.86,119
CDM,3068756401,HC IADNA MTB RIFAMPIN RESISTANCE AMP PRB TQ,207.86,155.9,2.49,187.07,119
CDM,3068758101,"HC MYCOPLASMA PNEUMONIE,AMPLIF NA PROBE",658.99,494.24,7.91,593.09,119
CDM,3068759101,HC N. GONORRHOEAE (GC) BY AMP DNA,99.4,74.55,1.19,89.46,119
CDM,3068759301,HC ORTHOPOXVIRUS AMP PRB EACH,189.07,141.8,2.27,170.16,119
CDM,3068759401,HC IADNA PNEUMOCYSTIS JIROVECII AMPLIFIED PROBE TQ,207.86,155.9,2.49,187.07,119
CDM,3068762301,HC HPV LOW-RISK TYPES; IA,333.7,250.28,4.0,300.33,119
CDM,3068762401,HC HPV HIGH RISK TYPES POOLED RSLT,294.05,220.54,3.53,264.65,119
CDM,3068762501,HC HPV TYPES 16 & 18 ONLY,392.06,294.04,4.7,352.85,119
CDM,3068763101,HC IA RESP VIRUS 3-5 TARGETS,541.9,406.42,6.5,487.71,119
CDM,3068763201,HC RESP VIRUS 6-11 TARGETS,1128.09,846.07,13.54,1015.28,119
CDM,3068763301,HC IA RESP VIRUS 12-25 TARGETS,1346.02,1009.52,16.15,1211.42,119
CDM,3068763601,HC SARSCOV2 & INF A&B AMP PRB,431.23,323.42,5.17,388.11,119
CDM,3068763701,HC IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,483.16,362.37,5.8,434.84,119
CDM,3068764001,HC STAPH A DNA AMP PROBE,453.56,340.17,5.44,408.2,119
CDM,3068764101,HC MR-STAPH DNA AMP PROBE,405.0,303.75,4.86,364.5,119
CDM,3068765101,HC STREP A DNA AMP PROBE,366.63,274.97,4.4,329.97,119
CDM,3068765301,HC STREP B DNA AMP PROBE,625.66,469.24,7.51,563.09,119
CDM,3068766001,"HC TRICHOMONAS VAGIN, DIR PROBE",190.46,142.84,2.29,171.41,119
CDM,3068766101,HC TRICHOMONAS VAGINALIS AMPLIF,130.36,97.77,1.56,117.32,119
CDM,3068766201,HC ZIKA VIRUS DNA/RNA AMP PROBE,280.17,210.13,3.36,252.15,119
CDM,3068779801,HC DETECT AGENT NOS DNA AMP,453.56,340.17,5.44,408.2,119
CDM,3068779841,"HC INFECTIOUS AGENT; NOS,AMPLIF PROBE, EA ORG",453.56,340.17,5.44,408.2,119
CDM,3068779843,HC BORDETELLA PARAPETUSSIS PERTUSSIS,331.52,248.64,3.98,298.37,119
CDM,3068779844,HC ENTEROVIRUS PCR,331.52,248.64,3.98,298.37,119
CDM,3068779846,HC HUMAN PARVOVIRUS BY PCR,453.56,340.17,5.44,408.2,119
CDM,3068779849,HC NOROVIRUS 1&2 BY PCR,660.42,495.32,7.93,594.38,119
CDM,3068779850,HC PERTUSSIS BY PCR,453.56,340.17,5.44,408.2,119
CDM,3068779851,HC PNEUMOCYSTIS BY PCR,487.8,365.85,5.85,439.02,119
CDM,3068779852,HC VARICELLA ZOSTER BY PCR,118.07,88.55,1.42,106.26,119
CDM,3068779853,HC P. JIROVECII DNA,365.0,273.75,4.38,328.5,119
CDM,3068779941,"HC QUANTIFICATION, EA ORGANISM",845.76,634.32,10.15,761.18,119
CDM,3068779942,HC EBV QUANT PCR - RL,539.29,404.47,6.47,485.36,119
CDM,3068780141,HC DNA RNA MULTIPLE ORG AMP PROBE,972.72,729.54,11.67,875.45,119
CDM,3068780401,HC INFLUENZA A/B ANTIGEN,472.12,354.09,5.67,424.91,119
CDM,3068780601,HC HIV ANTIGEN W/HIV ANTIBODIES,41.91,31.43,0.5,37.72,119
CDM,3068780701,HC RSV I/A W DIR OBSERV,115.84,86.88,1.39,104.26,119
CDM,3068788001,HC STREP A ASSAY W/OPTIC,182.97,137.23,2.2,164.67,119
CDM,3068788019,HC STREP A ASSAY W/OPTIC POC,182.97,137.23,2.2,164.67,119
CDM,3068789941,HC MALARIA ANTIGEN SCREEN,539.29,404.47,6.47,485.36,119
CDM,3068789943,HC SHIGELLA TOXIN,539.29,404.47,6.47,485.36,119
CDM,3068789945,"HC INFECTIOUS ANTIGEN DETECT IMMUNOASSAY W DIRECT OPT OBS, NOS",539.29,404.47,6.47,485.36,119
CDM,3068790001,HC PHENOTYPE INFECT AGENT DRUG,480.58,360.44,5.77,432.52,119
CDM,3068790101,HC HIV 1  GENOTYPE ANALYSIS NUC ACID-RL,2412.49,1809.37,28.95,2171.24,119
CDM,3068790201,HC HEP C GENOTYPING BY SEQUENCIN,1208.55,906.41,14.5,1087.7,119
CDM,3068790601,HC GENOTYPE DNA/RNA HIV,358.59,268.94,4.3,322.73,119
CDM,3068791001,HC GENOTYPE CYTOMEGALOVIRUS,949.2,711.9,11.39,854.28,119
CDM,3068791201,HC GENOTYPE DNA HEPATITIS B VIRUS,519.13,389.35,6.23,467.22,119
CDM,3068799983,HC COM CON ENVIRONMENTAL CULTURE,414.77,311.08,4.98,373.29,119
CDM,306U000201,HC SARS-COVID-19 PCR NON-CDC/ NON HIGH TP,213.23,159.92,2.56,191.91,119
CDM,3071,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,22.29,16.72,0.27,20.06,238
CDM,3074,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.17,0.13,0.01,0.15,119
CDM,3078100101,HC URINALYSIS W/MICROSCOPY,43.67,32.75,0.52,39.3,119
CDM,3078100201,HC N-AUTOM URINALYS WO MICRO,27.95,20.96,0.34,25.16,119
CDM,3078100301,HC URINALYSIS W/O MICRO AUTOMATED,19.68,14.76,0.24,17.71,119
CDM,3078100319,HC URINALYSIS W/O MICRO AUTOMATED POCL/POCBS,61.8,46.35,0.74,55.62,119
CDM,3078101501,HC URINALYSIS MICROSCOPY ONLY,33.97,25.48,0.41,30.57,119
CDM,3078102501,HC PREGNANCY TEST URINE,77.74,58.3,0.93,69.97,119
CDM,3078102519,HC PREGNANCY TEST URINE POC,41.35,31.01,0.5,37.22,119
CDM,3078105001,HC TIMED URINE VOLUME MEASUREMENT,12.56,9.42,0.15,11.3,119
CDM,30805,"BUPIVACAINE (PF) 0.125 %(1,250 MCG/ML)IN 0.9% SODIUM CHLORIDE EPIDURAL",118.2,88.65,1.42,106.38,119
CDM,3098141801,HC RX METAB GENOMIC SEQ ALYS PANEL AT LEAST 6 GENES,742.37,556.78,8.91,668.13,119
CDM,3098145601,HC TGSAP SO/HEMATOLYMPHOID NEO/DO 51/>RNA ANALYSIS,4481.82,3361.36,53.78,4033.64,119
CDM,3098223401,HC BETA-AMYLOID 1-42 (ABETA 42),860.99,645.74,10.33,774.89,119
CDM,3098499941,HC OSMOLALITY STOOL,117.62,88.22,1.41,105.86,119
CDM,3098499942,"HC PHENOPHTHALEIN,FECES",117.62,88.22,1.41,105.86,119
CDM,3098756301,HC IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH,211.66,158.74,2.54,190.49,119
CDM,3098932501,HC SPERM ANTIBODIES,332.45,249.34,3.99,299.2,119
CDM,310,ALLOPURINOL 100 MG TABLET,2.48,1.86,0.03,2.23,119
CDM,3100035U01,HC NEURO CSF PRION PRTN QUAL,1464.74,1098.56,17.58,1318.27,119
CDM,3103820501,HC BLOOD CELL HARVEST TRANSPLANT ALLO,9767.13,7325.35,117.21,8790.42,119
CDM,3103821401,HC TRANSPLANT PREP PLASMA DEPLETION,10657.88,7993.41,127.89,9592.09,119
CDM,3108112001,HC IDH1 COMMON VARIANTS,639.89,479.92,7.68,575.9,119
CDM,3108112101,HC IDH2 COMMON VARIANTS,979.41,734.56,11.75,881.47,119
CDM,3108116201,HC BRCA1/BRCA2 GENE ANALYSIS; FULL SEQUENCE DUP/DEL,2908.07,2181.05,34.9,2617.26,119
CDM,3108117001,HC ABL1 GENE,2419.61,1814.71,29.04,2177.65,119
CDM,3108120101,HC APC GENE FULL SEQUENCE,2653.82,1990.36,31.85,2388.44,119
CDM,3108120601,HC SPHZ BCR/ABL1 GENE MAJOR BP,407.51,305.63,4.89,366.76,119
CDM,3108120641,HC BCR/ABL1 GENE MAJOR BP QUALITATIVE,443.92,332.94,5.33,399.53,119
CDM,3108120642,HC ARUP  BCR/ABL1 GENE MAJOR TYRONSINE KINASE INHIBITOR,577.92,433.44,6.94,520.13,119
CDM,3108120741,HC BCR/ALB1 GENE MINOR BP,510.06,382.54,6.12,459.05,119
CDM,3108120801,"HC BCR/ALB1 OTR BREAKPOINT, QUAL OR QUAN",109.35,82.01,1.31,98.42,119
CDM,3108121001,HC SPHZ BRAF GENE,1321.93,991.45,15.86,1189.74,119
CDM,3108121043,HC ARUP BRAF CODON 600 MUTATION DECTECTION W REFLEX TO MLH 1,2732.21,2049.16,32.79,2458.99,119
CDM,3108121901,"HC CALR MUTATION ANALY, MPN",950.67,713.0,11.41,855.6,119
CDM,3108122001,HC CFTR GENE COM VARIANTS,721.7,541.28,8.66,649.53,119
CDM,3108122201,HC CFTR GENE DUP/DELET VARIANTS,1878.79,1409.09,22.55,1690.91,119
CDM,3108122301,HC CFTR GENE DUP/DELET SEQUENCE,2008.0,1506.0,24.1,1807.2,119
CDM,3108122501,HC CYP2C19 GENE COM VARIANTS,575.24,431.43,6.9,517.72,119
CDM,3108122601,HC CYP2D6 GENE COM VARIANTS,963.61,722.71,11.56,867.25,119
CDM,3108122901,HC CYTOGEN M ARRAY COPY NO&SNP,7255.23,5441.42,87.06,6529.71,119
CDM,3108123201,HC DPYD GENE COMMON VARIANTS,492.22,369.16,5.91,443.0,119
CDM,3108123501,HC SPHZ EGFR GENE COM VARIANTS,2568.02,1926.02,30.82,2311.22,119
CDM,3108124001,HC  F2 GENE ANALYSIS,643.9,482.92,7.73,579.51,119
CDM,3108124101,"HC  F5 GENE ANALYSIS, LEIDEN VARIANT",638.72,479.04,7.66,574.85,119
CDM,3108124301,HC FMR1 GENE DETECTION,284.29,213.22,3.41,255.86,119
CDM,3108124401,HC FMR1 GENE CHARAC ALLELES,2292.73,1719.55,27.51,2063.46,119
CDM,3108124501,HC FLT3 GENE,2287.78,1715.84,27.45,2059.0,119
CDM,3108124601,HC FLT3 GENE ANALYSIS,224.72,168.54,2.7,202.25,119
CDM,3108124901,HC G6PD GENE ANALYSIS FULL GENE SEQUENCE,1624.5,1218.38,19.49,1462.05,119
CDM,3108125101,HC GBA GENE,3343.21,2507.41,40.12,3008.89,119
CDM,3108125201,HC GJB2 GENE FULL SEQUENCE,2267.04,1700.28,27.2,2040.34,119
CDM,3108125601,HC HFE GENE ANALYSIS/HEMOCHROMOTOSIS,1033.13,774.85,12.4,929.82,119
CDM,3108125901,HC HBA1/HBA2 FULL GENE SEQUENCE,1624.5,1218.38,19.49,1462.05,119
CDM,3108126101,HC IGH GENE REARRANGE AMP METH,1757.29,1317.97,21.09,1581.56,119
CDM,3108126301,HC SPHZ IGH VARI REGIONAL MUTATION,1594.96,1196.22,19.14,1435.46,119
CDM,3108126341,HC IGH VARI REGIONAL MUTATION,1754.44,1315.83,21.05,1579.0,119
CDM,3108126401,HC IGK REARRANGE ABN CLONAL POP,1325.41,994.06,15.9,1192.87,119
CDM,3108126501,HC STR MARKERS SPECIMEN ANAL,1047.53,785.65,12.57,942.78,119
CDM,3108126701,HC CHIMERISM ANAL NO CELL SELEC,1036.77,777.58,12.44,933.09,119
CDM,3108126901,HC HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS,745.95,559.46,8.95,671.36,119
CDM,3108127001,HC SPHZ JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,543.14,407.36,6.52,488.83,119
CDM,3108127041,HC JAK2 GENE MUTATION,1510.27,1132.7,18.12,1359.24,119
CDM,3108127201,HC KIT GENE TARGETED SEQ ANALYSIS,4409.61,3307.21,52.92,3968.65,119
CDM,3108127301,HC KIT GENE ANALYS D816 VARIANT,983.07,737.3,11.8,884.76,119
CDM,3108127501,HC KRAS GENE,1675.04,1256.28,20.1,1507.54,119
CDM,3108127601,HC KRAS GENE ADDL VARIANTS,1782.92,1337.19,21.4,1604.63,119
CDM,3108127701,HC CYTOGENOMIC NEOPLASIA MICROARRAY ANALYSIS,3140.7,2355.52,37.69,2826.63,119
CDM,3108127801,HC IGH@/BCL2 TRANSLOCATION ALYS,1393.08,1044.81,16.72,1253.77,119
CDM,3108127901,HC SPHZ JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,641.31,480.98,7.7,577.18,119
CDM,3108127941,HC JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,641.31,480.98,7.7,577.18,119
CDM,3108128701,HC MGMT GENE PRMTR MTHLYTH ALYS,531.51,398.63,6.38,478.36,119
CDM,3108128801,HC MLH1 GENE,569.04,426.78,6.83,512.14,119
CDM,3108129101,HC MTHFR GENE,451.65,338.74,5.42,406.48,119
CDM,3108129201,HC MLH1 GENE FULL SEQ,211.37,158.53,2.54,190.23,119
CDM,3108129401,HC MLH1 GENE DUP/DELETE VARIANT,548.0,411.0,6.58,493.2,119
CDM,3108129501,HC MSH2 GENE FULL SEQ,1033.45,775.09,12.4,930.1,119
CDM,3108129701,HC MSH2 GENE DUP/DELETE VARIANT,577.51,433.13,6.93,519.76,119
CDM,3108129801,HC MSH6 GENE FULL SEQ,1737.81,1303.36,20.85,1564.03,119
CDM,3108130501,HC SPHZ  MYD88 GENE P.LEU265PRO VRNT,1066.05,799.54,12.79,959.44,119
CDM,3108130541,HC MYD88 GENE P.LEU265PRO VRNT,1066.05,799.54,12.79,959.44,119
CDM,3108130601,HC NUDT15 GENE ANALYSIS COMMON VARIANT,425.34,319.0,5.1,382.81,119
CDM,3108131001,HC NPM1 GENE,1459.73,1094.8,17.52,1313.76,119
CDM,3108131101,HC NRAS GENE VARIANTS EXON 2&3,800.86,600.64,9.61,720.77,119
CDM,3108131501,HC PML/RARALPHA COM BREAKPOINTS,2495.77,1871.83,29.95,2246.19,119
CDM,3108132401,HC PMP22 GENE ANALYSIS DUP/DEL,974.92,731.19,11.7,877.43,119
CDM,3108133101,HC SNRPN/UBE3A METHYLATION ANALYSIS,593.9,445.42,7.13,534.51,119
CDM,3108133201,HC SERPINA1 GENE,584.68,438.51,7.02,526.21,119
CDM,3108133501,HC TPMT GENE COM VARIANTS,344.44,258.33,4.13,310.0,119
CDM,3108133801,HC MPL GENE ANALYSIS COMMON VARIANTS,1331.36,998.52,15.98,1198.22,119
CDM,3108134201,HC TRG GENE REARRANGEMENT ANAL,2724.82,2043.62,32.7,2452.34,119
CDM,3108135101,HC TP53 GENE FULL GENE SEQUENCE,4128.65,3096.49,49.54,3715.78,119
CDM,3108135201,HC TP53 GENE TRGT SEQUENCE ALYS,892.15,669.11,10.71,802.94,119
CDM,3108136301,HC HBB GENE DUP/DEL VARIANTS,548.0,411.0,6.58,493.2,119
CDM,3108136401,HC HBB FULL GENE SEQUENCE,878.8,659.1,10.55,790.92,119
CDM,3108137301,"HC HLA CLASS 1 TYPING, LOW RESOLUTION, ONE LOCUS",2516.5,1887.38,30.2,2264.85,119
CDM,3108137401,HC HLA I TYPING 1 ANTIGEN,289.56,217.17,3.47,260.6,119
CDM,3108138001,HC HLA I TYPING 1 LOCUS HR,1337.59,1003.19,16.05,1203.83,119
CDM,3108138101,HC HLA I TYPING 1 ALLELE HR,2508.11,1881.08,30.1,2257.3,119
CDM,3108138201,HC HLA II TYPING 1 LOC HR,2424.71,1818.53,29.1,2182.24,119
CDM,3108140001,HC MOLECULAR PATHOLOGY PROC LEVEL 1,6228.35,4671.26,74.74,5605.52,119
CDM,3108140101,HC MOLECULAR PATHOLOGY PROC LEVEL 2,2279.31,1709.48,27.35,2051.38,119
CDM,3108140201,HC MOLECULAR PATHOLOGY PROC LEVEL 3,6228.35,4671.26,74.74,5605.52,119
CDM,3108140301,HC MOLECULAR PATHOLOGY PROC LEVEL 4,641.31,480.98,7.7,577.18,119
CDM,3108140401,HC MOLECULAR PATHOLOGY PROC LEVEL 5,3754.74,2816.06,45.06,3379.27,119
CDM,3108140501,HC MOLECULAR PATHOLOGY PROC LEVEL 6,5605.52,4204.14,67.27,5044.97,119
CDM,3108140601,HC MOLECULAR PATHOLOGY PROC LEVEL 7,2079.81,1559.86,24.96,1871.83,119
CDM,3108140701,HC MOLECULAR PATHOLOGY PROC LEVEL 8 DIFF VENDOR,3836.97,2877.73,46.04,3453.27,119
CDM,3108140801,HC MOLECULAR PATHOLOGY PROC LEVEL 9,123.3,92.48,1.48,110.97,119
CDM,3108141001,HC AORTIC DYSFUNCTION/DILATION,790.46,592.84,9.49,711.41,119
CDM,3108141101,HC AORTIC DYSFUNCTION/DILATION DUP/DEL ANALYSIS,2117.61,1588.21,25.41,1905.85,119
CDM,3108142001,HC FETAL CHROMOML ANEUPLOIDY,723.86,542.9,8.69,651.47,119
CDM,3108142201,HC FETAL CHROMOML MICRODELTJ,2055.13,1541.35,24.66,1849.62,119
CDM,3108143201,HC HRDTRY BRST CA-RLATD DSORDRS 5+ GEN,1766.33,1324.75,21.2,1589.7,119
CDM,3108143501,HC HEREDITARY COLON CA DISORDERS PANEL 5+,537.31,402.98,6.45,483.58,119
CDM,3108143701,HC HEREDTRY NURONDCRN TUM DSRDR 5+,3530.45,2647.84,42.37,3177.4,119
CDM,3108144301,HC GENETIC TESTING FOR SEVERE INHERITED CONDITIONS,2225.78,1669.34,26.71,2003.2,119
CDM,3108144801,HC HEREDITARY PERIPHERAL NEUROPATHY GEN SEQ PNL,2225.78,1669.34,26.71,2003.2,119
CDM,3108145042,HC TARGETED GENOMIC SEQ ANALYSIS,6422.8,4817.1,77.07,5780.52,119
CDM,3108145501,HC GEN SEQ ANALYS SOL ORG/HEMTOLMPHOID NEO 51/>GEN,6422.8,4817.1,77.07,5780.52,119
CDM,3108147941,HC UNLISTED MOLECULAR PATH PROC,159.01,119.26,1.91,143.11,119
CDM,3108147950,HC BREAST TUMOR,2316.3,1737.22,27.8,2084.67,119
CDM,3108147953,HC ARUP  TPMT & NUDT15 PCR PROBE HYBRIDIZATION,412.41,309.31,4.95,371.17,119
CDM,3108147955,"HC CYP2C8, CYP2C9 AND CYP2C CLUSTER",159.02,119.26,1.91,143.12,119
CDM,3108151101,HC FTL CGEN ABNOR FOUR ANALYTES,338.58,253.94,4.06,304.72,119
CDM,3108151501,HC NFCT DS BV&VAGINITIS RTPCR AMP DNA MARKERS,689.22,516.92,8.27,620.3,119
CDM,3108159901,HC UNLISTED MULTI ANALTYE ASSAY ANALYSIS,680.56,510.42,8.17,612.5,119
CDM,3108351942,HC HYDROXYLAS-21 ANTIBODY,290.16,217.62,3.48,261.14,119
CDM,3108439301,HC  TAU PHOSPHORYLATED EACH,723.86,542.9,8.69,651.47,119
CDM,3108439401,HC TOTAL TAU (TTAU),562.51,421.88,6.75,506.26,119
CDM,3108817401,"HC CYTOPATHOLOGY,CERV/VAG,AUTO THIN LAYER, UNDER MD SUPERVISION",177.61,133.21,2.13,159.85,119
CDM,3108826901,HC CHROMOSOME ANALYS AMNIOTIC,1715.97,1286.98,20.59,1544.37,119
CDM,3108836601,HC INSITU HYBRIDIZATION (FISH) EA MULTIPLEX PROBE,2117.49,1588.12,25.41,1905.74,119
CDM,3108836701,HC INSITU HYBRIDIZATION AUTO,1865.15,1398.86,22.38,1678.64,119
CDM,3108924041,HC UNLISTED MISCELLANEOUS PATHOLOGY TEST,330.06,247.54,3.96,297.05,119
CDM,311,ALLOPURINOL 300 MG TABLET,4.04,3.03,0.05,3.64,119
CDM,3118810401,HC CYTOPATH FLUIDS NONGYN SMEARS,248.94,186.7,2.99,224.05,119
CDM,3118810601,HC CYTOPATH FL NONGYN FILTER,329.28,246.96,3.95,296.35,119
CDM,3118810801,HC FLUID CYTOLOGY FILTER/INTERP,263.4,197.55,3.16,237.06,119
CDM,3118811201,HC CYTOPATH CELL ENHANCE TECH,263.4,197.55,3.16,237.06,119
CDM,3118814201,HC CERV/VAG THIN PREP CYTO SCREEN,250.86,188.14,3.01,225.77,119
CDM,3118816001,HC CYTO SMR SCREEN & INTERPRET,220.03,165.02,2.64,198.03,119
CDM,3118816101,HC CYTOPATHOLOGY PREP SCRN INTERP/TOUCH PREP,220.03,165.02,2.64,198.03,119
CDM,3118817201,HC FINE NEEDLE ASPIRATION EVAL,263.4,197.55,3.16,237.06,119
CDM,3118817301,HC EVAL OF FNA; INTERP & REPORT,263.4,197.55,3.16,237.06,119
CDM,3118817501,HC PAP THIN LAYER AUTO PREP & SCREEN,319.99,239.99,3.84,287.99,119
CDM,3118817701,HC CYTP C/V AUTO THIN LYR ADDL,303.66,227.74,3.64,273.29,119
CDM,3118818201,HC DNA ANALYSIS,232.47,174.35,2.79,209.22,119
CDM,3118818441,HC FLOW CYTOMETRY-FIRST MARKER,320.05,240.04,3.84,288.04,119
CDM,3118818501,HC FLOW CYTOMETRY EA ADDTL MARKER,240.05,180.04,2.88,216.04,119
CDM,3118823001,HC TISSUE CX NON NEOPLASTIC DIS LYMPHO,1319.48,989.61,15.83,1187.53,119
CDM,3118823301,HC CULTURE TISSUE SKIN,1737.4,1303.05,20.85,1563.66,119
CDM,3118823501,HC TISSUE CULTURE; AMNIOTIC FLUID,1673.52,1255.14,20.08,1506.17,119
CDM,3118823701,HC  TISSUE CULTURE BLOOD CELLS,1636.72,1227.54,19.64,1473.05,119
CDM,3118823901,HC TISSUE CULTRE SOLID TUMOR,1754.24,1315.68,21.05,1578.82,119
CDM,3118824001,HC CRYOPRESERVATION,119.61,89.71,1.44,107.65,119
CDM,3118826201,HC  CHROMOSOME ANALYSIS,1536.93,1152.7,18.44,1383.24,119
CDM,3118826301,HC CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE,1503.16,1127.37,18.04,1352.84,119
CDM,3118826401,HC CHROMOSOME ANALYSIS 20 25,1615.19,1211.39,19.38,1453.67,119
CDM,3118826701,HC CHROMOSOME ANALYSIS TISSUE,535.92,401.94,6.43,482.33,119
CDM,3118827142,HC DNA PROBE FISH,640.07,480.05,7.68,576.06,119
CDM,3118827144,HC ADDITIONAL BANDING-FISH,57.99,43.49,0.7,52.19,119
CDM,3118827145,HC BCR/ABL BY FISH,640.09,480.07,7.68,576.08,119
CDM,3118827148,HC MCG; DNA PROBE EA,290.3,217.72,3.48,261.27,119
CDM,3118827301,HC CYTOGENETICS 10-30 CELLS,1377.18,1032.88,16.53,1239.46,119
CDM,3118827401,HC CYTOGENETICS 25-99,114.74,86.06,1.38,103.27,119
CDM,3118827501,HC CYTOGENETICS 100 - 300,793.59,595.19,9.52,714.23,119
CDM,3118828001,HC CHROM ANALY ADDL KARYOT EA STUDY,427.14,320.36,5.13,384.43,119
CDM,3118833401,HC TOUCH PREP-SURG CONSULT-ADDL,423.27,317.45,5.08,380.94,119
CDM,3128830001,HC SURG PATH LEVEL-I GROSS EXAM ONLY,163.05,122.29,1.96,146.74,119
CDM,3128830201,HC LEVEL II SURG PATH GROSS/MICRO,275.43,206.57,3.31,247.89,119
CDM,3128830401,HC SURG PATH LEVEL-III GROSS & MICRO,300.47,225.35,3.61,270.42,119
CDM,3128830501,HC SURG PATH LEVEL-IV GROSS & MICRO,325.51,244.13,3.91,292.96,119
CDM,3128830701,HC SURG PATH LEVEL-V GROSS & MICRO,532.71,399.53,6.39,479.44,119
CDM,3128830901,HC SURG PATH LEVEL-VI GROSS & MICRO,570.76,428.07,6.85,513.68,119
CDM,3128831101,HC DECALCIFICATION PROCEDURE,109.14,81.86,1.31,98.23,119
CDM,3128831201,"HC SPECIAL STAINS; GROUP 1, EACH",336.69,252.52,4.04,303.02,119
CDM,3128831301,"HC SPECIAL STAINS; GROUP 2, EACH",336.69,252.52,4.04,303.02,119
CDM,3128831401,HC HISTOCHEMICAL STAIN ADD-ON,3075.56,2306.67,36.91,2768.0,119
CDM,3128831901,HC ENZYME HISTOCHEMICAL STAIN,919.4,689.55,11.03,827.46,119
CDM,3128832101,HC PATH CONSULT SENDOUT,705.17,528.88,8.46,634.65,119
CDM,3128832301,HC SLIDE REV/CON RPT COMPREHSIV,250.4,187.8,3.0,225.36,119
CDM,3128833101,HC TISSUE 1ST FROZEN SECTION EXAM,262.19,196.64,3.15,235.97,119
CDM,3128833201,HC TISSUE ADDL FROZEN SECT EXAM,262.19,196.64,3.15,235.97,119
CDM,3128833301,HC TOUCH PREP SURG CONSULT 1ST SITE,268.64,201.48,3.22,241.78,119
CDM,3128834101,HC IMMUNOHISTO AB SLIDE; PER SPEC; SINGLE STAIN,291.35,218.51,3.5,262.22,119
CDM,3128834201,HC IMMUNO; PER SPEC INIT SGLE AB,384.96,288.72,4.62,346.46,119
CDM,3128834401,HC IMMUNOHISTO ANTIBODY SLIDE; PER SPEC; MULTIPLEX AB STAIN,653.85,490.39,7.85,588.46,119
CDM,3128834601,HC IMMUNOFLUORESCENCE PER SPEC AB 1ST STAIN,310.08,232.56,3.72,279.07,119
CDM,3128834801,HC ELECTRON MICROSCOPY,1945.5,1459.12,23.35,1750.95,119
CDM,3128835001,HC IMMUNOFLUOR PER SPEC AB ADDITIONAL,310.08,232.56,3.72,279.07,119
CDM,3128836001,HC TUMOR IMM MAN PER SPEC/EA AB,307.89,230.92,3.69,277.1,119
CDM,3128836101,HC IMMUNO EA SGLE AB COMPUTER,1865.15,1398.86,22.38,1678.64,119
CDM,3128836401,HC INSITU HYBRIDIZATION (FISH); PER SPEC; EA ADDTL SINGLE PROBE,751.32,563.49,9.02,676.19,119
CDM,3128836501,HC TISSUE ISH SNGL PROBE PER SPEC,1865.15,1398.86,22.38,1678.64,119
CDM,3128836801,HC MORPH ISH SNGL PER SPEC/MAN,3185.59,2389.19,38.23,2867.03,119
CDM,3128837301,HC  M/PHMTRC ANALYS ISH QUANT/SEMIQ COMPUTER-ASSIST EACH ADDTL SINGLE PROBE,1633.79,1225.34,19.61,1470.41,119
CDM,3128837401,HC M/PHMTRC ANALYS ISH QUANT/SEMIQ COMPUTR-ASSIST EA MULTIPLEX PROBE,2213.01,1659.76,26.56,1991.71,119
CDM,3128837701,HC M/PHMTRC ANALYS ISH QUANT/SEMIQ; MANUAL EA MULTIPLEX PROBE,472.12,354.09,5.67,424.91,119
CDM,3128838001,HC MICRODISSECTION LASER,1481.09,1110.82,17.77,1332.98,119
CDM,3128838101,HC MICRODISSECTION MANUAL,651.23,488.42,7.81,586.11,119
CDM,312G041601,"HC PROSTATE BIOPSY, ANY METHOD",3369.85,2527.39,40.44,3032.86,119
CDM,3177,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,10356.43,7767.32,124.28,9320.79,119
CDM,3184,FLUOCINOLONE 0.025 % TOPICAL CREAM,175.5,131.62,2.11,157.95,119
CDM,3185,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,169.74,127.3,2.04,152.77,119
CDM,31863,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,9.61,7.205,0.12,8.66,238
CDM,31864,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,11.35,8.51,0.14,10.22,238
CDM,3187,FLUOCINONIDE 0.05 % TOPICAL CREAM,90.0,67.5,1.08,81.0,119
CDM,3190,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,120.0,90.0,1.44,108.0,119
CDM,3207003001,HC DI EYE FOREIGN BODY,34.61,25.96,0.42,31.15,119
CDM,3207010001,HC DI MANDIBLE LESS THAN 4 VWS,484.8,363.6,5.82,436.32,119
CDM,3207011001,HC DI MANDIBLE MIN 4 VIEWS,635.02,476.26,7.62,571.52,119
CDM,3207013001,HC DI MASTOIDS MIN 3 VIEWS,340.52,255.39,4.09,306.47,119
CDM,3207014001,HC DI FACIAL BONES <3 VIEWS,519.68,389.76,6.24,467.71,119
CDM,3207015001,HC DI FACIAL BONES MIN 3 VIEWS,631.87,473.9,7.58,568.68,119
CDM,3207016001,HC DI NASAL BONES MIN 3 VIEWS,458.99,344.24,5.51,413.09,119
CDM,3207020001,HC DI ORBITS COMPLETE 4 OR MORE VIEWS,784.21,588.16,9.41,705.79,119
CDM,3207020004,"HC DI ORBITS LESS THAN 4 VIEW,  LIMITED",871.3,653.48,10.46,784.17,119
CDM,3207021001,HC DI SINUSES <3 VIEWS,442.99,332.24,5.32,398.69,119
CDM,3207022001,HC DI SINUSES COMPLETE 3 OR MORE VIEWS,636.7,477.52,7.64,573.03,119
CDM,3207024001,HC DI SELLA TURCICA,207.96,155.97,2.5,187.16,119
CDM,3207025001,HC DI SKULL <4 VIEWS,554.71,416.03,6.66,499.24,119
CDM,3207026001,HC DI SKULL ROUTINE MIN 4 VIEWS,629.37,472.03,7.55,566.43,119
CDM,3207033001,HC DI TEMPOROMANDIBULAR JOINTS,571.38,428.54,6.86,514.24,119
CDM,3207033201,HC DI TMJ ARTHROGRAM UNILATERAL,1163.32,872.49,13.96,1046.99,119
CDM,3207035501,HC DI ORTHOPANTOGRAM,214.85,161.14,2.58,193.36,119
CDM,3207036001,HC DI NECK SOFT TISSUE,378.84,284.13,4.55,340.96,119
CDM,3207039002,HC SIALOGRAM UNILATERAL,724.16,543.12,8.69,651.74,119
CDM,3207039003,HC SIALOGRAPHY BILATERAL,1609.21,1206.91,19.31,1448.29,119
CDM,3207104501,HC DI CHEST 1 VIEW,403.62,302.71,4.84,363.26,119
CDM,3207104601,HC DI CHEST 2 VIEWS,477.12,357.84,5.73,429.41,119
CDM,3207104701,HC DI CHEST 3 VIEWS,467.96,350.97,5.62,421.16,119
CDM,3207104801,HC DI CHEST 4 VIEWS,570.02,427.52,6.84,513.02,119
CDM,3207110001,HC DI RIBS 2 VIEWS UNILATERAL,413.48,310.11,4.96,372.13,119
CDM,3207110101,HC DI X-RAY EXAM OF RIBS/CHEST,523.0,392.25,6.28,470.7,119
CDM,3207111001,HC DI RIBS 3 VIEWS BILATERAL,661.64,496.23,7.94,595.48,119
CDM,3207111101,HC DI RIBS PA CHEST 4 VIEWS BILATERAL,736.19,552.14,8.83,662.57,119
CDM,3207112001,HC DI STERNUM MIN 2 VIEWS,500.68,375.51,6.01,450.61,119
CDM,3207113001,HC DI STERNO-CLAVICULAR JOINTS,549.02,411.76,6.59,494.12,119
CDM,3207202001,HC SPINE SINGLE VIEW,422.02,316.52,5.06,379.82,119
CDM,3207204001,HC DI CERVICAL SPINE 2 OR 3 VIEWS,497.92,373.44,5.98,448.13,119
CDM,3207205001,HC DI CERVICAL SPINE 4 OR 5 VIEWS,596.69,447.52,7.16,537.02,119
CDM,3207205201,HC DI CERVICAL SPINE 6 OR MORE VIEWS,900.73,675.55,10.81,810.66,119
CDM,3207207001,HC DI THORACIC SPINE 2 VIEWS,483.98,362.98,5.81,435.58,119
CDM,3207207201,HC DI THORACIC SPINE 3 VIEWS,495.95,371.96,5.95,446.36,119
CDM,3207207401,HC THORACIC SPINE 4 VIEW MIN,512.5,384.38,6.15,461.25,119
CDM,3207208001,HC DI THORACOLUMAR MINIMUM 2 VIEWS,597.09,447.82,7.17,537.38,119
CDM,3207208101,HC DI SCOLIOSIS SPINE 1 VIEW,381.54,286.15,4.58,343.39,119
CDM,3207208201,HC DI SCOLIOSIS SPINE 2 OR 3 VIEWS,602.78,452.08,7.23,542.5,119
CDM,3207208301,HC DI SCOLIOSIS SPINE 4 OR 5 VIEWS,612.52,459.39,7.35,551.27,119
CDM,3207208401,HC DI SCOLIOSIS SPINE MIN 6 VIEWS,1069.78,802.34,12.84,962.8,119
CDM,3207210001,HC DI LUMBAR SPINE 2 OR 3 VIEWS,494.76,371.07,5.94,445.28,119
CDM,3207211001,HC DI L SPINE AP/LAT/OBL/OR FLEX/EXT,617.99,463.49,7.42,556.19,119
CDM,3207211401,HC DI L SPINE AP/LAT/OBL AND FLEX/EXT,659.09,494.32,7.91,593.18,119
CDM,3207212001,HC LUMBAR SPINE FLEX/EXT ONLY,526.29,394.72,6.32,473.66,119
CDM,3207217001,HC DI PELVIS 1 OR 2 VIEWS,410.42,307.82,4.93,369.38,119
CDM,3207219001,HC DI PELVIS MIN 3 VIEWS,535.75,401.81,6.43,482.18,119
CDM,3207220001,HC DI SACRO-ILIAC JOINTS<3 VIEWS,525.86,394.4,6.31,473.27,119
CDM,3207220201,HC DI SACRO-ILIAC JOINTS 3> VIEWS,593.54,445.16,7.12,534.19,119
CDM,3207222001,HC DI SACRUM/COCCYX MIN 2 VIEWS,538.42,403.82,6.46,484.58,119
CDM,3207224001,HC DI CERVICAL MYELOGRAM,1195.16,896.37,14.34,1075.64,119
CDM,3207225501,HC DI THORACIC MYELOGRAM,1897.38,1423.04,22.77,1707.64,119
CDM,3207226501,HC LUMBAR MYELOGRAM,1696.43,1272.32,20.36,1526.79,119
CDM,3207227001,HC DI MULTIPLE SITES MYELOGRAM,2455.7,1841.78,29.47,2210.13,119
CDM,3207300001,HC CLAVICLE COMPLETE UNILATERAL,390.44,292.83,4.69,351.4,119
CDM,3207300004,HC CLAVICLE 1 VIEW UNILATERAL-LIMITED,444.68,333.51,5.34,400.21,119
CDM,3207301001,HC DI SCAPULA COMPLETE,475.17,356.38,5.7,427.65,119
CDM,3207302001,HC DI SHOULDER ONE VIEW UNILATERAL,371.64,278.73,4.46,334.48,119
CDM,3207303001,HC DI SHOULDER MIN 2 VIEWS UNILATERAL,548.92,411.69,6.59,494.03,119
CDM,3207304001,HC DI ARTHROGRAM SHOULDER UNILATERAL S&I,1014.02,760.52,12.17,912.62,119
CDM,3207305001,HC DI A-C JOINTS W/WO WEIGHT,525.01,393.76,6.3,472.51,119
CDM,3207306001,HC DI HUMERUS MIN 2 VIEWS UNILATERAL,442.75,332.06,5.31,398.48,119
CDM,3207306004,HC DI HUMERUS 1 VIEW UNILATERAL-LIMITED,504.24,378.18,6.05,453.82,119
CDM,3207307001,HC DI ELBOW 2 VIEW UNILATERAL,287.6,215.7,3.45,258.84,119
CDM,3207307004,HC DI ELBOW 1 VIEW-LIMITED,327.55,245.66,3.93,294.8,119
CDM,3207308001,HC DI ELBOW 3 VIEW UNILATERAL,557.37,418.03,6.69,501.63,119
CDM,3207309001,HC DI FOREARM MIN 2 VIEW UNILATERAL,429.28,321.96,5.15,386.35,119
CDM,3207309004,HC DI FOREARM 1 VIEW LIMITED,429.28,321.96,5.15,386.35,119
CDM,3207309201,HC DI UPPER EXTRMTY UNILATERAL <12MO MIN 2 VIEW,324.85,243.64,3.9,292.36,119
CDM,3207309204,HC DI UPPER EXTRMTY UNILATERAL <12MO 1 VIEW LIMITED,360.91,270.68,4.33,324.82,119
CDM,3207310001,HC DI WRIST 2 VIEW UNILATERAL,309.71,232.28,3.72,278.74,119
CDM,3207310004,HC DI WRIST 1 VIEW UNILATERAL-LIMITED,344.12,258.09,4.13,309.71,119
CDM,3207311001,HC DI WRIST MIN 3 VIEW UNILAT,491.08,368.31,5.89,441.97,119
CDM,3207311501,HC DI ARTHROGRAM WRIST 1 INJ S&I UNILATERAL,994.71,746.03,11.94,895.24,119
CDM,3207312001,HC DI HAND 2 VIEW UNILATERAL,326.59,244.94,3.92,293.93,119
CDM,3207312004,HC DI HAND 1 VIEW UNILATERAL-LIMITED,326.59,244.94,3.92,293.93,119
CDM,3207313001,HC DI HAND MIN 3 VIEW UNILATERAL,468.52,351.39,5.62,421.67,119
CDM,3207314001,HC DI FINGERS MIN 2 VIEWS UNILATERAL,367.35,275.51,4.41,330.62,119
CDM,3207314004,HC DI FINGERS 1 VIEW UNILATERAL LIMITED,408.17,306.13,4.9,367.35,119
CDM,3207350101,HC DI HIP UNILATERAL +/- PELVIS 1 VIEW,476.96,357.72,5.72,429.26,119
CDM,3207350201,HC DI HIP UNILATERAL +/- PELVIS 2 OR 3 VIEW,1099.69,824.77,13.2,989.72,119
CDM,3207350301,HC DI HIP UNILATERAL +/- PELVIS MIN 4 VIEW,1338.39,1003.79,16.06,1204.55,119
CDM,3207352101,HC DI HIP BILATERAL +/- PELVIS 2 VIEW,1111.37,833.53,13.34,1000.23,119
CDM,3207352201,HC DI HIP BILATERAL +/- PELVIS 3 OR 4 VIEW,1160.51,870.38,13.93,1044.46,119
CDM,3207352301,HC DI HIP BILATERAL +/- PELVIS MIN 5 VIEW,1937.29,1452.97,23.25,1743.56,119
CDM,3207352501,HC DI ARTHROGRAM HIP S&I,956.99,717.74,11.48,861.29,119
CDM,3207355101,HC DI FEMUR 1 VIEW,327.74,245.8,3.93,294.97,119
CDM,3207355201,HC DI FEMUR MIN 2 VIEW UNILATERAL,443.6,332.7,5.32,399.24,119
CDM,3207356001,HC DI KNEE 1-2 VIEWS UNILATERAL,338.96,254.22,4.07,305.06,119
CDM,3207356201,HC DI KNEE 3 VIEWS UNILATERAL,482.58,361.94,5.79,434.32,119
CDM,3207356401,HC DI KNEE MIN 4 VIEW UNILATERAL,513.3,384.98,6.16,461.97,119
CDM,3207356501,HC DI KNEES STANDING AP BILATERAL,403.98,302.98,4.85,363.58,119
CDM,3207358001,HC ARTHROGRAPHY KNEE UNILATERAL S&I,746.35,559.76,8.96,671.72,119
CDM,3207359001,HC DI TIBIA/FIBULA 2 VIEW UNILATERAL,382.15,286.61,4.59,343.94,119
CDM,3207359004,HC DI TIBIA/FIBULA 1 VIEW UNILATERAL-LIMITED,435.25,326.44,5.22,391.72,119
CDM,3207359201,HC LWER EXTRMTY <12 MO 2 VIEWS UNILATERAL,338.04,253.53,4.06,304.24,119
CDM,3207359204,HC LWER EXTRMTY <12 MO 1 VIEW UNILATERAL LIMITED,381.49,286.12,4.58,343.34,119
CDM,3207360001,HC DI ANKLE 2 VIEW UNILATERAL,295.52,221.64,3.55,265.97,119
CDM,3207360004,HC DI ANKLE 1 VIEW-LIMITED,328.35,246.26,3.94,295.52,119
CDM,3207361001,HC DI ANKLE MIN 3 VIEW UNILATERAL,534.41,400.81,6.41,480.97,119
CDM,3207361501,HC ARTHROGRAM ANKLE S/I UNILATERAL,903.19,677.39,10.84,812.87,119
CDM,3207362001,HC DI FOOT 2 VIEW UNILATERAL,325.08,243.81,3.9,292.57,119
CDM,3207362004,HC DI FOOT 1 VIEW-LIMITED,325.08,243.81,3.9,292.57,119
CDM,3207363001,HC DI FOOT MIN 3 VIEW UNILATERAL,533.95,400.46,6.41,480.56,119
CDM,3207365001,HC DI OS CALCIS MIN 2 VIEW UNILATERAL,438.49,328.87,5.26,394.64,119
CDM,3207365004,HC DI OS CALCIS 1 VIEW UNILATERAL-LIMITED,394.63,295.97,4.74,355.17,119
CDM,3207366001,HC DI TOES MIN 2 VIEWS UNLATERAL,438.17,328.63,5.26,394.35,119
CDM,3207366004,HC DI TOES 1 VIEW UNLATERAL-LIMITED,438.17,328.63,5.26,394.35,119
CDM,3207401801,HC ABDOMEN 1 VIEW,407.53,305.65,4.89,366.78,119
CDM,3207401901,HC DI ABDOMEN 2 VIEWS,480.57,360.43,5.77,432.51,119
CDM,3207402101,HC DI ABDOMEN 3  OR MORE VIEWS,443.01,332.26,5.32,398.71,119
CDM,3207402201,HC DI ABDOMEN COMPLETE W/PA CHEST,644.79,483.59,7.74,580.31,119
CDM,3207419001,HC PERITONEOGRAM,504.49,378.37,6.05,454.04,119
CDM,3207422001,HC DI ESOPHAGRAM,818.62,613.96,9.82,736.76,119
CDM,3207422101,HC X-RAY XM ESOPHAGUS 2CNTRST,773.61,580.21,9.28,696.25,119
CDM,3207423001,HC DI SWALLOWING EVAL W/VIDEO,1042.57,781.93,12.51,938.31,119
CDM,3207424001,HC DI X-RAY UPPER GI DELAY W/KUB,676.53,507.4,8.12,608.88,119
CDM,3207424041,HC DI X-RAY UPPER GI DELAY W/KUB (W/SM BOWEL),1521.54,1141.16,18.26,1369.39,119
CDM,3207424601,HC DI X-RAY XM UPR GI TRC 2CNTRST,1610.03,1207.52,19.32,1449.03,119
CDM,3207424641,HC DI X-RAY XM UPR GI TRC 2CNTRST (W/SM BOWEL),1521.45,1141.09,18.26,1369.3,119
CDM,3207424801,HC DI X-RAY SM INT F-THRU STD,1319.71,989.78,15.84,1187.74,119
CDM,3207425001,HC X-RAY XM SM INT 1CNTRST STD,1115.55,836.66,13.39,1004.0,119
CDM,3207425101,HC X-RAY XM SM INT 2CNTRST STD,1228.9,921.68,14.75,1106.01,119
CDM,3207427001,HC X-RAY XM COLON 1CNTRST STD,1218.99,914.24,14.63,1097.09,119
CDM,3207428001,HC X-RAY XM COLON 2CNTRST STD,1295.31,971.48,15.54,1165.78,119
CDM,3207428301,HC DI THERAPEUTIC ENEMA,921.55,691.16,11.06,829.4,119
CDM,3207430001,HC DI OR CHOLANGIOGRAM,920.54,690.4,11.05,828.49,119
CDM,3207430101,HC XR CHOLANGIOGRAM INTRAOPERATIVE ADDED,585.65,439.24,7.03,527.08,119
CDM,3207432801,HC BILIARY ERCP IMAGING,1085.11,813.83,13.02,976.6,119
CDM,3207432901,HC DI ERCP PANCRATC DUCT SYST IMG,1056.89,792.67,12.68,951.2,119
CDM,3207433001,HC BILIARY AND PANCREATIC ERCP IMAGING,1128.35,846.26,13.54,1015.52,119
CDM,3207434001,HC INTRO LONG GI TUBE INCL FLUORO W IMG S&I,1350.87,1013.15,16.21,1215.78,119
CDM,3207436001,HC INTRALUMINAL DILATION,5241.5,3931.12,62.9,4717.35,119
CDM,3207436301,HC PERC BILIARY DILATION W/WO STENT,2335.07,1751.3,28.02,2101.56,119
CDM,3207440001,HC IVP W/WO TOMOS,1059.46,794.6,12.71,953.51,119
CDM,3207441501,HC NEPHROTOMOGRAM,1618.54,1213.9,19.42,1456.69,119
CDM,3207442001,HC DI PYELOGRAM RETROGRADE,955.24,716.43,11.46,859.72,119
CDM,3207442501,HC UROGRAPHY ANTEGRADE RS&I,863.21,647.41,10.36,776.89,119
CDM,3207443001,HC CYSTOGRAM 3 VIEWS,659.04,494.28,7.91,593.14,119
CDM,3207445001,HC URETHROGRAM RETROGRADE,790.78,593.08,9.49,711.7,119
CDM,3207445501,HC DI CYSTOURETHROGRAM VOIDNG,727.25,545.44,8.73,654.52,119
CDM,3207448501,HC URETERAL DILATION UNILATERAL,3408.26,2556.2,40.9,3067.43,119
CDM,3207474001,HC HYSTEROSALPINGOGRAM,897.85,673.39,10.77,808.06,119
CDM,3207477501,HC PERINEOGRAM,1197.62,898.22,14.37,1077.86,119
CDM,3207560001,HC AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,2803.81,2102.86,33.65,2523.43,119
CDM,3207580501,HC LYMPHANGIOGRAPHY PEL/ABD UNILATERAL,2474.75,1856.06,29.7,2227.28,119
CDM,3207580701,HC LYMPHANGIOGRAPHY PEL/ABD BILATERAL,4273.01,3204.76,51.28,3845.71,119
CDM,3207580901,HC SHUNTOGRAM NON VASCULAR,836.91,627.68,10.04,753.22,119
CDM,3207581001,HC SPLENOPORTOGRAPHY,3037.07,2277.8,36.44,2733.36,119
CDM,3207582001,HC VENOGRAM EXTREMITY UNILATERAL,1850.05,1387.54,22.2,1665.04,119
CDM,3207582201,HC VENOGRAM EXTREMITY BILATERAL,2392.83,1794.62,28.71,2153.55,119
CDM,3207582501,HC INFERIOR VENACAVAGRAM,8007.17,6005.38,96.09,7206.45,119
CDM,3207582701,HC SUPERIOR VENACAVAGRAM,2178.22,1633.66,26.14,1960.4,119
CDM,3207583101,HC VENOGRAM RENAL UNILATERAL,3839.16,2879.37,46.07,3455.24,119
CDM,3207583301,HC VENOGRAM RENAL BILATERAL,3694.2,2770.65,44.33,3324.78,119
CDM,3207584001,HC VENOGRAM ADRENAL UNILATERAL,2692.26,2019.2,32.31,2423.03,119
CDM,3207584201,HCD VENOGRAM ADRENAL BILATERAL,2601.94,1951.46,31.22,2341.75,119
CDM,3207586001,HC SINUS/JUGULAR CATH VENOGRAM,1949.63,1462.22,23.4,1754.67,119
CDM,3207587001,HC SUPERIOR SAGITTAL SINUS VENOGRAM,2745.55,2059.16,32.95,2471.0,119
CDM,3207588501,HC PORTOGRAPHY LIVER  W/HEMO EVAL,3519.44,2639.58,42.23,3167.5,119
CDM,3207588701,HC PORTOGRAPHY W/O PRESSURE,3068.85,2301.64,36.83,2761.96,119
CDM,3207588901,HC VENOGRAPHY HEPATIC W/PRESSURE,3635.88,2726.91,43.63,3272.29,119
CDM,3207589101,HC VENOGRAPHY HEPATIC WO /PRESSURE,2947.08,2210.31,35.36,2652.37,119
CDM,3207589301,HC VENOUS SAMPLING THROUGH CATH,1795.6,1346.7,21.55,1616.04,119
CDM,3207589401,HC TRANSCATH EMBOLIZATION S&I,4622.68,3467.01,55.47,4160.41,119
CDM,3207590201,HC MECH REMV INTRALUM CV S&I,1112.65,834.49,13.35,1001.39,119
CDM,3207597001,HC TRANSCATHETER BIOPSY S&I,3369.1,2526.82,40.43,3032.19,119
CDM,3207598401,HC CHANGE CATHETER W/CONTRAST,1056.05,792.04,12.67,950.44,119
CDM,3207598901,HC GUIDANCE FOR PERCUTANEOUS DRAINAGE,1180.6,885.45,14.17,1062.54,119
CDM,3207600001,HC FLUOROSCOPY UP TO 1 HR,739.55,554.66,8.87,665.6,119
CDM,3207601001,HC FOREIGN BODY XRAY PEDS,307.62,230.72,3.69,276.86,119
CDM,3207608001,HC ABSCESS FISTULA SINUS S/I,1108.34,831.26,13.3,997.51,119
CDM,3207609801,HC SPECIMEN RADIOGRAPHY EXAM,362.13,271.6,4.35,325.92,119
CDM,3207649642,HC XR GUB GASTRO CHALLENGE TUBE PLACEMENT,2601.75,1951.31,31.22,2341.58,119
CDM,3207649643,HC SELECTIVE HEPATIC VEIN PRESSURES W/O VENOGRAPHY,2601.75,1951.31,31.22,2341.58,119
CDM,3207649941,HC UNLISTED DIAGNOSTIC RADIOGRAPHY PROCEDURE,577.25,432.94,6.93,519.52,119
CDM,3207649942,HC WHOLE BODY DXA,122.51,91.88,1.47,110.26,119
CDM,3207649943,HC NERVE STIMULATOR PLACEMENT VERIFICATION,721.56,541.17,8.66,649.4,119
CDM,3207700101,HC FLUORO FOR CVC PROCEDURE,1100.01,825.01,13.2,990.01,119
CDM,3207700201,HC FLUORO GUIDANCE FOR NEEDLE PLACEMENT,838.57,628.93,10.06,754.71,119
CDM,3207700301,HC FLUORO GUIDANCE SPINAL INJECT,1052.23,789.17,12.63,947.01,119
CDM,3207707201,HC DI BONE AGE STUDY,332.84,249.63,3.99,299.56,119
CDM,3207707301,HC BONE LENGTH STUDY,655.16,491.37,7.86,589.64,119
CDM,3207707401,HC DI BONE SURVEY LIMITED,793.43,595.07,9.52,714.09,119
CDM,3207707501,HC DI BONE SURVEY COMPLETE,1285.13,963.85,15.42,1156.62,119
CDM,3207707601,HC DI BONE SURVEY INFANT,1284.04,963.03,15.41,1155.64,119
CDM,3207707701,HC DI JOINT SURVEY TWO OR >JOINTS,441.06,330.8,5.29,396.95,119
CDM,3207708001,HC DXA BONE DENSITY AXIAL 1+ SITES,607.61,455.71,7.29,546.85,119
CDM,3207708101,HC DXA BONE DENSITY/PERIPHERAL,504.26,378.2,6.05,453.83,119
CDM,3207708501,HC DEXA BONE DENSITY INCL VERT FX ASSESSMENT,625.31,468.98,7.5,562.78,119
CDM,3207709001,HC TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,234.5,175.88,2.81,211.05,119
CDM,3207709101,HC TBS TECHNICAL CALCULATION ONLY,225.04,168.78,2.7,202.54,119
CDM,3208,"FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION",553.185,414.89,4.18,682.1,238
CDM,3221,FLUPHENAZINE 5 MG TABLET,8.69,6.52,0.1,7.82,119
CDM,3227308501,HC DI ARTHROGRAM ELBOW S&I UNILATERAL,677.54,508.16,8.13,609.79,119
CDM,3232,FOLIC ACID 5 MG/ML INJECTION SOLUTION,273.21000000000004,204.91,2.52,302.78,238
CDM,3233,FOLIC ACID 1 MG TABLET,0.585,0.435,0.01,0.94,357
CDM,32338,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,2.685,2.0100000000000002,0.01,3.74,238
CDM,3237560501,HC THORACIC AORTOGRAM,16365.54,12274.16,196.39,14728.99,119
CDM,3237562501,HC ABDOMINAL AORTOGRAPHY,3965.45,2974.09,47.59,3568.9,119
CDM,3237563001,HC ABDOMEN AORTOGRAPHY RUNOFF,5946.92,4460.19,71.36,5352.23,119
CDM,3237570501,HC ANGIOGRAPHY SPINAL,4041.84,3031.38,48.5,3637.66,119
CDM,3237571001,HC ANGIO EXTREMITY UNILATERAL,3680.03,2760.02,44.16,3312.03,119
CDM,3237571601,HC ANGIO EXTREMITY BILATERAL,4155.49,3116.62,49.87,3739.94,119
CDM,3237572601,HC ANGIO VISCERAL SELECT,2062.84,1547.13,24.75,1856.56,119
CDM,3237573101,HC ANGIO ADRENAL UNILATERAL,3248.91,2436.68,38.99,2924.02,119
CDM,3237573301,HC ANGIO ADRENAL BILATERAL,7380.81,5535.61,88.57,6642.73,119
CDM,3237573601,HC ANGIO PELVIC SELECTIVE,3926.52,2944.89,47.12,3533.87,119
CDM,3237574101,HC ANGIO PULMONARY UNILATERAL,3782.97,2837.23,45.4,3404.67,119
CDM,3237574301,HC ANGIO PULMONARY BILATERAL,4188.13,3141.1,50.26,3769.32,119
CDM,3237574601,HC ANGIO PULM VENOUS  NONSELECT,3493.95,2620.46,41.93,3144.56,119
CDM,3237575601,HC ANGIO INTERNAL MAMMARY,7603.99,5702.99,91.25,6843.59,119
CDM,3237577401,HC ANGIO SELECTIVE VESSEL ADDL,2361.05,1770.79,28.33,2124.95,119
CDM,3237589801,HC ANGIO POST EMBOLIZATION,2062.84,1547.13,24.75,1856.56,119
CDM,323C800401,HC SIM ANG W/PRS CATH RAD EMB,49059.9,36794.93,588.72,44153.91,119
CDM,32470,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,14.715,11.04,0.14,16.07,357
CDM,32471,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,31.8,23.85,0.38,28.62,238
CDM,325,ALPRAZOLAM 0.5 MG TABLET,2.21,1.66,0.03,1.99,238
CDM,32589,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,162.0,121.5,1.94,145.8,119
CDM,326,ALPRAZOLAM 1 MG TABLET,0.37,0.27,0.01,0.33,119
CDM,32855,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,561.36,421.02,6.74,505.22,119
CDM,3291,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,12.0,9.0,0.08,31.54,1666
CDM,3293,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,12.3,9.23,0.15,11.07,119
CDM,3294,FUROSEMIDE 20 MG TABLET,1.01,0.76,0.01,0.91,119
CDM,3295,FUROSEMIDE 40 MG TABLET,0.3,0.22,0.01,0.27,119
CDM,3296,FUROSEMIDE 80 MG TABLET,0.39,0.29,0.01,0.35,119
CDM,3300745T01,HC CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,7655.87,5741.9,91.87,6890.28,119
CDM,3300746T01,HC CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,23356.39,17517.29,280.28,21020.75,119
CDM,3300747T01,HC CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,6151.71,4613.78,73.82,5536.54,119
CDM,3307730071,PBB BASIC RADIATION DOSIMETRY CALCULATION,564.57,423.43,6.77,508.11,119
CDM,3307731771,PBB BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2366.63,1774.97,28.4,2129.97,119
CDM,3307779971,PBB RADIUM/RADIOISOTOPE THERAPY UNLIST,1195.34,896.5,14.34,1075.81,119
CDM,3319640101,HC CHEMO SQ OR IM NON-HORMONAL,459.39,344.54,5.51,413.45,119
CDM,3319640201,HC CHEMO SQ OR IM HORMONAL,277.22,207.92,3.33,249.5,119
CDM,3319640501,HC CHEMO INTRALESIONAL UP TO 7,2042.36,1531.77,24.51,1838.12,119
CDM,3319640601,HC CHEMO INTRALESIONAL OVER 7,2781.55,2086.16,33.38,2503.4,119
CDM,3319640901,HC CHEMO IV PUSH INITIAL,683.9,512.92,8.21,615.51,119
CDM,3319641101,HC CHEMO IV PUSH EACH ADDL,331.6,248.7,3.98,298.44,119
CDM,3319642001,HC CHEMO INTRA ARTERIAL PUSH,892.09,669.07,10.71,802.88,119
CDM,3319645001,HC CHEMO CNS INTRATHECAL W/LP,1444.22,1083.16,17.33,1299.8,119
CDM,3319645041,HC CHEMOTHERAPY INTO CNS,1444.22,1083.16,17.33,1299.8,119
CDM,3319654201,HC CHEMO INJ VIA SQ RESERVOIR,524.29,393.22,6.29,471.86,119
CDM,33227,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.88,2.91,0.05,3.49,119
CDM,33228,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,5.44,4.08,0.07,4.9,119
CDM,33229,AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSION,55.35,41.51,0.66,49.82,119
CDM,33230,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,117.0,87.75,1.4,105.3,119
CDM,33357,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.08,0.06,0.01,0.07,119
CDM,3337728001,HC SIMULATION SIMPLE,1638.62,1228.96,19.66,1474.76,119
CDM,3337729001,HC SIMULATION COMPLEX,2826.27,2119.7,33.92,2543.64,119
CDM,3337729301,HC RESPIRATORY MOTION MANAGEMENT SIMULATION,1417.89,1063.42,17.01,1276.1,119
CDM,3337729501,HC RADIOTHERAPY 3-D PLAN,7025.24,5268.93,84.3,6322.72,119
CDM,3337730001,HC BASIC DOSIMETRY,564.57,423.43,6.77,508.11,119
CDM,3337730101,HC IMRT DOSE PLAN,12859.86,9644.9,154.32,11573.87,119
CDM,3337730601,HC TELE ISODOSE PLAN SIMPLE; INCLUDES BASIC DOSE CALC,1951.97,1463.98,23.42,1756.77,119
CDM,3337730701,HC TELE ISODOSE PLAN COMPLEX; INCLUDES BASIC DOSE CALC,3256.92,2442.69,39.08,2931.23,119
CDM,3337731601,HC BRACHYTX ISODOSE PLAN SIMPLE; INCLUDES BASIC DOSE CALC,2249.56,1687.17,26.99,2024.6,119
CDM,3337731801,HC BRACHYTX ISODOSE PLAN COMPLEX; INCLUDES BASIC DOSE CALC,4143.33,3107.5,49.72,3729.0,119
CDM,3337732101,HC SPECIAL TELETHERAPY MEASURES,1481.88,1111.41,17.78,1333.69,119
CDM,3337733101,HC SPECIAL DOSIMETRY,575.07,431.3,6.9,517.56,119
CDM,3337733201,HC SIMPLE TREATMENT DEVICE (SIMPLE BLOCK; SIMPLE BOLUS),659.15,494.36,7.91,593.24,119
CDM,3337733301,"HC INTERMEDIATE TREATMENT DEVICE (STANDARD BLOCKS, STENTS, SP BOLUS, ADJ AIDS)",726.95,545.21,8.72,654.26,119
CDM,3337733401,HC COMPLEX TREATMENT DEVICE (CUSTOM),1399.25,1049.44,16.79,1259.32,119
CDM,3337733601,HC CONTINUING MEDICAL PHYSICS,596.02,447.02,7.15,536.42,119
CDM,3337733801,HC MULTI-LEAF COLLIMATOR MLC,7269.16,5451.87,87.23,6542.24,119
CDM,3337737001,HC SPECIAL PHYSICS CONSULT,978.2,733.65,11.74,880.38,119
CDM,3337737101,HC SRS RAD TX MULTISOURCE,75516.27,56637.2,906.2,67964.64,238
CDM,3337737201,HC LINEAR ACLRTR TX 1 SESSION,17713.81,13285.36,212.57,15942.43,119
CDM,3337737301,HC LINEAR ACCELERATOR MAX 5 FRACTIONS; INCLUDES IMAGE GUIDANCE,5312.31,3984.23,63.75,4781.08,119
CDM,3337738501,HCD IMRT TREATMENT SIMPLE; INCLUDES GUIDANCE AND TRACKING,2916.3,2187.22,35.0,2624.67,119
CDM,3337738601,HCD IMRT TREATMENT COMPLEX; INCLUDES GUIDANCE AND TRACKING,3253.31,2439.98,39.04,2927.98,119
CDM,3337738701,HC GUIDANCE FOR LOCALIZATION TARGET VOLUME IGRT,462.3,346.72,5.55,416.07,119
CDM,3337740201,HC RADIATION TREATMENT DELIVERY LEVEL 1,376.57,282.43,4.52,338.91,119
CDM,3337740701,HC RADIATION TREATMENT DELIVERY LEVEL 2,325.53,244.15,3.91,292.98,119
CDM,3337741201,HC RADIATION TREATMENT DELIVERY LEVEL 3,1036.64,777.48,12.44,932.98,119
CDM,3337741701,HC THERAPEUTIC RADIOLOGY PORT FILMS,236.34,177.26,2.84,212.71,119
CDM,3337747001,HC SPECIAL TREATMENT PROCEDURE,1797.6,1348.2,21.57,1617.84,119
CDM,3337776101,HC INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1529.0,1146.75,18.35,1376.1,119
CDM,3337776201,HC INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,2355.73,1766.8,28.27,2120.16,119
CDM,3337776301,HC INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3262.26,2446.7,39.15,2936.03,119
CDM,3337776701,HC HDR SKIN SURFACE BRACHYTHERAPY 2 CM OR 1 CHANNEL,1302.48,976.86,15.63,1172.23,119
CDM,3337776801,HC HDR SKIN SURFACE BRACHYTHERAPY 3+ CM / 2+ CHANNEL,1686.69,1265.02,20.24,1518.02,119
CDM,3337777001,HC HDR RADIONUCLIDE INTERSTITIAL/INTRACAV; 1 CHANNEL INCL BASIC CALC,4821.46,3616.1,57.86,4339.31,119
CDM,3337777101,HC HDR RADIONUCLIDE INTERSTITIAL/INTRAV; 2-12 CHANNELS INCL BASIC CALC,5007.23,3755.42,60.09,4506.51,119
CDM,3337777201,HC HDR RADIONUCLIDE INTERSTITIAL/INTRAV; >12 CHANNELS INCL BASIC CALC,6392.6,4794.45,76.71,5753.34,119
CDM,3337777801,HC INTERSTITIAL RADIATION SOURCE APPLICATION; INCL LOAD/HANDLING,5293.22,3969.92,63.52,4763.9,119
CDM,3337778901,HC SURFACE APPLICATION OF LOW DOSE RADIONUCLIDE SOURCE,611.56,458.67,7.34,550.4,119
CDM,3337779001,HC SUPERVISION/HANDLING-RADIOELEMENT NON-HDR,881.82,661.36,10.58,793.64,119
CDM,3359641301,HC CHEMO INFUSION INITIAL 1ST HR,1002.35,751.76,12.03,902.12,119
CDM,3359641501,HC CHEMO INFUSION EACH ADDL HOUR,573.11,429.83,6.88,515.8,119
CDM,3359641601,HC CHEMO PROLONGED WITH PUMP,866.23,649.67,10.39,779.61,119
CDM,3359641701,HC CHEMO INFUSION SEQNTL 1 HR,571.56,428.67,6.86,514.4,119
CDM,3359654941,HC CHEMO IV INFUSION CONCURRENT,645.91,484.43,7.75,581.32,119
CDM,335M022001,"HCD COVID INJ TIXAGEVIMAB AND CILGAVIMAB, INCL POST ADMIN MONITOR",295.06,221.3,3.54,265.55,119
CDM,335M022201,"HCD COVID INJ BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMIN MONITOR",583.0,437.25,7.0,524.7,119
CDM,335M024301,"HCD IV INFUSION, COVID-19, CASIRIVIMAB AND IMDEVIMAB",927.07,695.3,11.12,834.36,119
CDM,335M024701,"HCD COVID INTRAVENOUS INFUS, SOTROVIMAB INCL POST ADMIN MONITOR",1991.31,1493.48,23.9,1792.18,119
CDM,3378,GEMFIBROZIL 600 MG TABLET,0.71,0.53,0.01,0.64,119
CDM,3407826601,HC GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,534.93,401.2,6.42,481.44,119
CDM,3407944501,HC INTRA-ARTERIAL PARTICULATE ADMIN,2869.25,2151.94,34.43,2582.33,119
CDM,3410742T01,HC POSITIVE FLOW RESERVE CARDIAC SPECT,162.47,121.85,1.95,146.22,119
CDM,3417801201,HC NM THYROID UPTAKE SINGL OR MULT MEASUREMENTS,870.23,652.67,10.44,783.21,119
CDM,3417801301,HC THYROID IMAGING W OR WO BLOOD FLOW,2038.38,1528.78,24.46,1834.54,119
CDM,3417801401,HC THYROID IMAGING W SNGL/MULT MEASUREMENTS,2940.62,2205.46,35.29,2646.56,119
CDM,3417801501,HC NM THYROID CANCER METS LIMITED,2278.82,1709.12,27.35,2050.94,119
CDM,3417801801,HC NM THYROID WHOLE BODY,2789.82,2092.36,33.48,2510.84,119
CDM,3417802001,HC NM THYROID CANCER METS UPTAKE,535.79,401.84,6.43,482.21,119
CDM,3417807001,HC NM PARATHYROID IMAGING,1873.81,1405.36,22.49,1686.43,119
CDM,3417807101,HC PARATHYROID PLANAR IMAGING W SPECT,2342.32,1756.74,28.11,2108.09,119
CDM,3417807201,HC PARATHYROID PLANAR W SPECT AND CT,3584.68,2688.51,43.02,3226.21,119
CDM,3417810201,HC NM BONE MARROW IMAGING LIMITED,876.97,657.73,10.52,789.27,119
CDM,3417810401,HC BONE MARROW IMAGING WHOLE BODY,1202.52,901.89,14.43,1082.27,119
CDM,3417819501,HC NM LYMPHATIC IMAGING,2225.58,1669.18,26.71,2003.02,119
CDM,3417820101,HC NM LIVER IMAGING STATIC,900.89,675.67,10.81,810.8,119
CDM,3417821501,HC NM LIVER/SPLEEN STATIC IMAGING,1019.82,764.86,12.24,917.84,119
CDM,3417821601,HC NM LIVER AND SPLEEN WITH FLOW,5590.83,4193.12,67.09,5031.75,119
CDM,3417822601,HC HEPATOBILIARY IMAGING,2547.29,1910.47,30.57,2292.56,119
CDM,3417822701,HC HEPATOBILIARY W PHARM /EF,2567.22,1925.42,30.81,2310.5,119
CDM,3417826201,HC NM GASTRO REFLUX IMAGING,2133.02,1599.76,25.6,1919.72,119
CDM,3417826401,HC NM GASTRIC EMPTYING IMAGING,2150.36,1612.77,25.8,1935.32,119
CDM,3417827801,HC NM GI BLEED IMAGING,2191.65,1643.74,26.3,1972.48,119
CDM,3417829001,HC NM MECKELS BOWEL IMAGING,2430.09,1822.57,29.16,2187.08,119
CDM,3417830001,HC NM BONE IMAGING LIMITED AREA,2222.21,1666.66,26.67,1999.99,119
CDM,3417830501,HC NM BONE IMAGING MULTIPLE AREAS,2720.33,2040.25,32.64,2448.3,119
CDM,3417830601,HC NM BONE IMAGING WHOLE BODY,2472.01,1854.01,29.66,2224.81,119
CDM,3417831501,HC NM BONE IMAGING 3 PHASE,2745.56,2059.17,32.95,2471.0,119
CDM,3417843401,HC POSITIVE FLOW RESERVE CARDIAC PET,169.32,126.99,2.03,152.39,119
CDM,3417844501,HC NM VASCULAR IMAGING FLOW STUDY,1868.39,1401.29,22.42,1681.55,119
CDM,3417845101,HC HEART MUSCLE SPECT SINGLE,5165.43,3874.07,61.99,4648.89,119
CDM,3417845201,HC HEART MUSCLE SPECT MULT,5931.57,4448.68,71.18,5338.41,119
CDM,3417846901,HC MYOCARDIAL INFARCT SPECT,2331.7,1748.78,27.98,2098.53,119
CDM,3417847201,HC CARDIAC BLOOD POOL IMAGING W EF,2481.6,1861.2,29.78,2233.44,119
CDM,3417857901,HC PULMONARY VENTILATION,1187.3,890.48,14.25,1068.57,119
CDM,3417858001,HC PULMONARY PERFUSION PARTICULATE,1476.4,1107.3,17.72,1328.76,119
CDM,3417858201,HC PULMONARY VENT/PERFUSION IMAGING,2538.0,1903.5,30.46,2284.2,119
CDM,3417859701,HC PULMONARY PERF INCL DIFF COUNTS,1942.15,1456.61,23.31,1747.94,119
CDM,3417859801,HC PULM PERF/VENT W DIFF COUNTS,2147.73,1610.8,25.77,1932.96,119
CDM,3417860601,HC BRAIN IMAGING WITH FLOW STUDY,1674.86,1256.14,20.1,1507.37,119
CDM,3417861001,HC CEREBRAL VASCULAR FLOW ONLY,2309.8,1732.35,27.72,2078.82,119
CDM,3417863001,HC CISTERNOGRAM,2339.99,1754.99,28.08,2105.99,119
CDM,3417864501,HC CEREBROSPINAL SHUNT EVALUATION,1480.15,1110.11,17.76,1332.14,119
CDM,3417865001,HC CISTERNOG CSF LEAK-NUC MED,1617.09,1212.82,19.41,1455.38,119
CDM,3417870701,HC KIDNEY IMAGING W/O PHARM SINGLE W FLOW,2060.33,1545.25,24.72,1854.3,119
CDM,3417870801,HC KIDNEY IMAGING W/PHARM SINGLE W FLOW,2528.2,1896.15,30.34,2275.38,119
CDM,3417870901,HC KIDNEY IMAG MULT W/WO PHARM W FLOW,2408.39,1806.29,28.9,2167.55,119
CDM,3417872501,HC KIDNEY FUNCTION STUDY NON-IMAGING,827.11,620.33,9.93,744.4,119
CDM,3417874001,HC URETERAL REFLUX STUDY VOIDING,1391.83,1043.87,16.7,1252.65,119
CDM,3417880201,HC NM RP LOCLZJ TUM WHBDY 1 D IMG,1619.65,1214.74,19.44,1457.69,119
CDM,3417880301,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT 1 AREA",3089.01,2316.76,37.07,2780.11,119
CDM,3417880401,HC NM RADIOPHARM LOCTZN WHOLE BODY S&I,3092.81,2319.61,37.11,2783.53,119
CDM,3417880801,HC INJECT PROC RADIOPHARM LOCALIZTN NON-IMAGING,489.49,367.12,5.87,440.54,119
CDM,3417883001,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT W/CT 1",3089.01,2316.76,37.07,2780.11,119
CDM,3417883101,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT 2 AREAS",2560.82,1920.62,30.73,2304.74,119
CDM,3417883201,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT W/CT 2",2982.68,2237.01,35.79,2684.41,119
CDM,3423,GENTAMICIN 0.1 % TOPICAL CREAM,236.97,177.73,2.84,213.27,119
CDM,3424,GENTAMICIN 0.1 % TOPICAL OINTMENT,236.97,177.73,2.84,213.27,119
CDM,3426,GENTAMICIN 40 MG/ML INJECTION SOLUTION,113.88,85.41,0.33,179.93,476
CDM,3427900501,HC NM RADIOACTIVE THYROID TX-ORAL ADMIN,3650.49,2737.87,43.81,3285.44,119
CDM,3427910101,HC NM RADIOPHARMACEUTICAL TX FOR METS,1351.14,1013.36,16.21,1216.03,119
CDM,3430,GENTIAN VIOLET 1 % TOPICAL SOLUTION,31.505,23.63,0.25,38.23,238
CDM,343Q996901,HCD NON-HEU TC99M ADD ON PER STUDY DOSE,10.83,8.12,0.13,9.75,119
CDM,34505,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,2.64,1.98,0.03,2.38,238
CDM,34544,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,2.92,2.19,0.04,2.63,238
CDM,34574,GUAIFENESIN 400 MG TABLET,2.07,1.55,0.02,1.86,119
CDM,346,POTASSIUM ALUM (BULK) POWDER,465.0,348.75,5.16,449.98,238
CDM,34769,NICOTINE (POLACRILEX) 2 MG BUCCAL LOZENGE,2.32,1.74,0.03,2.09,119
CDM,34814,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10,000 UNIT/ML-1 % EAR SOLUTION",503.4,377.55,6.04,453.06,119
CDM,3497,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,24.48,18.36,0.2,29.38,476
CDM,3500042T01,HCD CT PERFUSION W/CONTRAST CBF,871.9,653.92,10.46,784.71,119
CDM,3507701101,HC CT STEREOTACTIC LOCALIZATION,3077.54,2308.16,36.93,2769.79,119
CDM,3507701201,HC CT GUIDE NEEDLE BX ASPRTN/INJECT,2248.54,1686.4,26.98,2023.69,119
CDM,3507701301,HC CT GUIDE  FOR TISSUE ABLATION (IE PARENCHYMAL),2132.32,1599.24,25.59,1919.09,119
CDM,3507701401,HCD CT GUIDANCE/RAD THERAPY FIELDS,888.49,666.37,10.66,799.64,119
CDM,3517045001,HC CT HEAD/BRAIN W/O CONTRAST,1806.74,1355.06,21.68,1626.07,119
CDM,3517046001,HC CT HEAD/BRAIN W/CONTRAST,2098.84,1574.13,25.19,1888.96,119
CDM,3517047001,HC CT HEAD/BRAIN W/WO CONTRAST,2679.5,2009.62,32.15,2411.55,119
CDM,3517048001,HC CT ORBIT/SELLA/IAC W/O CONTRAST,1758.29,1318.72,21.1,1582.46,119
CDM,3517048101,HC CT ORBIT/SELLA/IAC W/CONTRAST,2017.18,1512.88,24.21,1815.46,119
CDM,3517048201,HC CT ORBIT/SELLA/IAC W/WO CONTRAST,2097.16,1572.87,25.17,1887.44,119
CDM,3517048601,HC CT MAXILLOFACIAL W/O CONTRAST,2062.6,1546.95,24.75,1856.34,119
CDM,3517048701,HC CT MAXILLOFACIAL W/CONTRAST,2824.71,2118.53,33.9,2542.24,119
CDM,3517048801,HC CT MAXILLOFACIAL W/WO CONTRAST,2939.4,2204.55,35.27,2645.46,119
CDM,3517049001,HC CT NECK SOFT TISSUE W/O CONTRAST,2001.18,1500.88,24.01,1801.06,119
CDM,3517049101,HC CT NECK SOFT TISSUE W/CONTRAST,2441.63,1831.22,29.3,2197.47,119
CDM,3517049201,HC CT NECK SOFT TISS W/WO CONTRAST,2904.71,2178.53,34.86,2614.24,119
CDM,3517049601,HC CTA HEAD W/WO CONTRAST,3013.86,2260.4,36.17,2712.47,119
CDM,3517049801,HC CTA NECK W/WO CONTRAST,2964.87,2223.65,35.58,2668.38,119
CDM,35184,CYCLOBENZAPRINE 5 MG TABLET,2.13,1.595,0.01,3.69,238
CDM,3527125001,HC CT THORAX DX W/O CONTRAST,2192.76,1644.57,26.31,1973.48,119
CDM,3527126001,HC CT THORAX DX W/CONTRAST,3530.67,2648.0,42.37,3177.6,119
CDM,3527127001,HC CT THORAX DX W/WO CONTRAST,4287.61,3215.71,51.45,3858.85,119
CDM,3527127101,HC CT LOW DOSE LUNG CA SCREEN W/O,2392.59,1794.44,28.71,2153.33,119
CDM,3527127501,HC CTA PULMONARY W/WO CONTRAST,3517.15,2637.86,42.21,3165.44,119
CDM,3527212501,HC CT CERVICAL SPINE W/O CONTRAST,2191.67,1643.75,26.3,1972.5,119
CDM,3527212601,HC CT CERVICAL SPINE W/CONTRAST,2918.84,2189.13,35.03,2626.96,119
CDM,3527212701,HC CT CERVICALSPINE W/WO CONTRAST,3142.53,2356.9,37.71,2828.28,119
CDM,3527212801,HC CT THORACIC SPINE  W/O CONTRAST,2139.85,1604.89,25.68,1925.86,119
CDM,3527212901,HC CT THORACIC SPINE W/CONTRAST,3039.98,2279.98,36.48,2735.98,119
CDM,3527213001,HC CT THORACIC SPINE W/WO CONTRAST,3749.04,2811.78,44.99,3374.14,119
CDM,3527213101,HC CT LUMBAR SPINE W/O CONTRAST,2483.62,1862.72,29.8,2235.26,119
CDM,3527213201,HC CT LUMBAR SPINE W/CONTRAST,2946.67,2210.0,35.36,2652.0,119
CDM,3527213301,HC CT LUMBAR SPINE W/WO CONTRAST,3220.86,2415.64,38.65,2898.77,119
CDM,3527219101,HC CTA PELVIS W/WO CONTRAST,2860.78,2145.58,34.33,2574.7,119
CDM,3527219201,HC CT PELVIS W/O CONTRAST,2431.42,1823.56,29.18,2188.28,119
CDM,3527219301,HC CT PELVIS W/CONTRAST,3141.76,2356.32,37.7,2827.58,119
CDM,3527219401,HC CT PELVIS W/WO CONTRAST,3505.3,2628.98,42.06,3154.77,119
CDM,3527320001,HC CT UPPER EXTREMITY W/O CONTRAST,1972.19,1479.14,23.67,1774.97,119
CDM,3527320101,HC CT UPPER EXTREMITY W/CONTRAST,2374.85,1781.14,28.5,2137.36,119
CDM,3527320201,HC UPPR EXTR W/WO CONTRAST UNILATERAL,2688.95,2016.71,32.27,2420.05,119
CDM,3527320601,HC CTA UPPER EXTREMITY W/WO CONTRAST UNILATERAL,2974.23,2230.67,35.69,2676.81,119
CDM,3527370001,HC CT LOWER EXTREMITY W/O CONTRAST UNILATERAL,2113.28,1584.96,25.36,1901.95,119
CDM,3527370101,HC CT LOWER EXTREMITY W/CONTRAST UNILATERAL,2601.29,1950.97,31.22,2341.16,119
CDM,3527370201,HC CT LWR EXTR W/WO CONTRAST UNILATERAL,2797.29,2097.97,33.57,2517.56,119
CDM,3527370601,HC CTA LOWER EXTREMITY W/WO CONTRAST UNILATERAL,3363.19,2522.39,40.36,3026.87,119
CDM,3527415001,HC CT ABDOMEN W/O CONTRAST,2379.04,1784.28,28.55,2141.14,119
CDM,3527416001,HC CT ABDOMEN W/CONTRAST,3117.03,2337.77,37.4,2805.33,119
CDM,3527417001,HC CT ABDOMEN W/WO CONTRAST,3270.73,2453.05,39.25,2943.66,119
CDM,3527417401,HC CTA ABDOMEN AND PELVIS,3534.94,2651.2,42.42,3181.45,119
CDM,3527417501,HC CTA ABDOMEN W/WO CONTRAST,2848.33,2136.25,34.18,2563.5,119
CDM,3527417601,HC CT ABD & PELVIS W/O CONTRAST,3744.58,2808.44,44.93,3370.12,119
CDM,3527417701,HC CT ABDOMEN & PELVIS W/CONTRAST,4761.83,3571.37,57.14,4285.65,119
CDM,3527417801,HC CT ABD & PELVIS W/WO CONTRAST,6392.67,4794.5,76.71,5753.4,119
CDM,3527426101,HC CT DIAGNOSTIC COLONOGRAPHY W/O CONTRAST,2916.87,2187.65,35.0,2625.18,119
CDM,3527426301,HC CT SCREENING COLONOGRAPHY,410.97,308.23,4.93,369.87,119
CDM,3527557101,HC CT HEART QUAN CALCIUM W/O CONTRAST,426.26,319.7,5.12,383.63,119
CDM,3527557201,HC CT HEART W/CONTRAST STRUCTURE,6799.72,5099.79,81.6,6119.75,119
CDM,3527557301,HC CCTA W/CONTRAST CONGENITAL,6529.72,4897.29,78.36,5876.75,119
CDM,3527557401,HC CTA CORONARY ARTERIES W/CONTRAST,3697.75,2773.31,44.37,3327.98,119
CDM,3527563501,HC CTA ABD ILEO/FEMORAL RUNOFF W/WO CONTRAST,2565.1,1923.82,30.78,2308.59,119
CDM,353,ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,39.73,29.8,0.48,35.76,119
CDM,3579,HALOPERIDOL 1 MG TABLET,2.46,1.84,0.03,2.21,119
CDM,3583,HALOPERIDOL 5 MG TABLET,0.6,0.45,0.01,0.54,119
CDM,3584,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,35.94,26.96,0.43,32.35,238
CDM,3585,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,169.92,127.44,2.04,152.93,119
CDM,35865,"ALPRAZOLAM ER 1 MG TABLET,EXTENDED RELEASE 24 HR",4.33,3.24,0.05,3.9,119
CDM,35902,"PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE",2.34,1.76,0.03,2.11,119
CDM,3601186497,HC OR PROCEDURE AT BEDSIDE LEVEL PER MIN,63.07,47.3,0.76,56.76,119
CDM,3601186597,HC OR PROCEDURE LEVEL 1 PER MIN,79.32,59.49,0.95,71.39,119
CDM,3601186697,HC OR PROCEDURE LEVEL 2 PER MIN,131.36,98.52,1.58,118.22,119
CDM,3601186797,HC OR PROCEDURE LEVEL 3 PER MIN,160.64,120.48,1.93,144.58,119
CDM,3601186897,HC OR PROCEDURE LEVEL 4 PER MIN,176.5,132.38,2.12,158.85,119
CDM,3601186997,HC OR PROCEDURE LEVEL 5 PER MIN,198.96,149.22,2.39,179.06,119
CDM,3601187097,HC OR PROCEDURE LEVEL 6 PER MIN,210.5,157.88,2.53,189.45,119
CDM,3601187197,HC OR PROCEDURE LEVEL 7 PER MIN,264.49,198.37,3.17,238.04,119
CDM,3603394601,HC ECMO-ECLS INITIATION VENO-VENOUS,4368.15,3276.11,52.42,3931.33,119
CDM,3603398101,HC RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP,27075.0,20306.25,324.9,24367.5,119
CDM,3603398401,HC ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,3468.56,2601.42,41.62,3121.7,119
CDM,3603398601,HC ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,27075.0,20306.25,324.9,24367.5,119
CDM,36063,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,42.0,31.5,0.5,37.8,238
CDM,3606682101,HC AFTER CATARACT LASER SURGERY,1676.66,1257.49,20.12,1508.99,119
CDM,3610810T01,HC SUBRTA NJX RX AGT W/VTRC,27266.85,20450.14,327.2,24540.16,238
CDM,3611014597,HC BRONCH INCL FLUOR GUIDE; EBUS INVNT PERIPHERAL LESIONS,13161.05,9870.79,157.93,11844.94,119
CDM,3611014797,HC BRONCH INCL FLUOR GUIDE; EBUS SAMPLING 1/2 NODES,14139.44,10604.58,169.67,12725.5,119
CDM,3611014997,HC BRONCH INCL FLUOR GUIDE; EBUS SAMPLING 3 OR MORE NODES,15775.67,11831.75,189.31,14198.1,119
CDM,3611015197,HC BRONCH W/ NEEDLE ASPIRATION,14034.63,10525.97,168.42,12631.17,119
CDM,3611015397,HC BRONCH W/ TRACH STENT INSERT,15364.23,11523.17,184.37,13827.81,119
CDM,3611015597,HC BRONCH W/BIOPSY-BRUSHING,13161.05,9870.79,157.93,11844.94,119
CDM,3611015997,HC BRONCH W/BX-NEEDLE ASPIRATE,13161.05,9870.79,157.93,11844.94,119
CDM,3611016197,HC BRONCH W/ENDOBRONCHIAL BX,7378.65,5533.99,88.54,6640.78,119
CDM,3611016597,HC BRONCH W/TRANSBRONCH BX SINGLE LOBE,9220.0,6915.0,110.64,8298.0,119
CDM,3611016797,HC BRONCH WITH CELL WASHING,3600.0,2700.0,43.2,3240.0,119
CDM,3611017897,HC BRONCHOSCOPY DIAGNOSTIC,648.39,486.29,7.78,583.55,119
CDM,3611018797,HC BRONCHOSCOPY W DILATION,6976.51,5232.38,83.72,6278.86,119
CDM,3611019197,HC BRONCHOSCOPY W/BRUSHING,4323.94,3242.96,51.89,3891.55,119
CDM,3611019597,HC BRONCHOSCOPY W/TX ASP INIT W/FLUORO,7378.65,5533.99,88.54,6640.78,119
CDM,3611019797,"HC BRONCHOSCOPY WNEEDLE ASPIRATION, EA ADD LOBE USE W 989L",3478.08,2608.56,41.74,3130.27,119
CDM,3611019897,"HC BRONCHOSCOPY, W PLACEMENT FIDUCIAL MARKERS (INCLUDES FLUORO)",22218.43,16663.82,266.62,19996.59,119
CDM,3611034997,HC ROBOTIC ASSISTED BRONCHOSCOPY,4283.85,3212.89,51.41,3855.47,119
CDM,3611036997,HC CENTRAL LINE INSERT/REPAIR/RMVL,18.71,14.03,0.22,16.84,119
CDM,3611058297,HC DX BRONCHOSCOPY W/LAVAGE,13161.05,9870.79,157.93,11844.94,119
CDM,3611156597,HC LARYNGOSCOPY,2046.45,1534.84,24.56,1841.8,119
CDM,3611159197,HC LUMBAR PUNCTURE,1725.0,1293.75,20.7,1552.5,119
CDM,3611169997,HC MINOR PROCEDURE,504.41,378.31,6.05,453.97,119
CDM,3611173297,HC MINOR PROCEDURE 0-30 MIN,627.05,470.29,7.52,564.34,119
CDM,3611179197,HC COM CON NERVE BLOCK INJECTION,1341.3,1005.98,16.1,1207.17,119
CDM,3611191597,HC PAIN MANAGEMENT-UNILATERAL,3588.87,2691.65,43.07,3229.98,119
CDM,3611192097,HC PARACENTESIS,1428.09,1071.07,17.14,1285.28,119
CDM,3611199997,HC PICC (CENTRAL VENOUS CATHETER INSERT),5158.19,3868.64,61.9,4642.37,119
CDM,3611202797,HC PLEURAL BIOPSY--PERCUT BX LUNG/MEDIASTINUM,4597.8,3448.35,55.17,4138.02,119
CDM,3611207697,HC OTHER PERIPHERAL NERVE BLOCK INJECTION,1407.9,1055.92,16.89,1267.11,119
CDM,3611207797,HC LATERAL FEMORAL CUTAN (LFCN) NERVE BLOCK INJECTION,1407.9,1055.92,16.89,1267.11,119
CDM,3611207897,HC PPG NERVE BLOCK INJECTION,1407.9,1055.92,16.89,1267.11,119
CDM,3611207997,HC LATERAL FEMORAL CUTAN NERVE BLOCK INJECTION,1407.9,1055.92,16.89,1267.11,119
CDM,3611208097,"HC TAP,RECTUS SHEATH,QL,SUBCOSTAL TAP NERVE BLOCK INJECTION",1407.9,1055.92,16.89,1267.11,119
CDM,3611208197,"HCD BIL TAP, BIL QL,SUBCOSTAL TAP NERVE BLOCK INJECTION",1407.9,1055.92,16.89,1267.11,119
CDM,3611208297,"HC ESP,PECS I/II,SERRATUS ANTERIOR,PIFB,TTP,PARASTERNAL NERVE BLOCK INJECTION",1407.9,1055.92,16.89,1267.11,119
CDM,3611208397,"HC BIL ESP,PECS I/II,SERRATUS ANTERIOR,PARASTERNAL NERVE BLOCK INJECTION",1407.9,1055.92,16.89,1267.11,119
CDM,3611208497,"HC FASCIA ILIACA,SUPRAINGUINAL FICB,PEND,IPACK NERVE BLOCK INJECTION",1407.9,1055.92,16.89,1267.11,119
CDM,3611208597,HC CAUDAL NERVE BLOCK INJECTION,1407.9,1055.92,16.89,1267.11,119
CDM,3611213397,HC RF ABLATION ADDITIONAL FACET JT,511.56,383.67,6.14,460.4,119
CDM,3611213597,HC RF ABLATION FACET JOINT INITIAL,1006.09,754.5699999999999,6.65,1312.34,238
CDM,3611264397,HC TB CATH ASP W SCOPE:BEDSD,921.58,691.18,11.06,829.42,119
CDM,3611266997,HC THORACENTESIS,1701.24,1275.93,20.41,1531.12,119
CDM,3611272497,HC TRANSBRONCHIAL BX ADDL LOBE,5414.72,4061.04,64.98,4873.25,119
CDM,3613327701,HC INSJ PHRNC NRV STIM TRANSVNS,9329.89,6997.42,111.96,8396.9,119
CDM,3613328101,HC REPOSG PHRNC NRV STIM TRNSVN,7933.05,5949.79,95.2,7139.74,119
CDM,3613328701,HC RMV&RPLCMT PHRNC NRV STIM PG,3613.19,2709.89,43.36,3251.87,119
CDM,3613395101,HC ECMO INSERT ART AND/OR VENOUS <6 YRS,1431.62,1073.71,17.18,1288.46,119
CDM,3616446602,HC THRC FASCIAL PLN BLK UNILATERIAL NJX,1120.91,840.68,13.45,1008.82,119
CDM,3616447302,HC LWR XTR FSCL PLN BLK UNILATERIAL NJX,1120.91,840.68,13.45,1008.82,119
CDM,3619358401,HC VNGRPH CHD ANOM/PERSIST SVC,5349.68,4012.26,64.2,4814.71,119
CDM,3619358501,HC VNGRPH CHD AZYGS/HEMIAZYGS,5349.68,4012.26,64.2,4814.71,119
CDM,3619358601,HC VENOGRAPHY CHD CORONARY SINUS,2878.57,2158.93,34.54,2590.71,119
CDM,3619359301,HC HEART CATH CONGENITAL RIGHT SIDE - NORMAL NATIVE,9363.34,7022.5,112.36,8427.01,119
CDM,3619359401,HC HEART CATH CONGENITAL RIGHT SIDE - ABNORMAL NATIVE,9403.39,7052.54,112.84,8463.05,119
CDM,3619359501,HC HEART CATH CONGENITAL LEFT SIDE - NORM/ABNORM NATIVE,10410.49,7807.87,124.93,9369.44,119
CDM,3619359601,HC HEART CATH CONGENITAL RIGHT/LEFT SIDE - NORM NATIVE,9379.79,7034.84,112.56,8441.81,119
CDM,3619359701,HC HEART CATH CONGENITAL RIGHT/LEFT SIDE - ABNORM NATIVE,9386.65,7039.99,112.64,8447.98,119
CDM,364,AMANTADINE HCL 100 MG CAPSULE,11.98,8.98,0.14,10.78,119
CDM,365,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,23.7,17.77,0.28,21.33,119
CDM,36776,"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",1.37,1.03,0.02,1.23,119
CDM,3697,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,42.72,32.04,0.25,58.0,357
CDM,3698,HYDRALAZINE 10 MG TABLET,1.16,0.87,0.01,1.04,119
CDM,36987,ZONISAMIDE 25 MG CAPSULE,0.94,0.71,0.01,0.85,119
CDM,36988,ZONISAMIDE 50 MG CAPSULE,1.1,0.83,0.01,0.99,119
CDM,3700,HYDRALAZINE 25 MG TABLET,0.89,0.67,0.01,0.8,119
CDM,3701,HYDRALAZINE 50 MG TABLET,1.24,0.93,0.01,1.12,119
CDM,3701005597,HC ANESTHESIA PER MINUTE,12.12,9.09,0.15,10.91,119
CDM,3701029097,HC EPIDURAL NERVE BLOCK INJECTION,1332.07,999.05,15.98,1198.86,119
CDM,3709915101,HC MODERATE SEDATION SAME PHYS AS PERF INTITAL 15 MIN <5 YRS,819.76,614.82,9.84,737.78,119
CDM,3709915201,HC MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,819.76,614.82,9.84,737.78,119
CDM,3709915301,HC MODERATE SEDATION UNDER PHYS SUPRVSN EA ADDTL 15 MIN,491.86,368.9,5.9,442.67,119
CDM,3709915501,HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,901.73,676.3,10.82,811.56,119
CDM,3709915601,HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,901.73,676.3,10.82,811.56,119
CDM,3709915701,HC MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,541.03,405.77,6.49,486.93,119
CDM,3720,HYDROCHLOROTHIAZIDE 25 MG TABLET,1.26,0.94,0.02,1.13,119
CDM,3724,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,238.39,178.79,0.05,378.02,476
CDM,3725,HYDROCORTISONE 0.5 % TOPICAL CREAM,19.77,14.83,0.24,17.79,119
CDM,3726,HYDROCORTISONE 1 % TOPICAL CREAM,5.28,3.96,0.06,4.75,119
CDM,3727,HYDROCORTISONE 2.5 % TOPICAL CREAM,19.8,14.85,0.24,17.82,119
CDM,3731,HYDROCORTISONE 1 % TOPICAL OINTMENT,12.6,9.45,0.15,11.34,119
CDM,3732,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,19.73,14.8,0.24,17.76,119
CDM,3733,HYDROCORTISONE 10 MG TABLET,1.72,1.29,0.02,1.55,119
CDM,3734,HYDROCORTISONE 20 MG TABLET,3.08,2.31,0.04,2.77,119
CDM,3738,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,9.265,6.945,0.1,8.98,238
CDM,3757,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,25.92,19.44,0.31,23.33,119
CDM,37578,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,75.87,56.9,0.91,68.28,119
CDM,3760,HYDROMORPHONE 2 MG TABLET,1.13,0.85,0.01,1.93,595
CDM,3761,HYDROMORPHONE 4 MG TABLET,1.31,0.905,0.01,1.19,357
CDM,37637,METOPROLOL TARTRATE 25 MG TABLET,0.57,0.43,0.01,0.51,119
CDM,3770,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,138.92,104.19,1.67,125.03,119
CDM,3771,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,1503.055,1127.2900000000002,0.08,2699.79,238
CDM,3772,HYDROXYZINE HCL 10 MG TABLET,0.64,0.48,0.01,0.58,119
CDM,3774,HYDROXYZINE HCL 25 MG TABLET,1.55,1.17,0.02,1.4,119
CDM,3775,HYDROXYZINE HCL 50 MG TABLET,1.11,0.83,0.01,1.0,119
CDM,38224,"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",1.22,0.91,0.01,1.1,119
CDM,38225,"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",1.35,1.01,0.02,1.22,119
CDM,38245,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,85.14,63.86,1.02,76.63,119
CDM,38390,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP (REPACKAGING),21.3,15.98,0.02,20.41,476
CDM,3841,IBUPROFEN 200 MG TABLET,0.4,0.3,0.01,0.36,119
CDM,38421,MIRTAZAPINE 7.5 MG TABLET,6.5,4.87,0.08,5.85,119
CDM,3843,IBUPROFEN 400 MG TABLET,0.41,0.31,0.01,0.37,119
CDM,3844,IBUPROFEN 600 MG TABLET,0.51,0.38,0.01,0.46,119
CDM,3845,IBUPROFEN 800 MG TABLET,0.45,0.34,0.01,0.4,119
CDM,38488,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,25.725,19.294999999999998,0.21,30.78,357
CDM,3862,IMIPRAMINE 50 MG TABLET,1.86,1.4,0.02,1.67,119
CDM,38961,SELENIUM SULFIDE 1 % SHAMPOO,17.39,13.04,0.21,15.65,119
CDM,3897,INDOMETHACIN 25 MG CAPSULE,1.15,0.86,0.01,1.03,119
CDM,3898,INDOMETHACIN 50 MG CAPSULE,1.34,1.0,0.02,1.21,119
CDM,390P901001,HC WHOLE BLOOD FOR TRANSFUSION PER UNIT,1688.31,1266.23,20.26,1519.48,119
CDM,390P901141,"HC BLOOD, SPLIT UNIT - FFP",341.95,256.46,4.1,307.76,119
CDM,390P901142,HC PROCESS LEUKO PED PLT ALIQUOT,1312.05,984.04,15.74,1180.84,119
CDM,390P901143,HC PROCESS LEUKO PED RBC ALIQUOT,497.4,373.05,5.97,447.66,119
CDM,390P901201,HC PROCESS CRYOPRECIPATE,451.7,338.78,5.42,406.53,119
CDM,390P901641,"HC PROCESS, LEUKOREDUCED RED CELLS",1651.19,1238.39,19.81,1486.07,119
CDM,390P901701,HC ONE DONOR FRESH FROZN PLASMA,457.87,343.4,5.49,412.08,119
CDM,390P902141,HC PROCESS AUTOLOGOUS RBC-OUTSIDE,1421.22,1065.92,17.05,1279.1,119
CDM,390P902201,HC WASHED RED BLOOD CELLS EA UNIT,2642.07,1981.55,31.7,2377.86,119
CDM,390P903501,"HC PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",4128.42,3096.32,49.54,3715.58,119
CDM,390P903701,HC PLATELETS PHERESIS LR IRRAD EA UNIT,4500.62,3375.46,54.01,4050.56,119
CDM,390P903801,HC RBC IRRADIATED EACH UNIT,4069.65,3052.24,48.84,3662.68,119
CDM,390P903901,HC RBC DEGLYCEROLIZED EACH UNIT WASHED,4241.75,3181.31,50.9,3817.58,119
CDM,390P904001,HC RBCS LEUKOREDUCED IRRAD,2522.86,1892.14,30.27,2270.57,119
CDM,390P904401,HC CRYOPRECIPITATE REDUCED PLASMA,509.2,381.9,6.11,458.28,119
CDM,390P905101,HC RBCS LEUKOREDUCED CMV NEG,1792.37,1344.28,21.51,1613.13,119
CDM,390P905201,HC PLATELETS HLA MATCHED LEUKOREDUCED,5600.67,4200.5,67.21,5040.6,119
CDM,390P905301,HC PLATELETS APHER IRRAD CMV NEG,4141.47,3106.1,49.7,3727.32,119
CDM,390P905501,HC PLATELETS APHER CMV NEG,3835.96,2876.97,46.03,3452.36,119
CDM,390P905801,HC RBCS LEUKOREDUCED IRRAD.CMV NEG,2097.91,1573.43,25.17,1888.12,119
CDM,390P905901,"HC PROCESS FFP,8-24 HRS COLLECT,EA UNIT",459.54,344.66,5.51,413.59,119
CDM,390P907301,"HC PLATELETS, PHERESIS, PATHOGEN REDUCED EA UNIT",3442.63,2581.97,41.31,3098.37,119
CDM,391,AMILORIDE 5 MG TABLET,1.34,1.0,0.02,1.21,119
CDM,39136,"NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",42.03,31.52,0.5,37.83,119
CDM,3913643001,HC ADMIN BLOOD TRANSFUSION DAILY,1107.34,830.5,13.29,996.61,119
CDM,3913646001,HC TRANSFUSION INTRAUTERINE FETAL,1999.79,1499.84,24.0,1799.81,119
CDM,39267,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,201.195,150.89499999999998,1.07,226.29,714
CDM,39622,GLYCERIN 99.5 % TOPICAL SOLUTION,127.71,95.78,1.53,114.94,119
CDM,39801,BIOTIN 1 MG TABLET,0.29,0.22,0.01,0.26,119
CDM,4009222801,HC REMOTE IMG MGMT OF RETINAL DS,147.67,110.75,1.77,132.9,119
CDM,4009225001,HC FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,1587.83,1190.87,19.05,1429.05,119
CDM,4017706101,HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,165.35,124.01,1.98,148.82,119
CDM,4017706203,HC BREAST TOMOSYNTHESIS BILATERAL,165.35,124.01,1.98,148.82,119
CDM,4017706501,"HC DIAG MAMMO, UNILATERAL INCL CAD WHEN PERFORMED",763.67,572.75,9.16,687.3,119
CDM,4017706601,"HC DIAG MAMMO, BILATERAL INCL CAD WHEN PERFORMED",919.39,689.54,11.03,827.45,119
CDM,4025179801,HC BLADDER SCAN/URINE CAPACITY MEASUREMENT,392.76,294.57,4.71,353.48,119
CDM,4027,ISONIAZID 300 MG TABLET,1.49,1.12,0.02,1.34,119
CDM,4027650601,HC ECHOENCEPHALOGRAM SONO,945.62,709.22,11.35,851.06,119
CDM,4027651201,HC US OPTHALMC DIAG B SCAN UNILATERAL,267.88,200.91,3.21,241.09,119
CDM,4027653601,HC US HEAD/NECK SOFT TISSUE,822.34,616.76,9.87,740.11,119
CDM,4027660401,HC US CHEST/THORACIC,709.46,532.1,8.51,638.51,119
CDM,4027660404,HC US CHEST WALL LIMITED,709.46,532.1,8.51,638.51,119
CDM,4027664102,HC US BREAST UNILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS,1357.27,1017.95,16.29,1221.54,119
CDM,4027664103,HC US BREAST BILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS,2714.54,2035.9,32.57,2443.09,119
CDM,4027664202,HC US BREAST UNILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS,824.81,618.61,9.9,742.33,119
CDM,4027664203,HC US BREAST BILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS,1566.95,1175.21,18.8,1410.26,119
CDM,4027670001,HC ULTRASOUND ABDOMEN COMPLETE,1093.33,820.0,13.12,984.0,119
CDM,4027670501,HC ULTRASOUND ABDOMEN LIMITED,842.95,632.21,10.12,758.66,119
CDM,4027670601,HC US ABDL AORTA SCREEN AAA,424.57,318.43,5.09,382.11,119
CDM,4027677001,HC US RETROPERITONEAL COMPLETE,916.88,687.66,11.0,825.19,119
CDM,4027677501,HC US RETROPERITONEAL LIMITED,706.96,530.22,8.48,636.26,119
CDM,4027677601,HC US KIDNEY TRANSPLANT,890.29,667.72,10.68,801.26,119
CDM,4027680001,HC US SPINE,1115.32,836.49,13.38,1003.79,119
CDM,4027680101,"HC US, OB < 14 WKS, SINGLE FETUS",855.2,641.4,10.26,769.68,119
CDM,4027680201,HC OB US < 14 WKS ADDL FETUS,616.35,462.26,7.4,554.72,119
CDM,4027680501,HC US PREG 2ND/3RD TRIMESTER,1005.63,754.22,12.07,905.07,119
CDM,4027681001,"HC US, OB >/= 14 WKS, ADDL FETUS",593.78,445.34,7.13,534.4,119
CDM,4027681101,HC US OB COMPLETE SINGLE GESTATION,1337.41,1003.06,16.05,1203.67,119
CDM,4027681201,HC US OB COMPLETE EACH ADDL GESTATION,532.88,399.66,6.39,479.59,119
CDM,4027681301,HC OB US NUCHAL MEAS 1 GEST,1402.55,1051.91,16.83,1262.3,119
CDM,4027681401,HC OB US NUCHAL MEAS ADD-ON,568.94,426.7,6.83,512.05,119
CDM,4027681501,HC ULTRASOUND OB LIMITED,470.82,353.12,5.65,423.74,119
CDM,4027681601,HC US OB FOLLOW-UP INITIAL FETUS,701.36,526.02,8.42,631.22,119
CDM,4027681605,HC US OB FOLLOW-UP EACH ADDL FETUS,701.36,526.02,8.42,631.22,119
CDM,4027681701,HC TRANSVAGINAL ULTRASOUND PREGNANCY,730.43,547.82,8.77,657.39,119
CDM,4027681771,PBB US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,730.43,547.82,8.77,657.39,119
CDM,4027681801,HC BIOPHYSICAL PROFILE W/NST INITIAL,552.95,414.71,6.64,497.66,119
CDM,4027681805,HC BIOPHYSICAL PROFILE W/NST EACH ADDITIONAL,601.28,450.96,7.22,541.15,119
CDM,4027681901,HC BIOPHYSCIAL PROFILE W/O NST INITIAL,487.22,365.42,5.85,438.5,119
CDM,4027681905,HC BIOPHYSICAL PROFILE W/O NST ADDL,513.96,385.47,6.17,462.56,119
CDM,4027682001,HC UMBILICAL ARTERY ECHO,636.0,477.0,7.63,572.4,119
CDM,4027682005,HC UMBILICAL ARTERY ECHO ADDL FETUS,636.0,477.0,7.63,572.4,119
CDM,4027682101,HC FETAL MIDL CEREBRAL ARTERY ECHO,689.73,517.3,8.28,620.76,119
CDM,4027682105,HC FETAL MIDL CEREBRAL ARTERY ECHO ADDL FETUS,689.73,517.3,8.28,620.76,119
CDM,4027682501,HC US FETAL ECHO W2ND (2D) ULTRASOUND,1207.44,905.58,14.49,1086.7,119
CDM,4027682601,HC SONO FETAL HEART F/U,896.67,672.5,10.76,807.0,119
CDM,4027682701,HC COMPL FETAL DOPPLER ECHOCARGIOGRAM,819.04,614.28,9.83,737.14,119
CDM,4027682801,HC US FETAL DOPPR ECHOCARDGM LIMITED,896.67,672.5,10.76,807.0,119
CDM,4027683001,HC US TRANSVAGINAL NON-OB S&I,902.71,677.03,10.83,812.44,119
CDM,4027683101,"HC SONO EXAM, HYSTEROSONOGRAPHY",1096.61,822.46,13.16,986.95,119
CDM,4027685601,HC US PELVIC NON-OB S&I,818.07,613.55,9.82,736.26,119
CDM,4027685701,"HC US EXAM, PELVIC, LIMITED",771.7,578.78,9.26,694.53,119
CDM,4027687001,HC US SCROTUM AND CONTENTS,765.36,574.02,9.18,688.82,119
CDM,4027687201,HC ULTRASOUND TRANSRECTAL,762.2,571.65,9.15,685.98,119
CDM,4027687301,HC US PROSTATE VOLUME STUDY FOR BRACHYTHERAPY LDR,935.32,701.49,11.22,841.79,119
CDM,4027688101,HC US COMP JOINT REALTIME W IMAGE,795.75,596.81,9.55,716.18,119
CDM,4027688202,HC US LIMITED JOINT OR NONVASC EXTREM UNILATERAL,467.69,350.77,5.61,420.92,119
CDM,4027688203,HC US LIMITED JOINT OR NONVASC EXTREM BILATERAL,935.39,701.54,11.22,841.85,119
CDM,4027688501,HC US HIP BILATERAL,817.75,613.31,9.81,735.98,119
CDM,4027688601,HC US INFANT HIPS W/O MANIPULATIN,44.0,33.0,0.53,39.6,119
CDM,4027693201,HC US ENDOMYOCARDIAL BIOPSY,499.15,374.36,5.99,449.24,119
CDM,4027693601,HC US GUIDED COMPRESSION REPAIR,332.7,249.52,3.99,299.43,119
CDM,4027693701,HC US GUIDE VASCULAR ACCESS,347.17,260.38,4.17,312.45,119
CDM,4027694101,HC US FOR FETAL TRANSF/CORDOCENTESIS,914.24,685.68,10.97,822.82,119
CDM,4027694201,HC US GUIDED NEEDLE PLACEMENT,1304.95,978.71,15.66,1174.46,119
CDM,4027694501,HC US CHORINONIC VILLUS SAMPLE,499.64,374.73,6.0,449.68,119
CDM,4027694601,HC US GUIDANCE AMNIOCENTESIS,564.13,423.1,6.77,507.72,119
CDM,4027696501,HC US GUIDANCE INTERSTITIAL RADIOELEMENT APPLICATION (NEEDLES),631.27,473.45500000000004,6.44,653.36,238
CDM,4027697801,HC IR TRGT DYNAMIC MICROBUBBLE; 1ST LESION,766.43,574.82,9.2,689.79,119
CDM,4027698101,HC US ELASTOGRAPHY; PARENCHYMA,1434.15,1075.61,17.21,1290.74,119
CDM,4027698201,HC US ELASTOGRAPHY; 1ST TARGET LESION,898.03,673.52,10.78,808.23,119
CDM,4027699801,HC ULTRASOUND INTRAOPERATIVE,1092.82,819.62,13.11,983.54,119
CDM,4027699903,HC US BREAST SCREENING BILATERAL,471.85,353.89,5.66,424.66,119
CDM,4027699942,HC US LYMPH NODES,471.82,353.86,5.66,424.64,119
CDM,4027699943,HC US GB EJECTION FRACTION CALC,392.12,294.09,4.71,352.91,119
CDM,4027699944,HC SPECIMEN BREAST TISSUE SURGICAL,471.85,353.89,5.66,424.66,119
CDM,4029120001,HC US SHEER WAVE ELAST LIVER,534.8,401.1,6.42,481.32,119
CDM,4029389201,HC TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,957.97,718.48,11.5,862.17,119
CDM,4029392201,HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,1014.1,760.58,12.17,912.69,119
CDM,4029392401,HC N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,881.84,661.38,10.58,793.66,119
CDM,4029397001,HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1687.75,1265.81,20.25,1518.98,119
CDM,4029397101,HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,1142.46,856.84,13.71,1028.21,119
CDM,4029398001,HC DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,596.86,447.64,7.16,537.17,119
CDM,4029398101,HC DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,583.17,437.38,7.0,524.85,119
CDM,4029398501,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1372.88,1029.66,16.47,1235.59,119
CDM,4029398601,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,988.82,741.62,11.87,889.94,119
CDM,4029399001,HC DUPLEX SCAN HEMODIALYSIS ACCESS,1195.77,896.83,14.35,1076.19,119
CDM,403,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,44.88,33.66,0.4,50.87,476
CDM,4034,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,900.0,675.0,7.56,972.0,595
CDM,4037706301,HC BREAST TOMOSYNTHESIS SCREENING BILATERAL,231.7,173.78,2.78,208.53,119
CDM,4037706304,HC BREAST TOMOSYNTHESIS SCREENING UNILATERAL,115.85,86.89,1.39,104.26,119
CDM,4037706701,"HC SCREEN MAMMO, BILATERAL INCL CAD WHEN PERFORMED",1336.04,1002.03,16.03,1202.44,119
CDM,4037706704,"HC SCREEN MAMMO, UNILATERAL INCL CAD WHEN PERFORMED",723.47,542.6,8.68,651.12,119
CDM,40378,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.21,0.16,0.01,0.19,119
CDM,4047842901,"HC MYOCARDIAL IMAGING, PET W/CT SCAN",7668.55,5751.41,92.02,6901.7,119
CDM,4047843001,HC NM MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,7929.11,5946.83,95.15,7136.2,119
CDM,4047843101,HC MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,11353.55,8515.16,136.24,10218.2,119
CDM,4047843301,HC NJH MYOCARDIAL IMAGING PET/CT PERFUSION W/ MET EVAL,8577.47,6433.1,102.93,7719.72,119
CDM,4047845901,HC PET MYOCARDIAL VIABILITY,9203.93,6902.95,110.45,8283.54,119
CDM,4047849101,HC PET CARDIAC PERFUSION  SINGLE,6833.41,5125.06,82.0,6150.07,119
CDM,4047849201,HC PET CARDIAC PERFUSION MULTIPLE,6281.4,4711.05,75.38,5653.26,119
CDM,4047860801,HC PET BRAIN METABOLIC EVALUATION,11377.02,8532.76,136.52,10239.32,119
CDM,4047860901,HC PET BRAIN PERFUSION EVALUATION,9967.72,7475.79,119.61,8970.95,119
CDM,4047881401,HC PET ATTEN LOC W/CT LIMITED,7562.97,5672.23,90.76,6806.67,119
CDM,4047881501,HC PET CT SKULL TO MID THIGH,11515.53,8636.65,138.19,10363.98,119
CDM,4047881601,HC PET IMAGE W/CT FULL BODY,13170.61,9877.96,158.05,11853.55,119
CDM,404G023501,HC PET CERVICAL NON CMS,154.77,116.08,1.86,139.29,119
CDM,4064,ISOSORBIDE DINITRATE 10 MG TABLET,3.66,2.74,0.04,3.29,119
CDM,4065,ISOSORBIDE DINITRATE 20 MG TABLET,5.27,3.95,0.06,4.74,119
CDM,4066,ISOSORBIDE DINITRATE 30 MG TABLET,6.26,4.69,0.08,5.63,119
CDM,408101548,DARBEPOETIN ALFA 40 MCG/0.4 ML (NEO WEEKLY) (UW),881.12,660.84,10.57,793.01,238
CDM,408101549,DARBEPOETIN ALFA 25 MCG/0.42 ML (NEO WEEKLY) (UW),550.7,413.03,6.61,495.63,238
CDM,408101553,DARBEPOETIN ALFA 60 MCG/0.3 ML (NEO WEEKLY) (UW),1276.4,957.3,15.32,1148.76,238
CDM,408190759,DARBEPOETIN ALFA 10 MCG/0.4 ML (NEO WEEKLY) (UW),235.88,176.91,2.83,212.29,238
CDM,408200895,INV BI1291583/PLACEBO 2.5 MG TABLET,0.01,0.01,0.01,0.01,119
CDM,408204209,INV PKN605/PLACEBO ORAL TABLET,0.01,0.01,0.01,0.01,119
CDM,408211661,INV NIPOCALIMAB/PLACEBO 30 MG/ML INJECTION,0.01,0.01,0.01,0.01,119
CDM,408215937,INV TOCILIZUMAB 20 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,357
CDM,408217337,INV RESMETIROM (MGL-3196) OR PLACEBO 60 MG TABLET,0.01,0.01,0.01,0.01,119
CDM,408217338,INV RESMETIROM (MGL-3196) OR PLACEBO 80 MG TABLET,0.01,0.01,0.01,0.01,119
CDM,408217339,INV RESMETIROM (MGL-3196) OR PLACEBO 100 MG TABLET,0.01,0.01,0.01,0.01,119
CDM,4083700040,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),27.75,20.810000000000002,0.19,29.7,833
CDM,4088848,INV ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,0.01,0.01,0.01,0.01,119
CDM,40888510,INV ALBUTEROL SULFATE HFA 90 MCG/ACTUATION INHALER,0.01,0.01,0.01,0.01,119
CDM,40893501,INV FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
CDM,409000011,NUTRITIONAL FEEDING - ADULT (AFF),875.0,656.25,10.5,787.5,119
CDM,409000016,NUTRITIONAL FEEDING - ADULT (HRF),875.0,656.25,10.5,787.5,119
CDM,409000022,NUTRITIONAL FEEDING – ADULT (LUTHERAN),875.0,656.25,10.5,787.5,119
CDM,409000026,NUTRITIONAL FEEDING – ADULT (PVF),875.0,656.25,10.5,787.5,119
CDM,409000031,NUTRITIONAL FEEDING – ADULT (SJF),875.0,656.25,10.5,787.5,119
CDM,409000033,NUTRITIONAL FEEDING – ADULT (SMF),875.0,656.25,10.5,787.5,119
CDM,409000034,NUTRITIONAL FEEDING – ADULT (SVF),875.0,656.25,10.5,787.5,119
CDM,409000125,GELMIX ORAL POWDER PACKET (INF-PED NUTRITION),3.9,2.92,0.05,3.51,119
CDM,4101029797,HC DELIVERY EVALUATION,301.42,226.06,3.62,271.28,119
CDM,4101030297,HC RESPIRATORY EVALUATION,264.71,198.53,3.18,238.24,119
CDM,4101030997,HC MECHANICAL COUGH ASSIST TREATMENT,517.29,387.97,6.21,465.56,119
CDM,4101031197,HC CONTINUOUS AEROSOL GENERATING INHALATION TREATMENT,927.09,695.32,11.13,834.38,119
CDM,4103172001,HC NASOTRACH CATH ASPIRATION,129.93,97.45,1.56,116.94,119
CDM,4109400201,HC VENTILATOR 1ST DAY,1999.51,1499.63,23.99,1799.56,119
CDM,4109400301,HC VENTILATOR SUBSEQUENT DAY,2712.82,2034.62,32.55,2441.54,119
CDM,4109464001,HC AIRWAY INHALATION TREATMENT,149.82,112.36,1.8,134.84,119
CDM,4109464201,HC PENTAMDINE TREATMENT,357.28,267.96,4.29,321.55,119
CDM,4109464205,HC SPAG NEBULIZER,337.1,252.82,4.05,303.39,119
CDM,4109464501,HC CONTINUOUS NEB MED EACH ADDL HR,175.87,131.9,2.11,158.28,119
CDM,4109464505,HC CONTINUOUS NEB MED ADDL DAILY,511.56,383.67,6.14,460.4,119
CDM,4109464506,HC CONTINUOUS IEOP DAILY,6387.86,4790.9,76.65,5749.07,119
CDM,4109466001,HC POS AIRWAY PRESSURE CPAP/BIPAP,1064.86,798.64,12.78,958.37,119
CDM,4109466041,HC CPAP LIMITED,328.83,246.62,3.95,295.95,119
CDM,4109466042,HC THERAPY MONITORING OF HOME CPAP DEVICE DAILY,335.11,251.33,4.02,301.6,119
CDM,4109466043,HC THERAPY MONITORING OF VENTILATION HOME DEVICE DAILY,2759.81,2069.86,33.12,2483.83,119
CDM,4109466401,HC EVALUATE PT USE OF INHALER,356.05,267.04,4.27,320.44,119
CDM,4109466701,HC MANIPULATION CHEST WALL INITIAL,181.48,136.11,2.18,163.33,119
CDM,4109466801,HC MANIPULATION CHEST WALL SUSQNT,181.38,136.04,2.18,163.24,119
CDM,4109466901,HC CHEST WALL OSCILLATION,281.59,211.19,3.38,253.43,119
CDM,410G023701,HC RESPIRATORY MUSCLE THERAPY EA 15 MIN,149.51,112.13,1.79,134.56,119
CDM,410G023801,HC RESP FUNCTION 1:1 PER 15 MIN,79.99,59.99,0.96,71.99,119
CDM,410G023901,HC RESP MUSCLE/FUNCTION GROUP,183.08,137.31,2.2,164.77,119
CDM,41237,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,735.0,551.25,7.45,918.27,357
CDM,41382,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,73.09,54.82,0.88,65.78,238
CDM,4139209,INV PLERIXAFOR 20 MG/ML SUBCUTANEOUS SOLUTION,0.01,0.01,0.01,0.01,119
CDM,413G027701,HC HYPERBARIC OXYGEN FULL BODY CHAMBER PER 30 MIN,671.11,503.33,8.05,604.0,119
CDM,41623,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,123.19,92.39,1.48,110.87,119
CDM,4201007697,HC PT CONTINOUS PASSIVE MOTION (DAILY),216.25,162.19,2.6,194.62,119
CDM,420153,INV ION356/PLACEBO INTRATHECAL SOLUTION,0.01,0.01,0.01,0.01,119
CDM,4202835,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
CDM,4202940501,HC PT APPLY CAST BELOW KNEE TO TOES (SHORT LEG),495.44,371.58,5.95,445.9,119
CDM,4202944502,HC PT APPLICATION OF TOTAL CONTACT CAST UNILATERAL,1045.61,784.21,12.55,941.05,119
CDM,4202958002,HC PT UNNABOOT STRAPPING UNILATERAL,226.39,169.79,2.72,203.75,119
CDM,4202958003,HC PT UNNA BOOT STRAPPING BILATERAL,820.34,615.26,9.84,738.31,119
CDM,4202958401,HC PT APPLY MULTLAY COMPRS UPR ARM FOREARM HAND AND FINGERS,828.65,621.49,9.94,745.78,119
CDM,4202979901,HC PT CAST SERIAL 1 JOINT,223.08,167.31,2.68,200.77,119
CDM,4202979904,HC PT STRAPPING LOW BACK,258.33,193.75,3.1,232.5,119
CDM,4202979941,HC PT CAST SERIAL 2 JOINTS,301.67,226.25,3.62,271.5,119
CDM,4209090101,HC PT BIOFEEDBACK TRAINING,411.27,308.45,4.94,370.14,119
CDM,4209091201,HC PT BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,370.27,277.7,4.44,333.24,119
CDM,4209091301,HC PT BFB TRAING W/EMG&/MANOMETRY EACH ADDL 15 MIN CNTCT,370.27,277.7,4.44,333.24,119
CDM,4209252601,"HC PT SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",487.45,365.59,5.85,438.7,119
CDM,4209261001,HC PT EVAL ORAL/PHARYNGEAL FUNC,772.82,579.62,9.27,695.54,119
CDM,4209599201,HC PT CANALITH REPOSITIONING PER DAY,174.83,131.12,2.1,157.35,119
CDM,4209611201,HC PT NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,946.36,709.77,11.36,851.72,119
CDM,4209611301,HC PT NEURODEVELOPMENT EVAL EACH ADDL 30 MINS,512.48,384.36,6.15,461.23,119
CDM,4209701201,HC PT TRACTION MECHANICAL 1+ AREAS,120.36,90.27,1.44,108.32,119
CDM,4209701406,HC PT E-STIM UNATTENDED NON-WOUND,179.04,134.28,2.15,161.14,119
CDM,4209701601,HC PT VASOPNEUM DEVICE 1+ AREAS,151.05,113.29,1.81,135.95,119
CDM,4209701801,HC PT PARAFFIN BATH THERAPY 1+ AREAS,118.91,89.18,1.43,107.02,119
CDM,4209702201,HC PT WHIRLPOOL 1+ AREAS,284.97,213.73,3.42,256.47,119
CDM,4209702401,HC PT DIATHERMY 1+ AREAS,123.57,92.68,1.48,111.21,119
CDM,4209702601,HC PT LIGHT THERAPY 1+ AREAS,59.02,44.26,0.71,53.12,119
CDM,4209703201,HC PT E-STIM ATTENDED PER 15 MIN,157.87,118.4,1.89,142.08,119
CDM,4209703301,HC PT IONTOPHORESIS PER 15 MIN,191.36,143.52,2.3,172.22,119
CDM,4209703401,HC PT CONTRAST BATH PER 15 MIN,98.25,73.69,1.18,88.42,119
CDM,4209703501,HC PT ULTRASOUND PER 15 MIN,106.52,79.89,1.28,95.87,119
CDM,4209703901,HC PT FLUIDOTHERAPY,173.83,130.37,2.09,156.45,119
CDM,4209711001,HC PT THERAPEUTIC EX PER 15 MIN,136.83,102.62,1.64,123.15,119
CDM,4209711201,HC PT NEUROMUS RE-ED PER 15 MIN,157.7,118.28,1.89,141.93,119
CDM,4209711301,HC PT AQUATIC THERAPY/EX PER 15 MIN,159.0,119.25,1.91,143.1,119
CDM,4209711601,HC PT GAIT TRAINING 15 MIN,163.53,122.65,1.96,147.18,119
CDM,4209712401,HC PT THERAPEUTIC MASSAGE PER 15 MIN,146.78,110.08,1.76,132.1,119
CDM,4209712901,HC PT THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,167.89,125.92,2.01,151.1,119
CDM,4209713001,HC PT THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,134.28,100.71,1.61,120.85,119
CDM,4209714001,"HC PT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN",156.82,117.62,1.88,141.14,119
CDM,4209715001,HC PT THERAPEUTIC PROC-GROUP,213.0,159.75,2.56,191.7,119
CDM,4209753001,HC PT THERAPEUTIC ACTIVITY 15 MIN,160.27,120.2,1.92,144.24,119
CDM,4209753301,HC PT SENSORY INTEG ACT PER 15 MIN,116.24,87.18,1.39,104.62,119
CDM,4209753501,HC PT ADL/SELF CARE PER 15 MIN,182.82,137.12,2.19,164.54,119
CDM,4209753701,HC PT COMMUNITY/WORK/TRAINING 15 MIN,178.08,133.56,2.14,160.27,119
CDM,4209754201,HC PT WHEELCHAIR MGMT 15 MIN,157.29,117.97,1.89,141.56,119
CDM,4209754501,HC PT WORK HARDENING/CONDITIONING INIT 2 HRS,503.5,377.62,6.04,453.15,119
CDM,4209754601,HC PT WORK CONDITIONING/HARDENING EACH ADDL HR,238.9,179.18,2.87,215.01,119
CDM,4209755001,HC PT CAREGIVER TRAING 1ST 30 MIN,157.47,118.1,1.89,141.72,119
CDM,4209755101,HC PT CAREGIVER TRAING EA ADDL 15 MIN,84.57,63.43,1.01,76.11,119
CDM,4209755201,HC PT GROUP CAREGIVER TRAINING IN HOME/COMM,52.98,39.74,0.64,47.68,119
CDM,4209759701,HC PT SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,624.53,468.4,7.49,562.08,119
CDM,4209759801,HC PT SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,469.49,352.12,5.63,422.54,119
CDM,4209760201,HC PT NON-SELECTIVE DEBRIDE W/O ANES,431.93,323.95,5.18,388.74,119
CDM,4209760501,HC PT WOUND THRP W/DME  <50 SQ CM,761.44,571.08,9.14,685.3,119
CDM,4209760601,HC PT WOUND THRP W/DME >50 SQ CM,1055.81,791.86,12.67,950.23,119
CDM,4209760701,HC PT WOUND THRP W/O DME <50SQ CM,677.91,508.43,8.13,610.12,119
CDM,4209760801,HC PT WOUND THRP W/O DME >50SQ CM,1036.52,777.39,12.44,932.87,119
CDM,4209775001,HC PT PHYS PERF TEST/MEAS/REP 15MIN,156.04,117.03,1.87,140.44,119
CDM,4209775501,HC PT ASSTV TECHN ASSMNT EA 15M,151.79,113.84,1.82,136.61,119
CDM,4209776001,HC PT INITIAL ORTHOTICS FIT/TRAIN PER 15 MIN,110.39,82.79,1.32,99.35,119
CDM,4209776101,HC PT INITIAL PROSTHETIC TRAINING PER 15 MIN,131.23,98.42,1.57,118.11,119
CDM,4209776301,HC PT SUBSEQ ORTH/PROSTHETIC TRAIN PER 15 MIN,105.08,78.81,1.26,94.57,119
CDM,4209779944,HC PT APP PRESSURE OFFLOADING DVLPMNT 97799,106.2,79.65,1.27,95.58,119
CDM,4209779946,HC PT WHEELCHAIR FITTING EVAL 97799,413.35,310.01,4.96,372.02,119
CDM,420G028201,HC PT E-STIM UNATTENDED NON-WND ULCER G0282,132.42,99.32,1.59,119.18,119
CDM,4237,KETAMINE 100 MG/ML INJECTION SOLUTION,61.62,46.22,0.6,68.8,476
CDM,4238,KETAMINE 50 MG/ML INJECTION SOLUTION,27.66,20.74,0.33,24.89,238
CDM,4249716101,HC PT EVAL LOW COMPLEXITY,354.86,266.14,4.26,319.37,119
CDM,4249716201,HC PT EVAL MODERATE COMPLEXITY,444.13,333.1,5.33,399.72,119
CDM,4249716216,HC CLIENT ONLY HRH PHYSICAL THERAPY EVALUATION PER SESSION,444.13,333.1,5.33,399.72,119
CDM,4249716301,HC PT EVAL HIGH COMPLEXITY,535.83,401.87,6.43,482.25,119
CDM,4249716401,HC PT RE-EVALUATION,275.27,206.45,3.3,247.74,119
CDM,4294,CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,50.78,38.08,0.61,45.7,119
CDM,4300101T01,HC OT SHOCKWAVE THERAPY 0101T,109.3,81.98,1.31,98.37,119
CDM,4302906501,HC OT APPLY LONG ARM CAST,669.48,502.11,8.03,602.53,119
CDM,4302908501,HC OT APPLY CAST HAND & LOWER FOREARM,445.31,333.98,5.34,400.78,119
CDM,4302940501,HC OT APPLY CAST BELOW KNEE TO TOES (SHORT LEG),495.44,371.58,5.95,445.9,119
CDM,4302979901,HC OT CAST CONSTRAINT INDUCED,203.74,152.8,2.44,183.37,119
CDM,4302979941,HC OT CAST SERIAL 2 JOINTS,377.1,282.82,4.53,339.39,119
CDM,4302979942,HC OT CAST SERIAL 1 JOINTS,223.08,167.31,2.68,200.77,119
CDM,4309252601,"HC OT SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",529.33,397.0,6.35,476.4,119
CDM,4309599201,HC OT CANALITH RESPOSIONING PER DAY,121.13,90.85,1.45,109.02,119
CDM,4309611201,HC OT NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,1044.8,783.6,12.54,940.32,119
CDM,4309612501,HC OT COGNITIVE EVAL/REPORT PER HR,747.43,560.57,8.97,672.69,119
CDM,4309701406,HC OT E-STIM UNATTENDED NON-WOUND,97.81,73.36,1.17,88.03,119
CDM,4309701801,HC OT PARAFFIN BATH THERAPY 1+ AREAS,87.84,65.88,1.05,79.06,119
CDM,4309703201,HC OT E-STIM ATTENDED PER 15 MIN,156.46,117.34,1.88,140.81,119
CDM,4309703301,HC OT IONTOPHORESIS PER 15 MIN,141.36,106.02,1.7,127.22,119
CDM,4309703401,HC OT CONTRAST BATH PER 15 MIN,156.36,117.27,1.88,140.72,119
CDM,4309703501,HC OT ULTRASOUND PER 15 MIN,77.67,58.25,0.93,69.9,119
CDM,4309703701,HC OT LOW LEVEL LASER THERAPY 97037,95.34,71.5,1.14,85.81,238
CDM,4309703901,HC OT FLUIDOTHERAPY,128.41,96.31,1.54,115.57,119
CDM,4309711001,HC OT THERAPEUTIC EX PER 15 MIN,146.87,110.15,1.76,132.18,119
CDM,4309711201,HC OT NEUROMUS RE-ED PER 15 MIN,156.29,117.22,1.88,140.66,119
CDM,4309711301,HC OT AQUATIC THERAPY/EX PER 15 MIN,151.01,113.26,1.81,135.91,119
CDM,4309711601,HC OT GAIT TRAINING 15 MIN,162.07,121.55,1.94,145.86,119
CDM,4309712401,HC OT THERAPEUTIC MASSAGE PER 15 MIN,145.47,109.1,1.75,130.92,119
CDM,4309712901,HC OT THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,166.39,124.79,2.0,149.75,119
CDM,4309713001,HC OT THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,166.39,124.79,2.0,149.75,119
CDM,4309713901,HC OT UNLISTED THERA PROC EA 15 MIN,177.07,132.8,2.12,159.36,119
CDM,4309714001,"HC OT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN",155.42,116.56,1.87,139.88,119
CDM,4309715001,HC OT THERAPEUTIC PROC GROUP,211.11,158.33,2.53,190.0,119
CDM,4309753001,HC OT THERAPEUTIC ACTIVITY 15 MIN,158.84,119.13,1.91,142.96,119
CDM,4309753301,HC OT SENSORY INTEG ACT PER 15 MIN,157.97,118.48,1.9,142.17,119
CDM,4309753501,HC OT ADL/SELF CARE PER 15 MIN,181.19,135.89,2.17,163.07,119
CDM,4309753701,HC OT COMMUNITY/WORK/TRAINING 15 MIN,223.48,167.61,2.68,201.13,119
CDM,4309754201,HC OT WHEELCHAIR MGMT 15 MIN,155.89,116.92,1.87,140.3,119
CDM,4309755001,HC OT CAREGIVER TRAING 1ST 30 MIN,157.46,118.1,1.89,141.71,119
CDM,4309755101,HC OT CAREGIVER TRAING EA ADDL 15 MIN,91.59,68.69,1.1,82.43,119
CDM,4309755201,HC OT GROUP CAREGIVER TRAINING IN HOME/COMM,40.08,30.06,0.48,36.07,119
CDM,4309759701,HC OT SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,545.64,409.23,6.55,491.08,119
CDM,4309759801,HC OT SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,401.18,300.88,4.81,361.06,119
CDM,4309760201,HC OT NON-SELECTIVE DEBRIDE W/O ANES,333.16,249.87,4.0,299.84,119
CDM,4309760501,HC OT WOUND VAC <50 SQ CM,810.54,607.9,9.73,729.49,119
CDM,4309760601,HC OT WOUND VAC >50 SQ CM,1037.73,778.3,12.45,933.96,119
CDM,4309775001,HC OT PHYS PERF TEST/MEAS/REP 15 MIN,154.65,115.99,1.86,139.18,119
CDM,4309775501,HC OT ASSTV TECHN ASSMNT EA 15M,101.36,76.02,1.22,91.22,119
CDM,4309776001,HC OT INITIAL ORTHOTICS FIT/TRAIN PER 15 MIN,150.03,112.52,1.8,135.03,119
CDM,4309776101,HC OT INITIAL PROSTHETIC TRAINING PER 15 MIN,136.98,102.74,1.64,123.28,119
CDM,4309776301,HC OT SUBSEQ ORTH/PROSTHETIC TRAIN PER 15 MIN,142.84,107.13,1.71,128.56,119
CDM,4309779941,HC OT IN CAR DRIVER EVALUATION,155.22,116.42,1.86,139.7,119
CDM,4309779945,HC OT WHEELCHAIR FITTING EVAL 97799,305.32,228.99,3.66,274.79,119
CDM,430G028101,HC OT ELEC STIM UNATTEND FOR PRESS,143.23,107.42,1.72,128.91,119
CDM,430G028301,HC OT ELEC STIM OTHER THAN WOUND,109.39,82.04,1.31,98.45,119
CDM,4318,LACTATED RINGERS INTRAVENOUS SOLUTION,28.5,21.375,0.32,27.0,357
CDM,432,AMITRIPTYLINE 10 MG TABLET,0.67,0.5,0.01,0.6,119
CDM,433,AMITRIPTYLINE 100 MG TABLET,5.3,3.98,0.06,4.77,119
CDM,434342,INV 27T51 CAR-T INJECTION,0.01,0.01,0.01,0.01,119
CDM,4349261001,HC OT SWALLOWING EVAL FUNCTION,765.93,574.45,9.19,689.34,119
CDM,4349261101,HC OT SWALLOW STUDY W/RADIOLOGY,864.35,648.26,10.37,777.92,119
CDM,4349261201,HC OT FIBEROPTIC SWALLOW EVAL W/CINE VIDEO,750.43,562.82,9.01,675.39,119
CDM,4349261801,HC COM CONN AAC EVAL EA ADDL 30MIN,209.62,157.22,2.52,188.66,119
CDM,4349716501,HC OT EVAL LOW COMPLEXITY,298.24,223.68,3.58,268.42,119
CDM,4349716601,HC OT EVAL MODERATE COMPLEXITY,585.72,439.29,7.03,527.15,119
CDM,4349716616,HC CLIENT ONLY HRH OCCUPATIONAL THERAPY EVAL PER SESSION,585.72,439.29,7.03,527.15,119
CDM,4349716701,HC OT EVAL HIGH COMPLEXITY,726.22,544.66,8.71,653.6,119
CDM,4349716801,HC OT RE-EVALUATION,332.57,249.43,3.99,299.31,119
CDM,435,AMITRIPTYLINE 25 MG TABLET,2.58,1.94,0.03,2.32,119
CDM,435481,INV PIRFENIDONE (AP-LTE-008 SAIL) INHALATION SOLUTION,0.01,0.01,0.01,0.01,119
CDM,43556,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,852.12,639.09,10.23,766.91,119
CDM,4392,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,58.95,44.209999999999994,0.63,58.95,357
CDM,4393,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,213.32,159.99,2.56,191.99,119
CDM,4397,LEUCOVORIN CALCIUM 25 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,4398,LEUCOVORIN CALCIUM 5 MG TABLET,8.09,6.07,0.1,7.28,119
CDM,4409090101,HC ST BIOFEEDBACK TRAINING,265.65,199.24,3.19,239.08,119
CDM,4409250701,HC ST TRTMT SPEECH LANG VOICE INDIV,534.38,400.78,6.41,480.94,119
CDM,4409250801,HC ST TRTMT SPEECH/LANG/VOICE GRP,196.56,147.42,2.36,176.9,119
CDM,4409252001,HC ST LARYNGEAL FUNCTION STUDIES,362.69,272.02,4.35,326.42,119
CDM,4409252601,"HC ST SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",532.78,399.58,6.39,479.5,119
CDM,4409260601,HC ST TRTMNT/MOD ALT COMM/NON-SPEECH,142.95,107.21,1.72,128.66,119
CDM,4409260901,HC ST TRTMNT/MOD ALT COMM/SPEECH,297.26,222.94,3.57,267.53,119
CDM,4409261101,HC ST SWALLOW STUDY W/RADIOLOGY,806.69,605.02,9.68,726.02,119
CDM,4409263001,HC SLP AUD PRE-LING HEAR LOSS,270.77,203.08,3.25,243.69,119
CDM,4409611201,HC ST NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,833.01,624.76,10.0,749.71,119
CDM,4409612501,HC ST COGNITIVE EVAL/REPORT PER HR,161.83,121.37,1.94,145.65,119
CDM,4409711001,HC ST THERAPEUTIC EXERCISE/15 MIN,148.19,111.14,1.78,133.37,119
CDM,4409711201,HC ST NEUROMM RE-ED 15 MIN,103.56,77.67,1.24,93.2,119
CDM,4409712401,HC ST THERAPEUTIC MASSAGE PER 15 MIN,148.66,111.5,1.78,133.79,119
CDM,4409712901,HC ST THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,161.38,121.04,1.94,145.24,119
CDM,4409713001,HC ST THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,161.38,121.04,1.94,145.24,119
CDM,4409753001,HC ST THERAPEUTIC ACTIVITY 15 MIN,149.44,112.08,1.79,134.5,119
CDM,4409753301,HC ST SENSORY INTEG ACT PER 15 MIN,157.88,118.41,1.89,142.09,119
CDM,4409753501,HC ST ADL/SELF CARE PER 15 MIN,163.9,122.92,1.97,147.51,119
CDM,4409755001,HC ST CAREGIVER TRAING 1ST 30 MIN,170.54,127.9,2.05,153.49,119
CDM,4409755101,HC ST CAREGIVER TRAING EA ADDL 15 MIN,91.59,68.69,1.1,82.43,119
CDM,4409755201,HC ST GROUP CAREGIVER TRAINING IN HOME/COMM,53.61,40.21,0.64,48.25,119
CDM,4418,LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,924.36,693.27,11.09,831.92,119
CDM,4420,LEVOTHYROXINE 25 MCG TABLET,2.63,1.98,0.03,2.37,119
CDM,4421,LEVOTHYROXINE 50 MCG TABLET,2.81,2.11,0.03,2.53,119
CDM,4422,LEVOTHYROXINE 75 MCG TABLET,3.52,2.64,0.04,3.17,119
CDM,4423,LEVOTHYROXINE 100 MCG TABLET,3.495,2.625,0.04,3.25,238
CDM,4424,LEVOTHYROXINE 125 MCG TABLET,4.26,3.2,0.05,3.83,119
CDM,4425,LEVOTHYROXINE 150 MCG TABLET,0.94,0.7,0.01,0.85,119
CDM,4426,LEVOTHYROXINE 200 MCG TABLET,1.22,0.91,0.01,1.1,119
CDM,4449252101,HC ST EVAL SPEECH FLUENCY,705.48,529.11,8.47,634.93,119
CDM,4449252201,HC ST EVAL SPEECH SOUND PRODUCTION,495.78,371.84,5.95,446.2,119
CDM,4449252301,HC ST EVAL ST SOUND PROD W/LANG COMP,864.06,648.04,10.37,777.65,119
CDM,4449252401,HC ST EVAL ST BEHAVIORAL ANALYS VOICE/RESN,757.83,568.37,9.09,682.05,119
CDM,4449259701,HC ST EVAL VOICE PROSTHETIC DEVICE,795.05,596.29,9.54,715.54,119
CDM,4449260501,HC ST EVAL AUGMNT COM/NON-SPEECH 1ST,386.11,289.58,4.63,347.5,119
CDM,4449260701,HC ST EVAL AUGMENT COMM/SPEECH 1ST HR,395.29,296.47,4.74,355.76,119
CDM,4449260801,HC ST EVAL AUG SPEECH DEV EACH ADDL 30M,209.76,157.32,2.52,188.78,119
CDM,4449261001,HC ST SWALLOWING EVAL FUNCTION,777.57,583.18,9.33,699.81,119
CDM,4449261101,HC ST MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,864.35,648.26,10.37,777.92,119
CDM,4449261201,HC ST FIBEROPTIC SWALLOW EVAL W/CINE VIDEO,1017.49,763.12,12.21,915.74,119
CDM,4449261601,HC ST FLEX SWALLOW EVAL WITH SENSORY TESTING W/CINE VIDEO,527.4,395.55,6.33,474.66,119
CDM,4449261801,HC ST AAC EVAL EA ADDL 30MIN,209.62,157.22,2.52,188.66,119
CDM,4449262601,"HC ST EVAL AUDITORY REHAB, FIRST HOUR",264.91,198.68,3.18,238.42,119
CDM,4449262701,"HC ST EVAL AUDITORY REHAB, EACH ADD 15 MINUTES",60.96,45.72,0.73,54.86,119
CDM,4449610501,HC ST ASSESS APHASIA/REPORT PER HR,737.28,552.96,8.85,663.55,119
CDM,4450,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,183.0,137.25,0.29,216.0,595
CDM,4452,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,21.36,16.02,0.11,30.78,595
CDM,4454,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,23.04,17.28,0.28,20.74,238
CDM,4455,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,29.01,21.76,0.35,26.11,238
CDM,450,AMOXICILLIN 250 MG CAPSULE,0.31,0.23,0.01,0.28,119
CDM,4501031597,HC FULL TRAUMA ACTIVATION W/O PRENOTIFICATION RC 450,20839.79,15629.84,250.08,18755.81,119
CDM,4501031697,HC FULL TRAUMA ACTIVATION W/O PRENOTIFICATION W/O CRITICAL CARE RC 450,19239.58,14429.68,230.87,17315.62,119
CDM,4501031797,HC LIMITED TRAUMA ACTIVATION W/O PRENOTIFICATION RC 450,15861.61,11896.21,190.34,14275.45,119
CDM,4501031897,HC LIMITED TRAUMA ACTIVATION W/O PRENOTIFICATION W/O CRITICAL CARE RC 450,14643.67,10982.75,175.72,13179.3,119
CDM,4501156697,HC LAVAGE-PERITONEAL,1755.72,1316.79,21.07,1580.15,119
CDM,4501161897,HC MAJOR PROCEDURE,1755.72,1316.79,21.07,1580.15,119
CDM,4501269597,HC THROMBOLYSIS IV INFUSION,1779.17,1334.38,21.35,1601.25,119
CDM,4501272397,HC TRACHEOSTOMY-EMERGENT,1779.17,1334.38,21.35,1601.25,119
CDM,4501287897,HC VENTRICULOSTOMY,1755.72,1316.79,21.07,1580.15,119
CDM,4501585301,HC REMOVAL SUT/STPL WO ANES NOT PLACED BY ED,327.45,245.59,3.93,294.7,119
CDM,4504375301,HC GASTRIC INTUBATION AND ASPIRATION TX,1755.72,1316.79,21.07,1580.15,119
CDM,4504591501,HC REMOVAL OF FECAL IMPACTION/FB W/ ANESTH; NOT ANOSCOPY,775.62,581.72,9.31,698.06,119
CDM,4505170101,HC NON-INDWELLING CATHETER,621.35,466.01,7.46,559.22,119
CDM,4505170301,HC INSERT COMPLEX CATHETER,1024.55,768.41,12.29,922.1,119
CDM,4509928101,HC EMERGENCY ROOM-LEVEL 1,1090.55,817.91,13.09,981.5,119
CDM,4509928104,HC EMERGENCY ROOM - LEVEL 1 W/MOD,1090.55,817.91,13.09,981.5,119
CDM,4509928201,HC EMERGENCY ROOM-LEVEL 2,1635.16,1226.37,19.62,1471.64,119
CDM,4509928204,HC EMERGENCY ROOM - LEVEL 2 W/MOD,1635.16,1226.37,19.62,1471.64,119
CDM,4509928301,HC EMERGENCY ROOM-LEVEL 3,2452.43,1839.32,29.43,2207.19,119
CDM,4509928304,HC EMERGENCY ROOM - LEVEL 3 W/MOD,2452.43,1839.32,29.43,2207.19,119
CDM,4509928404,HC EMERGENCY ROOM - LEVEL 4 W/MOD,3678.43,2758.82,44.14,3310.59,119
CDM,4509928504,HC EMERGENCY ROOM - LEVEL 5 W/MOD,5517.56,4138.17,66.21,4965.8,119
CDM,4509929101,HC ER CRITICAL CARE,8275.37,6206.53,99.3,7447.83,119
CDM,4509929104,HC ER CRITICAL CARE W/MOD,8275.37,6206.53,99.3,7447.83,119
CDM,4509929201,HC ER CRITICAL CARE-'ADDL 30 MIN,3975.56,2981.67,47.71,3578.0,119
CDM,451,AMOXICILLIN 500 MG CAPSULE,0.88,0.66,0.01,0.79,119
CDM,4526,LISINOPRIL 20 MG TABLET,0.41,0.31,0.01,0.37,119
CDM,4528,LITHIUM CARBONATE 150 MG CAPSULE,0.9,0.68,0.01,0.81,119
CDM,4529,LITHIUM CARBONATE 300 MG CAPSULE,0.53,0.4,0.01,0.48,119
CDM,454,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,29.7,22.28,0.36,26.73,119
CDM,4560,LOPERAMIDE 2 MG CAPSULE,5.1,3.82,0.06,4.59,119
CDM,456G046301,HC URGENT CARE,1192.3,894.22,14.31,1073.07,119
CDM,4572,LORAZEPAM 0.5 MG TABLET,0.26,0.2,0.01,0.23,119
CDM,4574,LORAZEPAM 2 MG TABLET,0.46,0.35,0.01,0.41,119
CDM,4609401001,HC SPIROMETRY,259.55,194.66,3.11,233.6,119
CDM,4609406001,HC SPIROMETRY BEFORE/AFTER B.D.,564.05,423.04,6.77,507.64,119
CDM,4609407001,HC BRONCHIAL PROVOCATION,971.64,728.73,11.66,874.48,119
CDM,4609415001,HC BEDSIDE VITAL CAPACITY,217.29,162.97,2.61,195.56,119
CDM,4609420001,HC MAXIMUM VOLUNTARY VENTILATION,419.18,314.38,5.03,377.26,119
CDM,4609437501,HC FLOW VOLUME LOOP,396.64,297.48,4.76,356.98,119
CDM,4609461001,HC ADMIN SURFACTANT THRU ET TUBE,341.7,256.27,4.1,307.53,119
CDM,4609461701,HC BRONCHOSPASM EXERCISE TEST,988.54,741.4,11.86,889.69,119
CDM,4609461801,HC PULMONARY STRESS TEST (6-MIN WALK) - FOR PULM REHAB,560.98,420.74,6.73,504.88,119
CDM,4609461901,HC EXERCISE TEST FOR BRONCHOSPA (EIB) W/O ELECT RECOR,988.54,741.4,11.86,889.69,119
CDM,4609462101,HC CARDIOPULMONARY EXERCISE TESTING,1282.06,961.54,15.38,1153.85,119
CDM,4609469001,HC METABOLIC NUTRITIONAL ASSMNT,72.27,54.2,0.87,65.04,119
CDM,4609472601,HC PFT PLETHYSMOGRAPHY,300.46,225.34,3.61,270.41,119
CDM,4609472701,HC PFT NITROGEN WASHOUT,253.36,190.02,3.04,228.02,119
CDM,4609472801,HC PFT AIRFLOW RESISTANCE,676.88,507.66,8.12,609.19,119
CDM,4609472901,HC PFT LUNG DIFFUSION,324.01,243.01,3.89,291.61,119
CDM,4609476001,HC PULSE OXIMETRY SINGLE,46.72,35.04,0.56,42.05,119
CDM,4609476101,HC PULSE OXIMETRY MULTIPLE,182.41,136.81,2.19,164.17,119
CDM,4609476141,HC NEWBORN CCHD PULSE OXIMETRY MULTIPLE,182.41,136.81,2.19,164.17,119
CDM,4609476201,HC PULSE OXIMETRY CONTINUOUS,264.62,198.46,3.18,238.16,119
CDM,4609476241,HC NOCTURNAL DESAT STUDY,358.23,268.67,4.3,322.41,119
CDM,4609479941,HC TRACH/VENT SPEAKING VALVE-INITIAL,68.7,51.52,0.82,61.83,119
CDM,4609479942,HC HYPERCAPNIC DRIVE,229.68,172.26,2.76,206.71,119
CDM,4609479945,HC MIP MEP TESTING,229.68,172.26,2.76,206.71,119
CDM,4609501201,HC EXHALED NITRIC OXYGEN MEASUREMENT,221.17,165.88,2.65,199.05,119
CDM,464,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,157.2,117.9,1.89,141.48,119
CDM,4709253701,HC CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,650.06,487.54,7.8,585.05,119
CDM,4709254001,HC BASIC VESTIBULAR EVALUATION,791.04,593.28,9.49,711.94,238
CDM,4709254201,HC POSITIONAL NYSTAGMUS TEST,216.49,162.37,2.6,194.84,119
CDM,4709255001,HC TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,117.56,88.17,1.41,105.8,119
CDM,4709255101,HC SCREENING PURE TONE AIR ONLY,130.62,97.96,1.57,117.56,119
CDM,4709255201,HC ST PURE TONE AUDIOMETRY AIR ONLY,154.75,116.06,1.86,139.28,119
CDM,4709255301,HC ST PURE TONE AUDIO AIR/BONE,305.05,228.79,3.66,274.54,119
CDM,4709255501,HC ST SPEECH AUDIOMETRY THRESHOLD,170.18,127.64,2.04,153.16,119
CDM,4709255601,HC SPEECH AUDIOMTRY THRESHLD W/RECE,238.12,178.59,2.86,214.31,119
CDM,4709256801,HC ST ACOUSTIC REFLEX TESTING,105.46,79.1,1.27,94.91,119
CDM,4709258201,HC ST CONDITIONING PLAY AUDIOMETRY,417.64,313.23,5.01,375.88,119
CDM,4709258701,HC ST EVOKED OTOACOUSTIC EMISSIONS,439.43,329.57,5.27,395.49,119
CDM,4709258801,HC ST EVOKED OTOACOUS EMISSIONS COMP,215.09,161.32,2.58,193.58,119
CDM,4709259201,HC HEARING AID CHECK MONAURAL,89.29,66.97,1.07,80.36,119
CDM,4709259301,HC HEARING AID CHECK BINAURAL,185.76,139.32,2.23,167.18,119
CDM,4709262001,HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,499.04,374.28,5.99,449.14,119
CDM,4709270001,HC UNLISTED OTORHINOLARYNGOLOGICAL SERVICE/PX,169.23,126.92,2.03,152.31,119
CDM,4709270041,HC VIDEO HEAD IMPULSE TEST VHIT,169.23,126.92,2.03,152.31,119
CDM,470V501101,HC HEARING AID FIT & COUNSEL,241.54,181.16,2.9,217.39,119
CDM,470V524001,"HC DISPENSING FEE, CONTRALATERAL BINAURAL",722.11,541.58,8.67,649.9,119
CDM,4711,MAGNESIUM CITRATE ORAL SOLUTION,17.76,13.32,0.21,15.98,119
CDM,4719251701,HC VEMP W/ INT & RPT CERVICAL,463.37,347.53,5.56,417.03,119
CDM,4719255701,HC ST COMPREHENSIVE AUDIOMETRY,480.82,360.62,5.77,432.74,119
CDM,4719255801,HC EVOKED AUDITORY TST COMPLETE,215.09,161.32,2.58,193.58,119
CDM,4719256701,HC ST TYPANOMETRY,106.76,80.07,1.28,96.08,119
CDM,4719259101,HC HEARING AID EXAMINATION & SELECTION BINAURAL,583.57,437.68,7.0,525.21,119
CDM,4719265001,HC AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,589.93,442.45,7.08,530.94,119
CDM,4719265101,HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R,589.93,442.45,7.08,530.94,119
CDM,4719265201,HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1415.95,1061.96,16.99,1274.36,119
CDM,4719265301,HC AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1415.96,1061.97,16.99,1274.36,119
CDM,4720,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,15.870000000000001,11.905,0.16,48.92,714
CDM,473,AMPICILLIN 250 MG SOLUTION FOR INJECTION,10.47,7.8549999999999995,0.11,10.24,476
CDM,474,AMPICILLIN 500 MG/5 ML SOLUTION FOR INJECTION,16.91,12.69,0.2,15.22,119
CDM,4744,MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,223.68,167.76,2.68,201.31,119
CDM,4749,MANNITOL 20 % INTRAVENOUS SOLUTION,207.0,155.25,1.37,270.0,238
CDM,4750,MANNITOL 25 % INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,238
CDM,4800518T01,HC REMOVAL OF GENERATOR COMPONENT,7842.28,5881.71,94.11,7058.05,119
CDM,4800519T01,HC REMOVAL/REPLACEMENT OF WIRELESS CARDIAC STIMULATOR,62715.63,47036.72,752.59,56444.07,119
CDM,4809295001,HC CPR,1721.75,1291.31,20.66,1549.58,119
CDM,4809295301,HC TEMP TRANSCUTANEOUS PACING,589.0,441.75,7.07,530.1,119
CDM,4809296001,HC CARDIOVERSION ELECTRIC EXTERNAL,1890.17,1417.63,22.68,1701.15,119
CDM,4809297401,HC CATH CORON IV BRACHYTX,994.74,746.06,11.94,895.27,238
CDM,4809299001,HC PERQ BALLOON VALVULOPLASTY - PULMONARY VALVE,41022.56,30766.92,492.27,36920.3,119
CDM,4809326001,HC PROGRAM DEVICE EVAL SUBQ DEFIB SYS,329.85,247.39,3.96,296.86,119
CDM,4809326101,HC INTEROGATE SUBQ DEVICE PRE/POST PROCEDURE,112.14,84.1,1.35,100.93,119
CDM,4809327901,HC PM DEVICE PROG EVAL SNGL,127.7,95.78,1.53,114.93,119
CDM,4809328001,HC PM DEVICE PROGR EVAL DUAL,119.74,89.8,1.44,107.77,119
CDM,4809328101,HC PM DEVICE PROGR EVAL MULTI,119.74,89.8,1.44,107.77,119
CDM,4809328201,HC SINGLE CHAMBER TRANSVENOUS  DEFIB ANAL,119.74,89.8,1.44,107.77,119
CDM,4809328301,HC DUAL TRANSVENOUS DEFIB ANALYSIS NO REPROGM,107.76,80.82,1.29,96.98,119
CDM,4809328401,HC ICD DEVICE PROGR EVAL MULT LEAD TRANSVENOUS,123.25,92.44,1.48,110.92,119
CDM,4809328501,HC ILR PROGRAMMING DEVICE EVAL,273.47,205.1,3.28,246.12,119
CDM,4809328601,HC PERI-PROC EVAL & PROGRAM PCMKR SYS/LDLSS PCMKR SYS IN PERSON,474.68,356.01,5.7,427.21,119
CDM,4809328701,HC PERI-PROC EVAL & PROGRAM ICD SYS IN PERSON,571.2,428.4,6.85,514.08,119
CDM,4809328801,HC PM INTERR IN PERSON,102.84,77.13,1.23,92.56,119
CDM,4809328901,HC DEFIB TRANSVENOUS ANALYSIS W/RPGM,104.12,78.09,1.25,93.71,119
CDM,4809329101,HC ILR DEVICE INTERROGATE IN PERSON,114.58,85.94,1.37,103.12,119
CDM,4809329601,HC PM/ICD REMOTE TECH SERVICE,318.56,238.92,3.82,286.7,119
CDM,4809356901,HC PULMONARY ANGIO W/ HEART CATH SELECTIVE UNILAT,5992.36,4494.27,71.91,5393.12,119
CDM,4809357301,HC PULMONARY ANGIO W/ HEART CATH SELECTIVE BILAT,6264.74,4698.56,75.18,5638.27,119
CDM,4809357401,HC PULMONARY VEIN ANGIO W/HEARTCATH SELECTIVE EACH,10895.2,8171.4,130.74,9805.68,119
CDM,4809357501,HC AORTOPULMONARY ANGIO W/CONGENITAL HEARTCATH EA,10895.2,8171.4,130.74,9805.68,119
CDM,4809358101,HC PERQ CLOSE VENTRICULR DEF,18648.35,13986.26,223.78,16783.52,119
CDM,4809360001,HC HIS BUNDLE,1234.9,926.18,14.82,1111.41,119
CDM,4809360201,HC INTRA-ATRIAL RECORDING,14913.09,11184.82,178.96,13421.78,119
CDM,4809360301,HC RT VENTRICULAR RECORDING,747.01,560.26,8.96,672.31,119
CDM,4809360901,HC MAPPING NOT 3-D,5968.47,4476.35,71.62,5371.62,119
CDM,4809361001,HC INTRA-ATRIAL PACING,20385.36,15289.02,244.62,18346.82,119
CDM,4809361201,HC INTRAVENTRICULAR PACING,15734.69,11801.02,188.82,14161.22,119
CDM,4809361301,HC 3D MAPPING,8678.96,6509.22,104.15,7811.06,238
CDM,4809361601,HC ESOPHAGEAL PACING,2453.88,1840.41,29.45,2208.49,119
CDM,4809361801,HC INDUCTION ARRYTH BY ELEC PACING,3154.55,2365.91,37.85,2839.1,238
CDM,4809361901,HC COMP EP W/O ARRYTHMIA INDUCTN,13193.07,9894.8,158.32,11873.76,119
CDM,4809362001,HC COMP EP W/ARRYTHMIA INDUCTN,16169.93,12127.45,194.04,14552.94,119
CDM,4809362101,HC LA/CORON/SINUS W/EP,16308.79,12231.59,195.71,14677.91,119
CDM,4809362201,HC COMPLETE EP/LV,13994.17,10495.63,167.93,12594.75,119
CDM,4809362301,HC STIM AFTER DRUG,3369.14,2526.86,40.43,3032.23,238
CDM,4809362401,HC EP FOLLOW-UP STUDY,6484.11,4863.08,77.81,5835.7,119
CDM,4809364001,HC EVAL ICD LEADS,3606.55,2704.91,43.28,3245.9,119
CDM,4809364101,HC ICD LEADS/GEN EVALUATION,6283.12,4712.34,75.4,5654.81,119
CDM,4809364201,HC EP EVAL TRANSVENOUS ICD RE-CHECK,3471.74,2603.8,41.66,3124.57,119
CDM,4809364401,HC EP EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,4855.55,3641.66,58.27,4370.0,119
CDM,4809366001,HC TILT TABLE CV EVALUATION,1200.0,900.0,14.4,1080.0,119
CDM,4809366801,HC PERIPHERAL VASCULAR REHAB (PAD),152.3,114.22,1.83,137.07,119
CDM,4809375001,HC INTERROGATION OF VAD,392.62,294.46,4.71,353.36,119
CDM,4809378601,HC AMBULATORY BLOOD PRESSURE MONITORING - HOOKUP/RECORD,322.52,241.89,3.87,290.27,119
CDM,4809378801,HC AMBULATORY BLOOD PRESSURE MONITORING - SCAN,367.55,275.66,4.41,330.8,238
CDM,4809379941,HC AQUIRED ASD CLOSURE,54873.35,41155.01,658.48,49386.02,119
CDM,4809379942,HC BASILICA,10210.63,7657.97,122.53,9189.57,119
CDM,4809379943,HC BASILICA-DIVISION OF LEAFLETS,17417.13,13062.85,209.01,15675.42,119
CDM,4809379944,HC CLOSURE OF FISTULA,53930.12,40447.59,647.16,48537.11,119
CDM,4809379945,HC DIVISION OF CORONARY LEAFLETS,10210.63,7657.97,122.53,9189.57,119
CDM,4809379946,HC EP PROVOCATIVE DRUG STUDY  (PROCAINAMIDE),2739.76,2054.82,32.88,2465.78,119
CDM,4809379947,HC INTRACARDIAC ECHO,15917.78,11938.34,191.01,14326.0,119
CDM,4809379948,HC LAMPOON-RF DIVISION OF LEAFLETS,17417.13,13062.85,209.01,15675.42,119
CDM,4809379949,HC PERICARDIOTOMY,3277.93,2458.45,39.34,2950.14,119
CDM,4809379952,HC ECMO DAILY MGMT,5102.2,3826.65,61.23,4591.98,119
CDM,4810237T01,HC TRLUML PERIP ATHREC BRCHIOCPH,22109.54,16582.16,265.31,19898.59,119
CDM,4810345T01,HC TMVR PERQ VIA CORONARY SINUS,19042.84,14282.13,228.51,17138.56,119
CDM,4810483T01,HC TMVI W PROSTHETIC VALVE PERCUTANEOUS APPROACH,60060.61,45045.46,720.73,54054.55,238
CDM,4810484T01,HC TMVI TRANSTHORACIC EXPOSURE,72049.81,54037.36,864.6,64844.83,119
CDM,4810543T01,HC TA MV RPR W/ARTIF CHORD TEND,1811.88,1358.91,21.74,1630.69,119
CDM,4810544T01,HC TCAT MV ANNULUS RCNSTJ,11368.52,8526.39,136.42,10231.67,119
CDM,4810569T01,HC TRANSCATH TRICUSPID VALVE REPAIR;INITIAL PROSTHESIS,19556.15,14667.11,234.67,17600.54,119
CDM,4810570T01,HC TRANSCATH TRICUSPID VALVE REPAIR;ADDTL PROSTHESIS,9720.13,7290.1,116.64,8748.12,119
CDM,4810571T01,HC INSERT/REPLMNT ICDS W/SUBSTERNAL ELECTRODE,46037.7,34528.28,552.45,41433.93,119
CDM,4810574T01,HC REPOS PREV SS IMPL DFB ELTRD,12719.1,9539.33,152.63,11447.19,119
CDM,4810577T01,HC EPHYS EVAL ICDS SS,3854.7,2891.02,46.26,3469.23,119
CDM,4810580T01,HC RMVL SS IMPL DFB PG ONLY,12719.1,9539.33,152.63,11447.19,119
CDM,4810643T01,HC TCAT L VENTR RSTRJ DEV IMPLT,19607.76,14705.82,235.29,17646.98,119
CDM,4810646T01,"HC TTVI PROSTHETIC VALVE, PERCUTANEOUS",51682.99,38762.24,620.2,46514.69,119
CDM,4810650T01,HC PRGRMG DEV EVAL SCRMS REMOTE,318.68,239.01,3.82,286.81,119
CDM,4810659T01,HC TCAT INTRA-C NFS SUPERSAT O2,4791.59,3593.69,57.5,4312.43,119
CDM,4810744T01,HC BIOPROSTHETIC VALVE INSERT VIA FEMORAL VEIN OPEN,65066.79,48800.09,780.8,58560.11,119
CDM,4810795T01,HC LEADLESS PM INSERT RT ATRIAL & RT VENTRICLE DUALSYS,27266.85,20450.14,327.2,24540.16,119
CDM,4810796T01,HC LEADLESS +RT ATRIAL COMPONENT/EXIST RT VENT DUAL SYS,27266.85,20450.14,327.2,24540.16,119
CDM,4810797T01,HC LEADLESS +RT VENTRICLE COMPONENT DUAL SYS,27266.85,20450.14,327.2,24540.16,119
CDM,4810798T01,HC LEADLESS PM SYSTEM REMOVAL COMPLETE DUAL CHAMBER,10323.87,7742.9,123.89,9291.48,119
CDM,4810799T01,HC LEADLESS PM RT ATRIAL COMPONENT REMOVAL DUAL SYSTEM,10323.87,7742.9,123.89,9291.48,119
CDM,4810800T01,HC LEADLESS PM RT VENTRICLE COMPONENT REMOVAL DUAL SYSTEM,10323.87,7742.9,123.89,9291.48,119
CDM,4810802T01,HC LEADLESS PM REMOVE & REPLACE RT ATRIAL OF DUAL,27266.85,20450.14,327.2,24540.16,119
CDM,4810803T01,HC LEADLESS PM REMOVE & REPLACE RT VENTRICLE OF DUAL,27266.85,20450.14,327.2,24540.16,119
CDM,4810804T01,HC LEADLESS PM PROGRAMMING EVAL DEVICE DUAL CHAMBER SYS,263.07,197.3,3.16,236.76,119
CDM,4810823T01,HC LEADLESS PM INSERT RT ATRIAL SINGLE CHAMBER SYS,49720.48,37290.36,596.65,44748.43,119
CDM,4810824T01,HC LEADLESS PM REMOVAL RT ATRIAL SINGLE CHAMBER SYS,7532.21,5649.16,90.39,6778.99,119
CDM,4810825T01,HC LEADLESS PM REMOVE & REPLACE RT ATRIAL SINGLE CHAM SYS,49720.48,37290.36,596.65,44748.43,119
CDM,4810826T01,HC LEADLESS PM PROGRAMMING EVAL DEVICE SINGLE CHAMBER SYS,127.7,95.78,1.53,114.93,119
CDM,4810913T01,"HC CORONARY DRUG-DELIV BLLN, SINGLE ARTERY",18998.73,14249.05,227.98,17098.86,119
CDM,4810914T01,"HC CORONARY DRUG-DELIV BLLN, ADDTL LESION",4296.69,3222.52,51.56,3867.02,119
CDM,4813301701,HC PERICARDIOCENTESIS W/IMAGING & INDWELLING CATH,3188.5,2391.38,38.26,2869.65,238
CDM,4813320601,HC ATRIAL PACER INSERT/REPLACE,24477.97,18358.48,293.74,22030.17,119
CDM,4813320701,HC VENTRIC PERM PACER INSRT/REPLACE W ELECTRODE,26832.64,20124.48,321.99,24149.38,119
CDM,4813320801,HC INSRT NEW/REPLACE PERM AV PACEMKR W ELECTRODE,29267.89,21950.92,351.21,26341.1,119
CDM,4813321001,HC TEMP SINGLE PACER INSERT/REPLACE,24729.11,18546.83,296.75,22256.2,119
CDM,4813321201,HC PACER GENERATOR CHANGE/SINGLE,4295.3,3221.48,51.54,3865.77,119
CDM,4813321301,HC PACER GENERATOR CHANGE/DUAL,34662.22,25996.66,415.95,31196.0,119
CDM,4813321401,HC PACEMAKER UPGRADE SGL TO DUAL,36741.94,27556.46,440.9,33067.75,119
CDM,4813321501,HC RA/RV LEAD REPOSITN PREV IMPLANT,8510.54,6382.9,102.13,7659.49,119
CDM,4813321601,HC INSERT SINGLE PACING LEAD,24262.49,18196.87,291.15,21836.24,119
CDM,4813321701,HC INSERT DUAL PACING LEADS,24581.35,18436.01,294.98,22123.22,119
CDM,4813321801,HC REPAIR 1 PACE-DEFIB LEAD ONLY,10809.86,8107.4,129.72,9728.87,119
CDM,4813322001,HC REPAIR 2 PACE-DEFIB LEADS ONLY,8900.91,6675.68,106.81,8010.82,119
CDM,4813322101,HC INSERT PULSE GEN MULT LEADS,57852.67,43389.5,694.23,52067.4,119
CDM,4813322201,HC POCKET REVISN/RELOCTN-PACMAKER,5632.215,4224.16,63.0,5413.24,238
CDM,4813322301,HC POCKET RELOCATION IMPLANTABLE  DEFIB,5577.06,4182.8,66.92,5019.35,119
CDM,4813322401,HC LV LEAD INSERT PREV PM AND DEFIB,38496.68,28872.51,461.96,34647.01,119
CDM,4813322501,HC LEFT VENT LEAD INSERT OF IMPLANT DIFIB PMKR,7820.14,5865.1,93.84,7038.13,119
CDM,4813322601,HC LEFT VENT LEAD REPOSITION,8896.87,6672.65,106.76,8007.18,119
CDM,4813322701,HC REMOVE&REPLACE PM GEN SINGL,28353.39,21265.04,340.24,25518.05,238
CDM,4813322801,HC REMV&REPLC PM GEN DUAL LEAD,33298.03,24973.52,399.58,29968.23,119
CDM,4813322901,HC REMV&REPLC PM GEN MULT LEADS,67424.84,50568.63,809.1,60682.36,238
CDM,4813323001,HC INSRT PULSE GEN W/DUAL LEADS,78914.91,59186.18,946.98,71023.42,119
CDM,4813323101,HC INSRT PULSE GEN W/MULT LEADS,5671.32,4253.49,68.06,5104.19,119
CDM,4813323301,HC PACEMAKER REMOVAL,27782.61,20836.96,333.39,25004.35,238
CDM,4813323401,HC SINGLE LEAD REMOVAL PACEMAKER,10122.42,7591.82,113.22,9728.87,238
CDM,4813323501,HC DUAL LEAD REMOVAL PACEMAKER,10302.535,7726.9,115.23,9901.99,238
CDM,4813324001,HC INSERT PULSE GEN WITH  SINGLE LEAD,9596.97,7197.73,115.16,8637.27,119
CDM,4813324101,HC REMOVAL ONLY IMPLANT DEFIB PULSE GEN,11016.93,8262.7,132.2,9915.24,238
CDM,4813324401,HC ICD LEAD EXTRACTION,11022.18,8266.64,132.27,9919.96,238
CDM,4813324901,HC IMPLANT/REPOS DEFIB  PULSE GEN W/LEADS SNG/DUAL,118743.74,89057.8,1424.92,106869.37,238
CDM,4813326201,HC REMOVE & REPL IMPLANT DEFIB PLS GEN SINGLE LEAD,76368.99,57276.74,916.43,68732.09,238
CDM,4813326301,HC REMOVE & REPLAC DEFIB PULSE GEN DUAL LEADS,80305.93,60229.45,963.67,72275.34,238
CDM,4813326401,HC REMOVE & REPLAC DEFIB PULSE GEN MULT LEADS,114039.16,85529.37,1368.47,102635.24,238
CDM,4813327001,HC INSERT/REPLMNT SUBQ IMPL DEFIB W SBQ ELECTRODE,98012.87,73509.65,1176.15,88211.58,119
CDM,4813327101,HC INSERT SUBQ DEFIB ELECTRODE,5520.39,4140.29,66.24,4968.35,119
CDM,4813327201,HC RMVL SUBQ DEFIB ELECTRODE,3685.57,2764.18,44.23,3317.01,238
CDM,4813327301,HC REPOS SUBQ DEFIB ELECTRODE AND/OR PLS GEN,8595.34,6446.5,103.14,7735.81,119
CDM,4813327401,HC TRANSCATH INSRT/REPLC PERM LEADLESS PCMKR RT VENT W/GUIDANCE,37247.09,27935.32,446.97,33522.38,119
CDM,4813327501,HC LEADLESS PM REMOVAL W/IMG,7532.21,5649.16,90.39,6778.99,119
CDM,4813327801,HC REMOVAL OF NEUROSTIMULATOR GENERATOR AND LEAD(S),23457.91,17593.43,281.49,21112.12,119
CDM,4813328501,HC INSERTION SUBCUTAN CARDIAC RHYTHM MONITOR INC PROGRAMMING,22565.89,16924.42,270.79,20309.3,119
CDM,4813328601,HC REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,1749.87,1312.4,21.0,1574.88,119
CDM,4813328901,HC TRANSCATHETER IMPLANT PULMONARY ARTERY SENSOR,11145.23,8358.92,133.74,10030.71,119
CDM,4813334001,"HC PERQ CLSR TCAT L ATR APNDG INC FLUOR, CAT PLC, ANGIO IF PER",20420.39,15315.29,228.4,19626.48,238
CDM,4813336101,HC EVASC AORTIC HRT VALVE (TAVR),61464.41,46098.31,737.57,55317.97,238
CDM,4813336201,HC REPLACE AORTIC VALVE OPEN FEMORAL ART APPROACH,70480.54,52860.4,845.77,63432.49,238
CDM,4813336301,HC REPLACE AORTIC VALVE OPEN AXILLARY APPROACH,68392.57,51294.43,820.71,61553.31,119
CDM,4813336401,HC REPLACE AORTIC VALVE OPEN ILIAC APPROACH,71023.16,53267.37,852.28,63920.84,119
CDM,4813336501,HC REPLAC AORTIC VALVE OPEN TRANSAORTIC APP,72769.36,54577.02,873.23,65492.42,119
CDM,4813336601,HC TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,73445.59,55084.19,881.35,66101.03,119
CDM,4813336701,HC REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,15422.8,11567.1,185.07,13880.52,119
CDM,4813336801,HC REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,17052.06,12789.04,204.62,15346.85,119
CDM,4813336901,HC REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,19783.48,14837.61,237.4,17805.13,119
CDM,4813337001,HC TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,70026.74,52520.06,840.32,63024.07,119
CDM,4813341801,HC TMVR PERQ INITIAL,20833.15,15624.86,250.0,18749.84,238
CDM,4813341901,HC TMVR PERQ ADD PROSTHESIS(ES),10411.98,7808.98,124.94,9370.78,238
CDM,4813347701,HC PULMONARY VALVE IMPLATANTATION PERQ,68599.57,51449.68,823.19,61739.61,119
CDM,4813374601,HC TIS CREATION W/STENT CONGENITAL CARDIAC EA ADDL SHNT,11598.18,8698.64,139.18,10438.36,119
CDM,4813388001,HC EVASC RPR TA DPLMNT AORT-ARTC TUBE NDGFT COV LSA,6685.08,5013.81,80.22,6016.57,119
CDM,4813388101,HC EVASC RPR TA DPLMNT AORT-ARTC TUB NDGFT XCOV LSA,13845.9,10384.42,166.15,12461.31,119
CDM,4813388301,HC PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,7781.37,5836.03,93.38,7003.23,119
CDM,4813388401,HCD PROXIMAL THORAC EXT ADDL,5536.16,4152.12,66.43,4982.54,119
CDM,4813390001,HC PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,35171.83,26378.87,422.06,31654.65,119
CDM,4813390101,HC PULMON ART REVASC W/ STENT INITIAL NATIVE BILAT,50221.01,37665.76,602.65,45198.91,119
CDM,4813390202,HC PULMON ART REVASC W/STENT INITIAL ABNORM UNILAT,34497.58,25873.18,413.97,31047.82,119
CDM,4813390401,HC PULMON ART REVASC W/ STENT EA ADDL NATIVE/ABNORM,12129.92,9097.44,145.56,10916.93,119
CDM,4813396701,HC BALLOON PUMP INSERT,12073.415,9055.060000000001,136.46,11497.91,238
CDM,4813396801,HC REMOVE INTRA AORTIC BALLN PUMP,2210.21,1657.66,26.52,1989.19,119
CDM,4813399001,HC PERCUTANEOUS INSERT VAD ARTERY ACCESS,18971.31,14228.48,227.66,17074.18,238
CDM,4813399101,HC INSERT VAD ARTERY VENOUS ACCESS,24474.81,18356.11,293.7,22027.33,238
CDM,4813399201,HC REMOVAL PERCUTANEOUS VAD AT  DIFFERENT SESSION,9828.69,7371.52,117.94,8845.82,238
CDM,4813399301,HC REPOSITION PERCUTANEOUS VAD DIFF SESSION,8582.8,6437.1,102.99,7724.52,238
CDM,4813399501,HC INSERTION PERQ VAD RT HRT VENOUS,14176.95,10632.71,170.12,12759.26,238
CDM,4813399701,HC REMOVAL PERQ RT HEART VAD,8352.64,6264.48,100.23,7517.38,119
CDM,4813399941,HC CAROTID APPROACH TAVR,60151.34,45113.5,721.82,54136.21,119
CDM,4813399945,HC TRANSCATHETER BICAVAL VALVE SYSTEM IMPLANTATION,57211.93,42908.95,686.54,51490.74,119
CDM,4813470101,HC EVAS RPR DPLMNT AORTO-AORTIC NDGFT,14192.33,10644.25,170.31,12773.1,119
CDM,4813470201,HC EVAS RPR DPLMNT AORTO-AORTIC NDGFT RPT,11848.46,8886.34,142.18,10663.61,119
CDM,4813470301,HC EVAS RPR DPLMNT AORTO UN-ILIAC NDGFT,54112.95,40584.71,649.36,48701.66,119
CDM,4813470401,HC EVASC RPR DPLMNT AORTO UN-ILIAC NDGFT RPT,54112.95,40584.71,649.36,48701.66,119
CDM,4813470501,HC EVASC RPR DPLMNT AORTO BI-ILIAC NDGFT,81825.48,61369.11,981.91,73642.93,119
CDM,4813470601,HC EVASC RPR DPLMNT AORTO BI-ILIAC NDGFT RPT,55414.32,41560.74,664.97,49872.89,119
CDM,4813470701,HC EVASC RPR DPLMNT ILIO-ILIAC NDGFT,10909.75,8182.31,130.92,9818.78,119
CDM,4813470801,HC EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,9925.87,7444.4,119.11,8933.28,119
CDM,4813470901,HC PLCMT XTN PROSTH FOR ENDOVASC RPR,13157.92,9868.44,157.9,11842.13,119
CDM,4813471001,HC DLYD PLCMT XTN PROSTH FOR EVASC RPR 1ST VESSEL,11269.2,8451.9,135.23,10142.28,119
CDM,4813471101,HC DLYD PLCMT XTN PROSTH FOR EVASC RPR EACH ADDL,7760.08,5820.06,93.12,6984.07,119
CDM,4813471201,HC TRANSCATHER DLVR ENHNCD FIXATION DEVICES RS &I,3149.07,2361.8,37.79,2834.16,119
CDM,4813471301,HC PERQ ACCESS & CLOSURE FEM ART FOR DLVR NDGFT =>12 FR,560.98,420.74,6.73,504.88,119
CDM,4813482001,HC OPEN ILIAC PROSTH-ABD/RP/UNILATERAL,1587.59,1190.69,19.05,1428.83,119
CDM,4813601301,HC CATH PLCMNT MAIN PUL ARTERY,1434.62,1075.96,17.22,1291.16,119
CDM,4813601402,HC CATH PLCMNT SELECT PUL ARTERY UNILATERAL,1238.45,928.84,14.86,1114.6,119
CDM,4813601403,HC CATH PLCMNT SELECT PUL ARTERY BILATERAL,2476.91,1857.68,29.72,2229.22,119
CDM,4813725201,HC INTRAVASC US NONCORONARY INITIAL,6514.55,4885.91,78.17,5863.1,119
CDM,4813725301,HC INTRAVASC US NONCORONARY ADDL,6017.92,4513.44,72.22,5416.13,119
CDM,4816366101,HC RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,3533.3,2649.98,42.4,3179.97,119
CDM,4819292001,HC PERQ TRLUML C ANGIOPLASTY 1 MAJ C ART&/BRANCHES,18733.31,14049.98,224.8,16859.98,119
CDM,4819292101,HCD REVASC PTCA ADDTL ART/BRNCH,7776.255,5832.1900000000005,86.8,7486.9,238
CDM,4819292401,PERQ TRLUML C ATHRC ANGIOP 1 MAJ C ART&/BRANCHES,29924.1,22443.08,359.09,26931.69,119
CDM,4819292501,HCD REVASC ATHER W/ PTCA ADDTL ART/BRNCH,2764.3,2073.22,33.17,2487.87,119
CDM,48192925LD,HCD CORONARY ATHERECT EACH ADDL BRANCH-LD,2764.3,2073.22,33.17,2487.87,119
CDM,4819292801,HC PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS,39763.79,29822.84,477.17,35787.41,119
CDM,4819292806,HC REVASC DES W/ PTCA INITIAL ART/BRNCH,39763.79,29822.84,477.17,35787.41,119
CDM,4819292812,HCD DRUG-ELUTING STENT/PTCA MAJOR ART OR BRANCH-LM,39763.79,29822.84,477.17,35787.41,119
CDM,4819292841,HC REVASC DES W/ PTCA INITIAL ART/BRNCH,27296.69,20472.52,327.56,24567.02,119
CDM,4819292901,HCD REVASC DES W/ PTCA ADDTL ART/BRNCH,9547.58,7160.685,106.58,9192.32,476
CDM,4819292906,HCD REVASC BMS W/ PTCA ADDTL ART/BRNCH,10213.69,7660.27,122.56,9192.32,119
CDM,4819292912,HCD DRUG-ELUTING STENT/PTCA EACH ADDL ART OR BRANCH-LD,1599.58,1199.68,19.19,1439.62,119
CDM,4819292941,HCD REVASC BMS W/ PTCA ADDTL ART/BRNCH,9547.58,7160.685,106.58,9192.32,238
CDM,4819293301,HC PERQ TRLUML C ATHRC ST ANGIOP 1 MAJ C ART&/BRNCH,56195.67,42146.75,674.35,50576.1,119
CDM,4819293306,HC REVASC DES & ATHER W/ PTCA INITIAL ART/BRNCH,56195.67,42146.75,674.35,50576.1,119
CDM,4819293313,HCD DRUG-ELUTING STENT/PTCA ATHERECT MAJ ART OR BRANCH-LM,56195.67,42146.75,674.35,50576.1,119
CDM,4819293341,HC REVASC DES & ATHER W/ PTCA INITIAL ART/BRNCH,40290.7,30218.025,449.76,38791.51,238
CDM,4819293401,HCD REVASC DES & ATHER W/ PTCA ADDTL ART/BRNCH,27655.37,20741.53,331.86,24889.83,119
CDM,4819293406,HCD REVASC BMS & ATHER W/ PTCA ADDTL ART/BRNCH,27655.37,20741.53,331.86,24889.83,119
CDM,4819293412,HCD DRUG-ELUTING STENT/PTCA ATHER EACH ADDL ART OR BRANCH-LD,27655.37,20741.53,331.86,24889.83,119
CDM,4819293441,HCD REVASC BMS & ATHER W/ PTCA ADDTL ART/BRNCH,27655.37,20741.53,331.86,24889.83,119
CDM,4819293701,HC PERQ TRLUML REVSC OF/-CAB GRF 1 MAJ C ART&/BRNCH,31471.61,23603.71,377.66,28324.45,119
CDM,4819293706,HC BYPASS GRAFT REVASC BMS/PTCA/ATHER INITIAL ART/BRNCH,30809.01,23106.76,369.71,27728.11,119
CDM,4819293741,HC BYPASS GRAFT REVASC BMS/PTCA/ATHER INITIAL ART/BRNCH,31471.61,23603.71,377.66,28324.45,119
CDM,4819293801,HCD BYPASS GRAFT REVASC DES W/PTCA/ATHER ADDTL ART/BRNCH,8243.61,6182.71,98.92,7419.25,119
CDM,4819293806,HCD BYPASS GRAFT REVASC BMS/PTCA/ATHER ADDTL ART/BRNCH,8243.61,6182.71,98.92,7419.25,119
CDM,4819293841,HCD BYPASS GRAFT REVASC BMS/PTCA/ATHER ADDTL ART/BRNCH,8243.61,6182.71,98.92,7419.25,119
CDM,4819294101,HC PERQ TRLUML REVSC TOT/STOT OCCLS AMI 1MAJ C ART,31261.24,23445.93,375.13,28135.12,119
CDM,4819294106,HC REVASC DURING AMI BMS/PTCA/ATHER,31261.24,23445.93,375.13,28135.12,119
CDM,4819294141,HC REVASC DURING AMI BMS/PTCA/ATHER,31261.24,23445.93,375.13,28135.12,119
CDM,4819294301,HC PERQ TRLUML REVSC CHRNC TOT OCCLS 1 C ART ANTGRD,37510.5,28132.88,450.13,33759.45,238
CDM,4819294306,HC PERQ TRLUML REVSC CHRNC TOT OCCLS BMS 1 C ART ANTGRD,39615.85,29711.89,475.39,35654.26,119
CDM,4819294341,HCD REVASC CTO BMS/PTCA/ATHER INITIAL ART/BRANCH,37524.65,28143.49,450.3,33772.19,119
CDM,4819294401,HCD REVASC CTO DES W/ PTCA/ATHER ADDTL ART/BRANCH,20118.51,15088.88,241.42,18106.66,119
CDM,4819294406,HCD REVASC CTO BMS/PTCA/ATHER ADDTL ART/BRANCH,20118.51,15088.88,241.42,18106.66,119
CDM,4819294441,HCD REVASC CTO BMS/PTCA/ATHER ADDTL ART/BRANCH,20118.51,15088.88,241.42,18106.66,119
CDM,4819296101,HC INTERNAL CARDIOVERSION,1563.74,1172.8,18.76,1407.37,119
CDM,4819297201,HC PERQ TRLUML CORONRY LITHOTRP,19968.58,14976.44,239.62,17971.72,119
CDM,4819297301,HC PERQ TRLUML CORONARY MCHNL ASPIR THROMBECTOMY,3983.02,2987.26,47.8,3584.72,119
CDM,4819297501,HCD THROMBOLYSIS CORONARY BY IC INFUSION,6229.07,4671.8,74.75,5606.16,119
CDM,4819297801,HC INTRA-CORONARY ULTRASOUND INITIAL INCL IV OCT,2825.71,2119.285,31.94,2691.02,238
CDM,4819297901,HC INTRA-CORONARY ULTRASOUND EACH ADDL INCL IV OCT,727.53,545.65,8.73,654.78,119
CDM,4819298601,HC PERC VALVULOPLASTYAORTIC VALVE,17462.43,13096.82,209.55,15716.19,119
CDM,4819298701,HC PERC VALVULOPLASTY MITRAL VALVE,32284.35,24213.26,387.41,29055.92,238
CDM,4819299701,HC PTA PULMONARY ARTERY SINGLE VESSEL,44229.07,33171.8,530.75,39806.16,119
CDM,4819299801,HC PTA PULMONARY ARTERY ADDITIONAL ARTERY,5301.03,3975.77,63.61,4770.93,119
CDM,4819345101,HC RT HEART CATH W/O2 SAT,6944.06,5208.04,83.33,6249.65,119
CDM,4819345201,HC LT HEART CATH W/VGRAM,10199.53,7649.65,122.39,9179.58,119
CDM,4819345301,HC RT/LT HEART CATH W/LT VGRAM,10548.78,7911.58,126.59,9493.9,119
CDM,4819345401,HC CORONARY ANGIOS ONLY,9255.25,6941.44,111.06,8329.72,119
CDM,4819345501,HC CORONARIES BY-PASS GRAFT,10022.42,7516.82,120.27,9020.18,119
CDM,4819345601,HC CORONARIES AND RT HEART CATH,10546.61,7909.96,126.56,9491.95,119
CDM,4819345701,HC CORONARY/BYPASS GRATS RT HRT,12083.445,9062.585,134.88,11633.83,238
CDM,4819345801,HC LT HEART/CORONARY LVGRAM,10378.36,7783.77,124.54,9340.52,119
CDM,4819345901,HC LT HEART/CORONARY LV GRAM/GRFT,11073.61,8305.21,132.88,9966.25,119
CDM,4819346001,HC LT/RT HEART LV GRAM CORONARY,11724.96,8793.72,140.7,10552.46,119
CDM,4819346101,HC LT/RT HRT/CORONARY LVGRM/GFT,12377.28,9282.96,148.53,11139.55,119
CDM,4819346201,HC LT HEART CATH TRANSSEPTL PUNCT,10463.48,7847.61,125.56,9417.13,238
CDM,4819346301,HC DRUG ADMIN HEMODYNAMIC MEAS,3653.91,2740.43,43.85,3288.52,238
CDM,4819346401,HC EXERCISE W/HEMODYNAMIC MEAS,1191.4,893.55,14.3,1072.26,119
CDM,4819350301,HC SWAN GAN CATH INSERTION,3469.3900000000003,2602.045,38.81,3334.51,238
CDM,4819350501,HC ENDOMYOCARDIAL BIOPSY,8614.19,6460.64,103.37,7752.77,119
CDM,4819356301,HC INJ CARDIAC CATH CONGNTL HEART,1503.73,1127.8,18.04,1353.36,119
CDM,4819356401,HC INJ CARDIAC CATH 1+ COR ARTER,3256.84,2442.63,39.08,2931.16,119
CDM,4819356501,HC INJ CARDIAC CATH LT VEN/ATRIAL,2198.09,1648.57,26.38,1978.28,119
CDM,4819356601,HC INJ CARDIAC CATH RT VEN/ATRIAL,987.8,740.85,11.85,889.02,119
CDM,4819356701,HC INJ CARDIAC CATH SUPRVAL AORTG,3436.085,2577.065,38.43,3302.5,238
CDM,4819356801,HC INJ CARDIAC CATH PULM ANGIO,5665.65,4249.24,67.99,5099.08,119
CDM,4819357101,HC IV DOP VEL&/PRESS C/FLO RSRV MEAS 1ST VESSEL,6445.155,4833.865,72.09,6194.58,238
CDM,4819357201,HC IV DOP VEL&/PRESS C/FLO RSRV MEAS EA ADDL VSL,1783.94,1337.955,19.95,1714.58,238
CDM,4819358001,HC TRANSCATH ASD REPAIR,48374.14,36280.61,580.49,43536.73,119
CDM,4819358201,HC PERC TRANSCATH CLOSURE PDA,62820.47,47115.35,753.85,56538.42,119
CDM,4819358701,HC VENOGRAPHY CONGENITAL VENOVENOUS ABOVE HEART,4349.9,3262.42,52.2,3914.91,119
CDM,4819358801,HC VENOGRAPHY CONGENITAL VENOVENOUS BELOW HEART,11443.6,8582.7,137.32,10299.24,119
CDM,4819359001,"HC CLOSURE PARAVALVULAR LEAK PERC; INITIAL, MITRAL VALVE",46945.26,35208.94,563.34,42250.73,119
CDM,4819359101,"HC PERIVALVULAR LEAK INITIAL DEVICE, AORTIC VALVE",52155.92,39116.94,625.87,46940.33,119
CDM,4819359201,HC PERIVALVULAR LEAK EA ADDTL DEVICE,7539.86,5654.9,90.48,6785.87,119
CDM,4819359801,HC CONGENITAL HEART CATH OUTPUT MEASURES/DILUTION,1451.86,1088.9,17.42,1306.67,119
CDM,4819365001,HC ATRIOVENTRIC NOTED ABLATION,18236.94,13677.7,218.84,16413.25,238
CDM,4819365301,HC EP & ABLATE SUPRAVENT ARRYTH,84959.97,63719.98,1019.52,76463.97,238
CDM,4819365401,HC EP & ABLATE VENTRICULAR TACHYCARDIA,93711.57,70283.68,1124.54,84340.41,238
CDM,4819365501,HC ABLATE ARRYTHMIA ADD ON,19403.15,14552.36,232.84,17462.84,238
CDM,4819365601,HC TX ATRIAL FIB ABLATE PULM VEIN ISOL,90864.19,68148.14,1090.37,81777.77,238
CDM,4819365701,HC TX LEFT/RIGHT ATRIAL FIB ADDL,18456.04,13842.03,221.47,16610.44,238
CDM,4819366201,HC INTRACARDIAC ULTRASOUND,17813.93,13360.45,213.77,16032.54,238
CDM,4819379941,HC IFR W/O PHARMACOLOGIC STRESS,6617.96,4963.47,79.42,5956.16,119
CDM,4819379942,HC IFR/RFR INITIAL VESSEL,6617.96,4963.47,79.42,5956.16,119
CDM,4819379943,HC IFR/RFR INITIAL VESSEL W/ 1 ADDITIONAL VESSEL,9395.89,7046.92,112.75,8456.3,119
CDM,4819379944,HC IFR/RFR INITIAL VESSEL W/ 2+ ADDITIONAL VESSELS,9894.45,7420.84,118.73,8905.01,119
CDM,481C976401,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY,26201.15,19650.86,314.41,23581.04,119
CDM,481C976403,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY BILATERAL,26201.15,19650.86,314.41,23581.04,238
CDM,481C976501,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY W/STENT,34717.25,26037.94,416.61,31245.52,119
CDM,481C976601,"HC OPEN/PERC INTRAVASCULAR LITHO W/ATHERECTOMY, LOWER EXTREM ARTERY",40464.52,30348.39,485.57,36418.07,119
CDM,481C976701,"HC OPEN/PERC INTRAVASCULAR LITHO W/ATHER & STENT, LOWER EXTREM ARTERY",49894.02,37420.52,598.73,44904.62,119
CDM,481C977201,"HC OPEN/PERC INTRAVASCULAR LITHO, TIB/PERONEAL ARTERY",21039.19,15779.39,252.47,18935.27,119
CDM,481C977301,HC OPEN/PERC INTRAVASCULAR LITHO W/STENT TIB/PERONEAL ARTERY,27877.51,20908.13,334.53,25089.76,119
CDM,481C977401,HC OPEN/PERC INTRAVASCULAR LITHO W/ATHERECTOMY TIB/PERONEAL ARTERY,34846.89,26135.17,418.16,31362.2,119
CDM,481C977501,HC OPEN/PERC INTRAVASCULAR LITHO W/ATHER & STENT TIB/PERONEAL ARTERY,49894.02,37420.52,598.73,44904.62,119
CDM,481G027801,HC ILIAC ANGIOGRAM,1307.25,980.44,15.69,1176.53,119
CDM,4829301701,HC CARDIOVASCULAR STRESS TEST,560.01,420.01,6.72,504.01,119
CDM,4839330301,HC TTE CONGENITAL COMPLETE,2292.85,1719.64,27.51,2063.56,119
CDM,4839330311,HC TTE CONGENITAL COMPLETE W/CONTRAST,2292.98,1719.74,27.52,2063.68,119
CDM,4839330401,HC TTE CONGENITAL LIMITED W/O CONTRAST,1461.01,1095.76,17.53,1314.91,119
CDM,4839330411,HC TTE CONGENITAL LIMITED W/ CONTRAST,1461.01,1095.76,17.53,1314.91,119
CDM,4839330601,HC TTE COMP W/DPLR & COLOR W/O CONTRAST,2201.14,1650.86,26.41,1981.03,119
CDM,4839330611,HC TTE COMP W/DPLR & COLOR W/CONTRAST,2293.73,1720.3,27.52,2064.36,119
CDM,4839330701,HC TTE COMP W/O DOPPLER OR COLOR FLOW,1167.25,875.44,14.01,1050.53,119
CDM,4839330705,HC TTE COMP W/O DOPPLER OR COLOR FLOW W/CONTRAST,1167.25,875.44,14.01,1050.53,119
CDM,4839330801,HC 2D TTE LIMITED W/O CONTRAST,1166.53,874.9,14.0,1049.88,119
CDM,4839330811,HC 2D TTE LIMITED W/CONTRAST,1166.53,874.9,14.0,1049.88,119
CDM,4839331201,HC TEE TRANSEOPHAG W/O CONTRAST,2876.82,2157.61,34.52,2589.14,119
CDM,4839331211,HC TEE TRANSEOPHAG W/CONTRAST,3196.45,2397.34,38.36,2876.8,119
CDM,4839331301,"HC ECHO, TEE FOR PLACEMT TRANSESOPHAGEAL PROBE ONLY",1283.64,962.73,15.4,1155.28,119
CDM,4839331501,HC TEE FOR CONGENITAL CARDIAC ANOMALIES,3997.36,2998.02,47.97,3597.62,119
CDM,4839331701,HC US TEE CONGENIT IMG AND REPORT ONLY,1473.1,1104.82,17.68,1325.79,119
CDM,4839331801,HC ECHO TEE FOR OR MONITORING,5838.27,4378.7,70.06,5254.44,119
CDM,4839331901,HC ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,1319.54,989.66,15.83,1187.59,119
CDM,4839332001,HC DOPPLER W/SPECTRAL COMPLETE,613.71,460.28,7.36,552.34,119
CDM,4839332101,HC DOPPLER W/SPECTRAL LIMITED,362.32,271.74,4.35,326.09,119
CDM,4839332501,HC DOPPLER COLOR FLOW,489.48,367.11,5.87,440.53,119
CDM,4839335101,HC US TTE STRESS AND ECG W/PHYS COMPLETE W/O CONTRAST,2416.22,1812.16,28.99,2174.6,119
CDM,4839335141,HC US TTE STRESS AND ECG W/PHYS COMPLETE W CONTRAST,2416.22,1812.16,28.99,2174.6,119
CDM,4839335501,HC ECHO TEE FOR INTERVENTION GUIDANCE,5755.58,4316.69,69.07,5180.02,119
CDM,4839335601,HC MYOCRD STRAIN IMG SPCKL TRCK,137.28,102.96,1.65,123.55,119
CDM,483C892701,HC US TEE OR OPEN NONVASC W/ CONTRAST,6421.76,4816.32,77.06,5779.58,119
CDM,4854,MEDROXYPROGESTERONE 10 MG TABLET,1.59,1.19,0.02,1.43,119
CDM,4855,MEDROXYPROGESTERONE 2.5 MG TABLET,0.85,0.64,0.01,0.76,119
CDM,4871,MEGESTROL 40 MG TABLET,4.19,3.14,0.05,3.77,119
CDM,4953,METHADONE 10 MG TABLET,2.04,1.53,0.02,1.89,238
CDM,4954,METHADONE 5 MG TABLET,1.74,1.3,0.02,1.57,119
CDM,4971,METHOCARBAMOL 500 MG TABLET,0.3,0.22,0.01,0.27,119
CDM,4972,METHOCARBAMOL 750 MG TABLET,0.37,0.28,0.01,0.33,119
CDM,4973,METHOTREXATE SODIUM 2.5 MG TABLET,4.24,3.18,0.05,3.82,119
CDM,4974,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,476
CDM,4986,METHYLPHENIDATE 10 MG TABLET,1.68,1.255,0.02,1.52,238
CDM,4993,METHYLPREDNISOLONE 4 MG TABLET,2.47,1.85,0.03,2.22,119
CDM,4995,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,60.0,45.0,0.72,54.0,238
CDM,4996,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,73.44,55.08,0.88,66.1,119
CDM,5002,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,16.65,12.49,0.16,18.09,357
CDM,5006,METOCLOPRAMIDE 5 MG TABLET,4.52,3.39,0.05,4.07,119
CDM,5007,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,7.77,5.83,0.06,7.02,595
CDM,5009,METOPROLOL TARTRATE 50 MG TABLET,0.13,0.09,0.01,0.12,119
CDM,5016,METRONIDAZOLE 500 MG TABLET,4.5,3.38,0.05,4.05,119
CDM,5018,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,13.2,9.899999999999999,0.15,12.42,238
CDM,5039,MICONAZOLE NITRATE 2 % TOPICAL CREAM,13.14,9.86,0.16,11.83,119
CDM,5040,MICONAZOLE NITRATE 2 % VAGINAL CREAM,48.33,36.25,0.58,43.5,119
CDM,5086,MINERAL OIL ORAL,9.9,7.43,0.12,8.91,119
CDM,5087,MINERAL OIL ENEMA,11.97,8.98,0.14,10.77,119
CDM,5088880007,EPINEPHRINE 10 MG IN NS QS 100 ML FOR ADS LOAD,501.0,375.75,6.01,450.9,119
CDM,5101014071,PBB I&D HEMATOMA SEROMA/FLUID COLLECTION,3509.44,2632.08,42.11,3158.5,119
CDM,5101016071,PBB PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,610.62,457.96,7.33,549.56,119
CDM,5101104271,PBB DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1150.96,863.22,13.81,1035.86,119
CDM,5102055271,PBB INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,553.0,414.75,6.64,497.7,119
CDM,5102060071,PBB ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,769.36,577.02,9.23,692.42,119
CDM,5102060571,PBB ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,666.58,499.94,8.0,599.92,119
CDM,5102061071,PBB ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,943.69,707.77,11.32,849.32,119
CDM,5102061271,PBB ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,850.38,637.78,10.2,765.34,119
CDM,5102910571,PBB APPLICATION LONG ARM SPLINT SHOULDER HAND,484.56,363.42,5.81,436.1,119
CDM,5102912571,PBB APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,578.95,434.21,6.95,521.06,119
CDM,5102951571,PBB APPLICATION SHORT LEG SPLINT CALF FOOT,499.21,374.41,5.99,449.29,119
CDM,5103255471,PBB THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,1781.07,1335.8,21.37,1602.96,119
CDM,5104908371,PBB ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,2700.9,2025.68,32.41,2430.81,119
CDM,5105902571,PBB FETAL NONSTRESS TEST,509.64,382.23,6.12,458.68,119
CDM,5106445071,PBB INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,186.84,140.13,2.24,168.16,119
CDM,5109079171,PBB PSYCHIATRIC DIAGNOSTIC EVALUATION,354.47,265.85,4.25,319.02,119
CDM,5109083271,PBB PSYCHOTHERAPY W/PATIENT 30 MINUTES,158.59,118.94,1.9,142.73,119
CDM,5109083471,PBB PSYCHOTHERAPY W/PATIENT 45 MINUTES,224.17,168.13,2.69,201.75,119
CDM,5109083771,PBB PSYCHOTHERAPY W/PATIENT 60 MINUTES,396.57,297.43,4.76,356.91,119
CDM,5109588501,HC NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,605.34,454.0,7.26,544.81,119
CDM,5109588601,HC NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,719.91,539.93,8.64,647.92,119
CDM,5109590701,HC NERVE CONDUCTION STUDIES 1-2 STUDIES,1050.67,788.0,12.61,945.6,119
CDM,5109590901,HC NERVE CONDUCTION STUDIES 5-6 STUDIES,1505.02,1128.77,18.06,1354.52,119
CDM,5109591001,HC NERVE CONDUCTION STUDIES 7-8 STUDIES,1926.33,1444.75,23.12,1733.7,119
CDM,5109591101,HC NERVE CONDUCTION STUDIES 9-10 STUDIES,2196.42,1647.32,26.36,1976.78,119
CDM,5109591201,HC NERVE CONDUCTION STUDIES 11-12 STUDIES,2438.17,1828.63,29.26,2194.35,119
CDM,5109592301,HC TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,3776.43,2832.32,45.32,3398.79,119
CDM,5109613671,PBB PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,124.22,93.16,1.49,111.8,119
CDM,5109613771,PBB PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,114.01,85.51,1.37,102.61,119
CDM,5109760271,PBB RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,510.87,383.15,6.13,459.78,119
CDM,5109920201,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 2,298.38,223.78,3.58,268.54,119
CDM,5109920301,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 3,484.57,363.43,5.81,436.11,119
CDM,5109920401,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 4,484.57,363.43,5.81,436.11,119
CDM,5109920501,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 5,334.01,250.51,4.01,300.61,119
CDM,5109921101,HC OFFICE/OUTPATIENT VISIT EST LEVEL 1,253.64,190.23,3.04,228.28,119
CDM,5109921201,HC OFFICE/OUTPATIENT VISIT EST LEVEL 2,272.33,204.25,3.27,245.1,119
CDM,5109921301,HC OFFICE/OUTPATIENT VISIT EST LEVEL 3,380.37,285.28,4.56,342.33,119
CDM,5109921401,HC OFFICE/OUTPATIENT VISIT EST LEVEL 4,449.6,337.2,5.4,404.64,119
CDM,5109921501,HC OFFICE/OUTPATIENT VISIT EST LEVEL 5,538.64,403.98,6.46,484.78,119
CDM,5109939101,"HC PREVENTIVE VISIT,EST, INFANT < 1 YR",484.57,363.43,5.81,436.11,119
CDM,5109960501,HC MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT,0.01,0.01,0.01,0.01,119
CDM,510G026071,PBB INJEC SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,2146.78,1610.08,25.76,1932.1,119
CDM,510G046301,HC E&M TECHNICAL VISIT,364.3,273.23,4.37,327.87,119
CDM,510G046371,PBB ESTABLISHED/NEW VISIT,334.01,250.51,4.01,300.61,119
CDM,5110,MINOCYCLINE 100 MG CAPSULE,2.76,2.07,0.03,2.48,119
CDM,5111,MINOCYCLINE 50 MG CAPSULE,1.38,1.03,0.02,1.24,119
CDM,5114,MINOXIDIL 10 MG TABLET,2.76,2.07,0.03,2.48,119
CDM,5115,MINOXIDIL 2.5 MG TABLET,1.26,0.94,0.02,1.13,119
CDM,5170,MORPHINE 2 MG/ML INJECTION SOLUTION,17.22,12.92,0.21,15.5,238
CDM,5176,MORPHINE 10 MG/5 ML ORAL SOLUTION,8.145,6.109999999999999,0.02,124.2,476
CDM,5178,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,4.55,3.41,0.05,4.1,119
CDM,5180,MORPHINE 10 MG RECTAL SUPPOSITORY,30.0,22.5,0.36,27.0,119
CDM,5330,NADOLOL 20 MG TABLET,17.51,13.13,0.21,15.76,119
CDM,5334,NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,339.8,254.85,4.08,305.82,238
CDM,5335,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
CDM,5339,NALBUPHINE 10 MG/ML INJECTION SOLUTION,31.935,23.95,0.32,33.41,357
CDM,5373,NALOXONE 0.4 MG/ML INJECTION SOLUTION,36.0,27.0,0.32,540.0,952
CDM,5391,NAPROXEN 250 MG TABLET,0.42,0.32,0.01,0.38,119
CDM,5393,NAPROXEN 500 MG TABLET,0.73,0.54,0.01,0.66,119
CDM,5395,NAPROXEN SODIUM 550 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,5472,NEOMYCIN 500 MG TABLET,6.66,5.0,0.08,5.99,119
CDM,5539,NIACIN 100 MG TABLET,0.1,0.07,0.01,0.09,119
CDM,5542,NIACIN 500 MG TABLET,0.16,0.12,0.01,0.14,119
CDM,5545,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",2.14,1.6,0.03,1.93,119
CDM,5558,NIFEDIPINE 10 MG CAPSULE,5.13,3.85,0.06,4.62,119
CDM,5595,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,4.13,3.1,0.05,3.72,119
CDM,5599760721,HC HH SN NEGATIVE PRESSURE WOUND THERAPY NON DME <50 SQ CM,801.78,601.34,9.62,721.6,119
CDM,5599760821,HC HH SN NEGATIVE PRESSURE WOUND THERAPY NON DME > 50 SQ CM,716.05,537.04,8.59,644.44,119
CDM,5604,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,15.6,11.7,0.19,14.04,238
CDM,5674,NORTRIPTYLINE 10 MG CAPSULE,1.18,0.88,0.01,1.06,119
CDM,5675,NORTRIPTYLINE 25 MG CAPSULE,1.55,1.17,0.02,1.4,119
CDM,5749,"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",119.88,89.91,1.44,107.89,119
CDM,5750,"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",83.97,62.98,1.01,75.57,119
CDM,5751,"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",5.07,3.8,0.06,4.56,119
CDM,5828,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,1355.875,1016.905,0.14,2430.28,238
CDM,5938,OXYBUTYNIN CHLORIDE 5 MG TABLET,0.53,0.4,0.01,0.48,238
CDM,5940,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,2.45,1.835,0.03,2.21,238
CDM,5943,OXYMETAZOLINE 0.05 % NASAL SPRAY,10.8,8.1,0.01,12.15,357
CDM,5944,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,20.7,15.52,0.11,75.6,595
CDM,6030,PAPAVERINE 30 MG/ML INJECTION SOLUTION,166.29500000000002,124.725,1.76,167.71,476
CDM,6085,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,225.0,168.75,2.7,202.5,238
CDM,6086,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,238
CDM,6093,PENICILLIN V POTASSIUM 500 MG TABLET,3.67,2.75,0.04,3.3,119
CDM,6107033601,HC MRI TMJ UNILATERAL,3532.7,2649.52,42.39,3179.43,119
CDM,6107054001,HC MRI NECK/ORBIT/FACE W/O CONTRAST,4383.44,3287.58,52.6,3945.1,119
CDM,6107054201,HC MRI NECK/ORBIT/FACE W/CONTRAST,5431.71,4073.78,65.18,4888.54,119
CDM,6107054301,HC MRI NECK/ORBIT/FACE W/WO CONTRAST,6599.79,4949.84,79.2,5939.81,119
CDM,6107155001,HC MRI CHEST W/O CONTRAST,4153.45,3115.09,49.84,3738.1,119
CDM,6107155101,HC MRI CHEST W/CONTRAST,3974.76,2981.07,47.7,3577.28,119
CDM,6107155201,HC MRI CHEST W/WO CONTRAST,6010.14,4507.6,72.12,5409.13,119
CDM,6107219501,HC MRI PELVIS W/O CONTRAST,4225.77,3169.33,50.71,3803.19,119
CDM,6107219601,HC MRI PELVIS W/CONTRAST,4070.62,3052.96,48.85,3663.56,119
CDM,6107219701,HC MRI PELVIS W/WO CONTRAST,4154.42,3115.82,49.85,3738.98,119
CDM,6107321801,HC MRI UPPER EXTREMITY W/O CONTRAST,3995.56,2996.67,47.95,3596.0,119
CDM,6107321901,HC MRI UPPER EXTREMITY W/CONTRAST UNILATERAL,4181.43,3136.07,50.18,3763.29,119
CDM,6107322001,HC MRI UPPER EXTREM W/WO CONTRAST UNILATERAL,5932.97,4449.73,71.2,5339.67,119
CDM,6107322101,HC MRI UPPER EXTREM 1 JOINT W/O CONTRAST,3663.7,2747.78,43.96,3297.33,119
CDM,6107322201,HC MRI UPPER JOINT UNILATERAL W/CONTRAST,4434.21,3325.66,53.21,3990.79,119
CDM,6107322301,HC MRI UPPER JOINT UNILATERAL W/WO CONTRAST,5313.11,3984.83,63.76,4781.8,119
CDM,6107371801,HC MRI LOWER EXTREM UNILATERAL W/O CONTRAST,3733.92,2800.44,44.81,3360.53,119
CDM,6107371901,HC MRI LOWER EXTREM UNILATERAL W/CONTRAST,3539.36,2654.52,42.47,3185.42,119
CDM,6107372001,HC MRI LOWER EXTREM UNILATERAL W/WO CONTRAST,5019.66,3764.74,60.24,4517.69,119
CDM,6107372101,HC MRI LOWER JOINT UNILATERAL W/O CONTRAST,3464.36,2598.27,41.57,3117.92,119
CDM,6107372201,HC MRI LOWER JOINT UNILATERAL W/CONTRAST,4468.4,3351.3,53.62,4021.56,119
CDM,6107372301,HC MRI LOWER JOINT UNILATERAL W/WO CONTRAST,5079.75,3809.81,60.96,4571.78,119
CDM,6107418101,HC MRI ABDOMEN W/O CONTRAST,4130.78,3098.08,49.57,3717.7,119
CDM,6107418201,HC MRI ABDOMEN W/CONTRAST,4758.93,3569.2,57.11,4283.04,119
CDM,6107418301,HC MRI ABDOMEN W/WO CONTRAST,5905.57,4429.18,70.87,5315.01,119
CDM,6107418304,HC MRI ABDOMEN W/WO LIMITED METS,5905.57,4429.18,70.87,5315.01,119
CDM,6107555701,HC MRI CARDIAC FOR MORPH,2556.49,1917.37,30.68,2300.84,119
CDM,6107555704,HC MRI CARDIAC FOR MORPH LIMITED,2556.49,1917.37,30.68,2300.84,119
CDM,6107555901,HC CARDIAC MRI W/STRESS IMG,4296.4,3222.3,51.56,3866.76,119
CDM,6107556101,HC MRI CARDIAC MORPH W/WO CONTRAST,4442.73,3332.05,53.31,3998.46,119
CDM,6107556301,HC CARD MRI W/STRESS IMG & DYE,5888.36,4416.27,70.66,5299.52,119
CDM,6107556501,HC MRI CARDIAC FLOW MAP,3658.12,2743.59,43.9,3292.31,119
CDM,6107637601,HC 3-D RECONSTRUCT W/O WORKSTATION,830.01,622.51,9.96,747.01,119
CDM,6107637701,HC 3-D RECONSTRUCT W/WORKSTATION,596.0,447.0,7.15,536.4,119
CDM,6107639001,HC MRI SPECTROSCOPY,1021.46,766.1,12.26,919.31,119
CDM,6107639101,HC MRI ELASTOGRAPHY,1988.37,1491.28,23.86,1789.53,119
CDM,6107649841,HC MRI CAD (NON BREAST),5517.04,4137.78,66.2,4965.34,119
CDM,6107649844,HC MRI WHOLE BODY LIMITED W/O CONTRAST,5974.95,4481.21,71.7,5377.46,119
CDM,6107649845,HC MRI WHOLE BODY LIMITED W/WO CONTRAST 1-4 AREAS,5974.95,4481.21,71.7,5377.46,119
CDM,6107649846,HC MRI WHOLE BODY WO CONTRAST,5974.95,4481.21,71.7,5377.46,119
CDM,6107649847,HC MRI LYMPHANGIOGRAM,4572.71,3429.53,54.87,4115.44,119
CDM,6107702101,HC MRI GUIDANCE BX/ASPRTN/INJECT,2620.03,1965.02,31.44,2358.03,119
CDM,6107704601,HC MRI BREAST W/O; UNILATERAL,2243.01,1682.26,26.92,2018.71,119
CDM,6107704701,HC MRI BREAST W/O; BILATERAL,4279.21,3209.41,51.35,3851.29,119
CDM,6107704801,"HC MRI BREAST W & WO, UNILATERAL, INCL CAD",5030.56,3772.92,60.37,4527.5,119
CDM,6107704901,"HC MRI BREAST W & WO, BILATERAL, INCL CAD",6735.05,5051.29,80.82,6061.54,119
CDM,6107704903,HC MRI BREAST WO/W FAST LTD BILATERAL,6735.05,5051.29,80.82,6061.54,119
CDM,6107704941,HC MRI BREAST WO/W FAST LTD BILAT SELECT HEALTH,6735.05,5051.29,80.82,6061.54,119
CDM,610C893701,HC MRI CAD BREAST,666.05,499.54,7.99,599.44,119
CDM,6117055101,HC MRI BRAIN W/O CONTRAST,4026.95,3020.21,48.32,3624.26,119
CDM,6117055104,HC MRI BRAIN LIMITED W/O CONTRAST,4729.11,3546.83,56.75,4256.2,119
CDM,6117055201,HC MRI BRAIN W/CONTRAST,4693.84,3520.38,56.33,4224.46,119
CDM,6117055204,HC MRI BRAIN LIMITED W/CONTRAST,4542.87,3407.15,54.51,4088.58,119
CDM,6117055301,HC MRI BRAIN W/WO CONTRAST,5833.02,4374.77,70.0,5249.72,119
CDM,6117055304,HC MRI IAC'S W AND W/O CONTRAST LIMITED,5833.02,4374.77,70.0,5249.72,119
CDM,6117055401,HC MRI FUNCTIONAL BRAIN IMAGING,4878.06,3658.54,58.54,4390.25,119
CDM,6117055501,HC MRI FUNCTIONAL BRAIN  IMAGING W PHYSICIAN,5280.23,3960.17,63.36,4752.21,119
CDM,6127214101,HC MRI CERVICAL SPINE W/O CONTRAST,4759.14,3569.36,57.11,4283.23,119
CDM,6127214104,HC MRI CERVICAL SPINE W/O CONTRAST-LIMITED,4759.14,3569.36,57.11,4283.23,119
CDM,6127214201,HC MRI CERVICAL SPINE W/CONTRAST,4865.15,3648.86,58.38,4378.64,119
CDM,6127214601,HC MRI THORACIC SPINE W/O CONTRAST,4399.05,3299.29,52.79,3959.15,119
CDM,6127214604,HC MRI THORACIC SPINE W/O CONTRAST-LIMITED,4399.05,3299.29,52.79,3959.15,119
CDM,6127214701,HC MRI THORACIC SPINE W/CONTRAST,4709.44,3532.08,56.51,4238.5,119
CDM,6127214801,HC MRI LUMBAR SPINE W/O CONTRAST,4126.6,3094.95,49.52,3713.94,119
CDM,6127214901,HC MRI LUMBAR SPINE W/CONTRAST,5042.43,3781.82,60.51,4538.19,119
CDM,6127215601,HC MRI CERVICAL SPINE W/WO CONTRAST,6666.24,4999.68,79.99,5999.62,119
CDM,6127215604,HC MRI CERVICAL SPINE W/WO CONTRAST-LIMITED,6666.24,4999.68,79.99,5999.62,119
CDM,6127215701,HC MRI THORACIC SPINE W/WO CONTRAST,6346.7,4760.02,76.16,5712.03,119
CDM,6127215704,HC MRI THORACIC SPINE W/WO CONTRAST-LIMITED,6346.7,4760.02,76.16,5712.03,119
CDM,6127215801,HC MRI LUMBAR SPINE W/WO CONTRAST,6639.88,4979.91,79.68,5975.89,119
CDM,6127215804,HC MRI LUMBAR SPINE W/WO CONTRAST -LIMITED,5517.92,4138.44,66.22,4966.13,119
CDM,6157054401,HC MRA HEAD W/O CONTRAST,3964.88,2973.66,47.58,3568.39,119
CDM,6157054501,HC MRA HEAD W/CONTRAST,3464.86,2598.64,41.58,3118.37,119
CDM,6157054601,HC MRA HEAD W/WO CONTRAST,5450.62,4087.96,65.41,4905.56,119
CDM,6157054701,HC MRA NECK W/O CONTRAST,3901.43,2926.07,46.82,3511.29,119
CDM,6157054801,HC MRA NECK W/CONTRAST,4553.22,3414.92,54.64,4097.9,119
CDM,6157054901,HC MRA NECK W/WO CONTRAST,6166.95,4625.21,74.0,5550.26,119
CDM,6159,PERPHENAZINE 8 MG TABLET,4.52,3.39,0.05,4.07,119
CDM,6167372511,HC MRA LOWER EXTREM UNILATERAL W/CONTRAST,4255.43,3191.57,51.07,3829.89,119
CDM,6167372512,HC MRA LOWER EXTREM UNILATERAL W/O CONTRAST,4255.19,3191.39,51.06,3829.67,119
CDM,6167372513,HC MRA LOWER EXTREM UNILATERAL W/WO CONTRAST,4255.19,3191.39,51.06,3829.67,119
CDM,6187155511,HC MRA CHEST W/CONTRAST,3731.3,2798.48,44.78,3358.17,119
CDM,6187155512,HC MRA CHEST W/O CONTRAST,4094.16,3070.62,49.13,3684.74,119
CDM,6187155513,HC MRA CHEST W/WO CONTRAST,6332.62,4749.46,75.99,5699.36,119
CDM,6187219811,HC MRA PELVIS W/CONTRAST,3933.07,2949.8,47.2,3539.76,119
CDM,6187219812,HC MRA PELVIS W/O CONTRAST,5168.77,3876.58,62.03,4651.89,119
CDM,6187219813,HC MRA PELVIS W/WO CONTRAST,5168.77,3876.58,62.03,4651.89,119
CDM,6187322511,HC MRA UPPER EXTREMITY W/ CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CDM,6187322512,HC MRA UPPER EXTREMITY W/O CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CDM,6187322513,HC MRA UPPER EXTREMITY W/WO CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CDM,6187418511,HC MRA ABDOMEN W/CONTRAST,3204.49,2403.37,38.45,2884.04,119
CDM,6187418512,HC MRA ABDOMEN W/O CONTRAST,3971.46,2978.6,47.66,3574.31,119
CDM,6187418513,HC MRA ABDOMEN W/WO CONTRAST,6039.69,4529.77,72.48,5435.72,119
CDM,6194,PHENAZOPYRIDINE 200 MG TABLET,2.88,2.16,0.03,2.59,119
CDM,6212,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,215.69,161.77,2.59,194.12,357
CDM,6215,PHENOBARBITAL 16.2 MG TABLET,2.55,1.91,0.03,2.3,119
CDM,6218,PHENOBARBITAL 60 MG TABLET,2.64,1.98,0.03,2.38,119
CDM,6219,PHENOBARBITAL 64.8 MG TABLET,4.02,3.01,0.05,3.62,119
CDM,622,ARGININE (L-ARGININE) 500 MG TABLET,0.44,0.33,0.01,0.4,119
CDM,6221,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,281.99,211.49,3.38,253.79,238
CDM,6224,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,117.81,88.36,0.94,106.73,714
CDM,6242,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,23.41,17.56,0.09,21.6,476
CDM,6246,PHENYLEPHRINE 2.5 % EYE DROPS,146.25,109.69,1.76,131.62,238
CDM,6255,PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,143.62,107.72,1.72,129.26,119
CDM,6256,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,10.155000000000001,7.62,0.1,10.77,476
CDM,6271,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,111.28,83.46,1.34,100.15,119
CDM,6279,PILOCARPINE 1 % EYE DROPS,445.14,333.86,5.34,400.63,119
CDM,6280,PILOCARPINE 2 % EYE DROPS,455.31,341.48,5.46,409.78,119
CDM,636J060101,HC SEVELAMER CARBONATE ORAL 20MG,0.18,0.14,0.01,0.16,119
CDM,636J060201,HC SEVELAMER CARBONATE ORAL POWDER 20 MG,0.22,0.16,0.01,0.2,119
CDM,636J060301,HC SEVELAMER HYDROCHLORIDE ORAL 20 MG,0.29,0.22,0.01,0.26,119
CDM,636J060501,HC SUCROFERRIC OXYHYDROXIDE ORAL 5MG,0.43,0.32,0.01,0.39,119
CDM,636J060701,"HC LANTHANUM CARBONATE, ORAL 5 MG",0.12,0.09,0.01,0.11,119
CDM,636J060801,"HC LANTHANUM CARBONATE, ORAL POWDER 5 MG",0.17,0.13,0.01,0.15,119
CDM,636J060901,HC FERRIC CITRATE ORAL 3 MG FERRIC IRON,0.27,0.2,0.01,0.24,119
CDM,636J061501,"HC CALCIUM ACETATE, ORAL, 23MG",0.04,0.03,0.01,0.04,119
CDM,6420,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,32.4,24.3,0.27,60.48,476
CDM,6432,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,35.19,26.39,0.42,31.67,119
CDM,6434,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,9.12,6.84,0.11,8.21,238
CDM,6451,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,270.0,202.5,1.06,258.96,595
CDM,6455,POVIDONE-IODINE 10 % TOPICAL OINTMENT,9.03,6.77,0.11,8.13,119
CDM,6468,PRAZOSIN 1 MG CAPSULE,9.06,6.8,0.11,8.15,119
CDM,6470,PRAZOSIN 5 MG CAPSULE,1.63,1.22,0.02,1.47,119
CDM,6483,PREDNISOLONE 5 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,6487,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",264.0,198.0,3.17,237.6,238
CDM,6493,PREDNISONE 1 MG TABLET,0.6,0.45,0.01,0.54,119
CDM,6494,PREDNISONE 10 MG TABLET,0.93,0.7,0.01,0.84,119
CDM,6495,PREDNISONE 2.5 MG TABLET,0.73,0.55,0.01,0.66,119
CDM,6496,PREDNISONE 20 MG TABLET,1.1,0.825,0.01,1.07,238
CDM,6497,PREDNISONE 5 MG TABLET,1.01,0.76,0.01,0.91,119
CDM,6498,PREDNISONE 50 MG TABLET,1.81,1.35,0.02,1.63,119
CDM,6541,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,8.03,6.02,0.1,7.23,119
CDM,6544,PRIMIDONE 250 MG TABLET,3.91,2.93,0.05,3.52,119
CDM,6561,PROBENECID 500 MG TABLET,3.56,2.67,0.04,3.2,119
CDM,6563,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,2304.0,1728.0,27.65,2073.6,119
CDM,656Q500530,HC HOSPICE ROOM/BOARD,1202.25,901.69,14.43,1082.03,119
CDM,6574908201,HC HH/HSPC ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,2700.9,2025.68,32.41,2430.81,119
CDM,6582,PROCHLORPERAZINE MALEATE 10 MG TABLET,3.12,2.34,0.04,2.81,119
CDM,6583,PROCHLORPERAZINE MALEATE 5 MG TABLET,6.64,4.98,0.08,5.98,119
CDM,6618,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,15.66,11.745000000000001,0.13,18.21,357
CDM,6620,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,232.72,174.54,2.79,209.45,119
CDM,6621,PROMETHAZINE 12.5 MG TABLET,0.48,0.36,0.01,0.43,119
CDM,6622,PROMETHAZINE 25 MG TABLET,0.29,0.22,0.01,0.26,119
CDM,664,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.2,0.15,0.01,0.18,119
CDM,6644,PROPARACAINE 0.5 % EYE DROPS,210.51,157.88,2.53,189.46,119
CDM,6654,PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,291.0,218.25,3.49,261.9,119
CDM,6656,PROPRANOLOL 10 MG TABLET,1.57,1.18,0.02,1.41,119
CDM,6657,PROPRANOLOL 20 MG TABLET,2.57,1.93,0.03,2.31,119
CDM,6662,PROPYLTHIOURACIL 50 MG TABLET,4.5,3.38,0.05,4.05,119
CDM,6677,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,205.14,153.85500000000002,1.11,285.66,357
CDM,6714,PSEUDOEPHEDRINE 30 MG TABLET,0.13,0.09,0.01,0.12,119
CDM,6738,PYRAZINAMIDE 500 MG TABLET,27.11,20.34,0.33,24.4,119
CDM,6744,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,97.78,73.34,1.17,88.0,238
CDM,6745,PYRIDOXINE (VITAMIN B6) 100 MG TABLET,0.14,0.1,0.01,0.13,119
CDM,6748,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.1,0.08,0.01,0.09,119
CDM,6777,QUINIDINE SULFATE 200 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,680,ASPIRIN 81 MG CHEWABLE TABLET,0.05,0.04,0.01,0.05,119
CDM,681,ASPIRIN 325 MG TABLET,0.04,0.03,0.01,0.04,119
CDM,6831067097,HC FULL TRAUMA ACTIVATION W/O CRITICAL CARE,19239.58,14429.68,230.87,17315.62,119
CDM,6831158097,HC LIMITED TRAUMA ACTIVATION W/O CRITICAL CARE,14643.67,10982.75,175.72,13179.3,119
CDM,683G039001,HC FULL TRAUMA ACTIVATION,20839.79,15629.84,250.08,18755.81,119
CDM,683G039006,HC LIMITED TRAUMA ACTIVATION,15861.61,11896.21,190.34,14275.45,119
CDM,693,ASPIRIN 300 MG RECTAL SUPPOSITORY,7.0,5.25,0.08,6.3,119
CDM,70536,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",108.0,81.0,1.3,97.2,119
CDM,7101024797,HC PHASE I RECOVERY PER MINUTE,35.51,26.63,0.43,31.96,119
CDM,7101024897,HC PHASE II RECOVERY PER MINUTE,8.18,6.14,0.1,7.36,119
CDM,7101029397,HC PACU PHASE 1 PER MINUTE,6.01,4.51,0.07,5.41,119
CDM,7101216097,HC PACU PHASE 2 PER MINUTE,8.18,6.14,0.1,7.36,119
CDM,7139,SELENIUM 200 MCG TABLET,0.28,0.21,0.01,0.25,119
CDM,717,ATENOLOL 25 MG TABLET,0.725,0.54,0.01,1.06,238
CDM,7201032797,HC L&D OUTPATIENT ASSESSMENT FOR TRIAGE,627.05,470.29,7.52,564.34,119
CDM,7201155197,HC L&D NON-DELIVERY PROC PER MIN,30.35,22.76,0.36,27.32,119
CDM,7205644001,HC MARSUPIALIZATION BARTHOLINS GLAND CYST,546.11,409.58,6.55,491.5,119
CDM,7205902001,HC FETAL CONTRACTION STRESS TEST,186.28,139.71,2.24,167.65,119
CDM,7205902501,HC FETAL NON-STRESS TEST,1019.28,764.46,12.23,917.35,119
CDM,7205902504,HC FETAL NON-STRESS TEST,509.64,382.23,6.12,458.68,238
CDM,7205932001,HC RESCUE CERCLAGE PLACEMENT L&D OR,5142.6,3856.95,61.71,4628.34,119
CDM,7205941201,HC EXT CEPHALIC VERSION W/WO TOCO,3059.83,2294.87,36.72,2753.85,119
CDM,7205941401,HC DELIVERY-PLACENTA ONLY,1302.03,976.52,15.62,1171.83,119
CDM,7221025597,HC VAGINAL DELIVERY - SINGLETON,3767.32,2825.49,45.21,3390.59,119
CDM,7221025697,HC VAGINAL DELIVERY - PREEMIE,4757.39,3568.04,57.09,4281.65,119
CDM,7221025797,HC VAGINAL DELIVERY - MULTIPLE,5962.03,4471.52,71.54,5365.83,119
CDM,7221025897,HC L&D OR DELIVERY SINGLETON,7910.8,5933.1,94.93,7119.72,119
CDM,7221025997,HC L&D OR DELIVERY PREEMIE,8428.2,6321.15,101.14,7585.38,119
CDM,7221026097,HC L&D OR DELIVERY MULTIPLE 2 OR 3,9453.49,7090.12,113.44,8508.14,119
CDM,7221026197,HC L&D OR DELIVERY >3 OR ADD ON PROCEDURE,9765.73,7324.3,117.19,8789.16,119
CDM,7224,SILVER SULFADIAZINE 1 % TOPICAL CREAM,132.345,99.25999999999999,0.89,285.12,476
CDM,7227,SIMETHICONE 80 MG CHEWABLE TABLET,0.18,0.14,0.01,0.16,119
CDM,7228,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",13.14,9.86,0.16,11.83,119
CDM,7229946501,HC DELIVERY BIRTHING ROOM RESUSCITATION,1267.89,950.92,15.21,1141.1,119
CDM,7235415001,HC CIRCUMCISION,541.5,406.12,6.5,487.35,119
CDM,730,ATROPINE 0.1 MG/ML INJECTION SYRINGE,68.7,51.53,0.82,61.83,119
CDM,7301,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,36.9,27.675,0.23,98.01,833
CDM,7306,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,93.825,70.365,0.56,127.06,357
CDM,7309,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,55.8,41.85,0.45,117.72,714
CDM,7309300001,HC EKG W/READ,59.57,44.68,0.71,53.61,119
CDM,7309300501,HC EKG 12 LEAD;TRACING ONLY W/O INTERP,242.99,182.24,2.92,218.69,119
CDM,7309327801,HC SIGNAL AVERAGE EKG,221.86,166.4,2.66,199.67,119
CDM,7313,SODIUM BICARBONATE 650 MG TABLET,1.22,0.91,0.01,1.1,119
CDM,7318,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,31.5,23.625,0.32,32.4,238
CDM,7319322501,HC HOLTER MONITOR HOOKUP/RECORDING =<48 HRS,515.77,386.83,6.19,464.19,119
CDM,7319322601,HC HOLTER MONITOR ANALYSIS W/REPORT =<48 HRS,556.46,417.34,6.68,500.81,119
CDM,7319324201,HC HOLTER EPATCH 48HR TO 7 DAY HOOKUP,515.77,386.83,6.19,464.19,119
CDM,7319324301,HC HOLTER MONITOR ANALYSIS W/ REP 48HR TO 7 DAYS,600.98,450.74,7.21,540.88,238
CDM,7319324601,HC HOLTER EPATCH 8 TO 15 DAYS OR MORE HOOKUP,193.11,144.83,2.32,173.8,119
CDM,7319327001,HC EVENT MONITOR HOOKUP,171.79,128.84,2.06,154.61,119
CDM,7319327101,HC EVENT MONITOR,176.83,132.62,2.12,159.15,119
CDM,7321,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,33.0,24.75,0.29,35.1,357
CDM,7322,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,79.2,59.4,0.48,83.16,476
CDM,7329322901,HC REMOTE 30 DAY TELE MONITOR,2166.0,1624.5,25.99,1949.4,119
CDM,7332,SODIUM CHLORIDE 5 % EYE DROPS,26.28,19.71,0.32,23.65,119
CDM,7351,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,178.425,133.82,1.32,222.51,357
CDM,736,ATROPINE 1 % EYE DROPS,163.66,122.75,1.94,238.84,714
CDM,7364,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,486.0,364.5,5.83,437.4,119
CDM,7409570001,HC EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS (IN PERSON),856.6,642.45,10.28,770.94,119
CDM,7409570501,HC EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,693.02,519.76,8.32,623.72,119
CDM,7409570601,HC EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,971.13,728.35,11.65,874.02,119
CDM,7409570701,HC EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,946.64,709.98,11.36,851.98,119
CDM,7409570801,HC EEG W/O VID BY TECH EA INCR 12-26HRUNMONITORED,1329.6,997.2,15.96,1196.64,119
CDM,7409570901,HC EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,2084.78,1563.58,25.02,1876.3,119
CDM,7409571001,HC EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3996.54,2997.4,47.96,3596.89,119
CDM,7409571101,HC VEEG BY TECH 2-12 HOURS UNMONITORED,831.6,623.7,9.98,748.44,119
CDM,7409571201,HC VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,3591.6,2693.7,43.1,3232.44,119
CDM,7409571301,HC VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,4809.17,3606.88,57.71,4328.25,119
CDM,7409571401,HC VEEG BY TECH 12-26 HOURS UNMONITORED,1595.53,1196.65,19.15,1435.98,119
CDM,7409571501,HC VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,2068.85,1551.64,24.83,1861.96,119
CDM,7409571601,HC VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,4973.62,3730.22,59.68,4476.26,119
CDM,7409578204,HC POLYSOM <6 YRS 4> PARAMTRS LESS THAN 7 HRS,5439.26,4079.44,65.27,4895.33,119
CDM,7409578301,HC POLYSOM <6 YRS CPAP/BILVL,7473.41,5605.06,89.68,6726.07,119
CDM,7409580301,"HC ACTIGRAPHY TESTING, 14 DAYS",768.32,576.24,9.22,691.49,119
CDM,7409580501,HC MLT SLEEP LATENCY OR MAINT OF WAKEFULNESS TSTG,2860.73,2145.55,34.33,2574.66,119
CDM,7409580601,HC SLEEP STUDY UNATTENDED,870.98,653.24,10.45,783.88,119
CDM,7409580604,HC SLEEP STUDY UNATTENDED LIMITED,870.98,653.24,10.45,783.88,119
CDM,7409580701,HC SLEEP STUDY; ATTENDED,1896.67,1422.5,22.76,1707.0,238
CDM,7409580704,HC SLEEP STUDY; ATTENDED,1896.67,1422.5,22.76,1707.0,238
CDM,7409581001,HC BASELINE SLEEP STUDY,4937.95,3703.46,59.26,4444.16,119
CDM,7409581101,HC SLEEP APNEA STUDY W/CPAP TITR,5843.23,4382.42,70.12,5258.91,119
CDM,7409581104,HC SLEEP APNEA STUDY W/CPAP TITR LESS THAN 6 HRS,5945.7,4459.27,71.35,5351.13,119
CDM,7409581201,HC EEG UP TO 1 HOUR,1094.81,821.11,13.14,985.33,119
CDM,7409581301,HC EEG GREATER THAN 1 HOUR,681.27,510.95,8.18,613.14,119
CDM,7409581601,HC EEG AWAKE/DROWSY,844.83,633.62,10.14,760.35,119
CDM,7409581901,HC EEG AWAKE/ASLEEP,922.26,691.7,11.07,830.03,119
CDM,7409582201,HC EEG COMA OR SLEEP ONLY,684.76,513.57,8.22,616.28,119
CDM,7409582401,HC EEG CEREBRAL SILENCE,1041.45,781.09,12.5,937.3,238
CDM,7409582901,HC ELECTROCORTICOGRAM DURING SURGERY,2011.3,1508.48,24.14,1810.17,119
CDM,7409595501,HC EEG DURING SURGERY,2248.75,1686.56,26.98,2023.88,119
CDM,7409595701,HC EEG DIGITAL ANALYSIS,2000.2,1500.15,24.0,1800.18,238
CDM,7409595801,HC WADA TESTING NEUROSTIM,2171.22,1628.42,26.05,1954.1,119
CDM,7409596101,HC FUNCTION CORTICAL MAP 1ST HOUR,4267.04,3200.28,51.2,3840.34,119
CDM,7413,SORBITOL 70 % SOLUTION,16.74,12.56,0.2,15.07,119
CDM,7437,SPIRONOLACTONE 25 MG TABLET,1.23,0.92,0.01,1.24,238
CDM,7485,"WATER FOR IRRIGATION, STERILE SOLUTION",26.25,19.689999999999998,0.29,25.65,238
CDM,7501004797,HC ANAL DILATION,4324.3,3243.22,51.89,3891.87,119
CDM,7501006297,HC ANORECTAL ADDL INTERVENTION,1993.74,1495.3,23.92,1794.37,119
CDM,7501006397,HC ANORECTAL W/INTERVENTION,5013.68,3760.26,60.16,4512.31,119
CDM,7501006497,HC ANORECTAL W/WO BRUSHING,611.3,458.48,7.34,550.17,119
CDM,7501044297,HC COLONOSCOPY ADDL INTERVENTION,866.71,650.03,10.4,780.04,119
CDM,7501044497,HC COLONOSCOPY W/INTERVENTION,3828.7,2871.52,45.94,3445.83,119
CDM,7501044697,HC COLONOSCOPY W/WO BRUSHING,3064.23,2298.17,36.77,2757.81,119
CDM,7501059297,HC EGD ADDL INTERVENTION,1067.34,800.5,12.81,960.61,119
CDM,7501059497,HC EGD W/EUS,5511.81,4133.86,66.14,4960.63,119
CDM,7501059597,HC EGD W/EUS AND W/INTERVENTION(S),4106.19,3079.64,49.27,3695.57,119
CDM,7501059697,HC EGD W/INTERVENTION,3049.55,2287.16,36.59,2744.6,119
CDM,7501059997,HC EGD W/WO BRUSHING,1826.93,1370.2,21.92,1644.24,119
CDM,7501060597,HC ENDOSCOPIC MUCOSAL RESECTION,9495.51,7121.63,113.95,8545.96,119
CDM,7501060897,HC ERCP ADDL INTERVENTION,1119.27,839.45,13.43,1007.34,119
CDM,7501060997,HC ERCP W/INTERVENTION,6265.44,4699.08,75.19,5638.9,119
CDM,7501061097,HC ERCP W/WO BRUSHING,4151.99,3113.99,49.82,3736.79,119
CDM,7501061197,HC ESOPHAGEAL DILATION W/O SCOPE,2561.33,1921.0,30.74,2305.2,119
CDM,7501063597,HC FLEX SIG ADDL INTERVENTION,3542.83,2657.12,42.51,3188.55,119
CDM,7501063797,HC FLEX SIG W/EUS FNA,4474.66,3356.0,53.7,4027.19,119
CDM,7501063897,HC FLEX SIG W/INTERVENTION,4629.14,3471.86,55.55,4166.23,119
CDM,7501064097,HC FLEX SIG W/WO BRUSHING,1409.12,1056.84,16.91,1268.21,119
CDM,7501064297,HC FLEX SIGMOID W/EUS,3460.0,2595.0,41.52,3114.0,119
CDM,7501067597,HC GASTROSTOMY TUBE CHANGE,907.98,680.98,10.9,817.18,119
CDM,7501149597,HC JEJUNOSTOMY TUBE CONVERSION,627.05,470.29,7.52,564.34,119
CDM,7501219097,HC SMALL BOWEL ADDL INTERVENTION,1849.63,1387.22,22.2,1664.67,119
CDM,7501219197,HC SMALL BOWEL W/INTERVENTION,2279.97,1709.98,27.36,2051.97,119
CDM,7501219297,HC SMALL BOWEL W/WO BRUSHING,3320.12,2490.09,39.84,2988.11,119
CDM,7501272697,HC TRANSENDOSCOPIC STENT PLACEMNT,4921.7,3691.28,59.06,4429.53,119
CDM,7503000597,HC COLONOSCOPY W/EUS,1297.5,973.12,15.57,1167.75,119
CDM,7504324601,HC EGD W/PEG PLACEMENT,3444.05,2583.04,41.33,3099.65,119
CDM,7504326501,HC ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,6271.25,4703.44,75.26,5644.12,119
CDM,7504327301,HC SPYGLASS ENDOSCOPIC PANCREATOSCOPY,6640.48,4980.36,79.69,5976.43,119
CDM,7504537801,HC DIAGNOSTIC COLONOSCOPY,3056.41,2292.31,36.68,2750.77,119
CDM,7509101001,HC ESOPHAGEAL MOTILITY,2711.37,2033.53,32.54,2440.23,119
CDM,7509102201,HC DUODENAL MANOMETRY,3118.07,2338.55,37.42,2806.26,119
CDM,7509103401,HC PH MONITORING GERD,1507.62,1130.71,18.09,1356.86,119
CDM,7509103501,HC BRAVO REFLUX W MUCOSAL PH,2516.69,1887.52,30.2,2265.02,119
CDM,7509111001,HC CAPSULE ENDOSCOPY ESOPH THROUGH ILEUM,4559.73,3419.8,54.72,4103.76,119
CDM,7509111201,HC GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,129.05,96.79,1.55,116.15,119
CDM,7509111301,HC CAPSULE GI TRACT IMAGING INTRALUMINAL COLON I&R,126.55,94.91,1.52,113.9,119
CDM,7509111701,HC COLONIC MANOMETRY,1801.45,1351.09,21.62,1621.3,119
CDM,7509112201,HCD ANORECTAL MANOMETRY,1801.45,1351.09,21.62,1621.3,119
CDM,750C977701,HC ESOPHAG MUC INTEG W/ESO EGD,20532.84,15399.63,246.39,18479.56,119
CDM,750G010501,HC SCREENING COLONOSCOPY HIGH RIS,2920.16,2190.12,35.04,2628.14,119
CDM,750G012101,HC SCREENING COLONOSCOPY LOW RISK,3670.28,2752.71,44.04,3303.25,119
CDM,750G045501,HC FECAL MICROBIOTA PREP WITH INSTILL ANY METHOD,4420.16,3315.12,53.04,3978.14,119
CDM,7536,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,57.0,42.75,0.68,51.3,238
CDM,7554,SULFADIAZINE 500 MG TABLET,72.13,54.1,0.87,64.92,119
CDM,7555,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,1.12,0.84,0.01,1.01,119
CDM,7556,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,222.3,166.725,2.63,203.15,238
CDM,7557,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.8,1.35,0.02,1.62,119
CDM,7562,SULFASALAZINE 500 MG TABLET,1.16,0.87,0.01,1.04,119
CDM,7563,"SULFASALAZINE 500 MG TABLET,DELAYED RELEASE",1.71,1.28,0.02,1.54,119
CDM,7610075T01,HC PLACE CAROTID ARTERY STENT INIT,19922.93,14942.2,239.08,17930.64,119
CDM,7610200T01,HC PERC SACROPLAST UNILATERAL INCL IMAGE AND BIOPSY,3850.77,2888.08,46.21,3465.69,119
CDM,7610201T01,HC PERC SACROPLAST BILATERAL INCL IMAGE AND BIOPSY,9516.38,7137.28,114.2,8564.74,119
CDM,7610232T01,HC NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,583.22,437.42,7.0,524.9,119
CDM,7610338T01,HC TRNSCTH RENAL SYMP DENRV UNL,16652.58,12489.44,199.83,14987.32,119
CDM,7610339T01,HC TRNSCTH RENAL SYMP DENRV BIL,24176.42,18132.31,290.12,21758.78,119
CDM,7610442T01,HC ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,14689.73,11017.3,176.28,13220.76,119
CDM,7611000501,HC FNA W US GUIDANCE; 1ST LESION,2361.25,1770.94,28.34,2125.12,119
CDM,7611000601,HC FNA W US GUIDANCE; EA ADDITIONAL,1153.99,865.49,13.85,1038.59,119
CDM,7611000901,HC FNA W CT GUIDANCE; 1ST LESION,3542.35,2656.76,42.51,3188.12,119
CDM,7611001001,HC FNA W CT GUIDANCE; EA ADDITIONAL,1228.09,921.07,14.74,1105.28,119
CDM,7611002101,HC FNA W/O IMAGE GUIDANCE,726.31,544.73,8.72,653.68,119
CDM,7611003001,HC SOFT TISSUE DRAINAGE W GUIDANCE,4592.73,3444.55,55.11,4133.46,119
CDM,7611003501,HC PLCMT SOFT TISSUE LOCAL DEVICE PERC W IMG 1ST LESION,2499.07,1874.3,29.99,2249.16,119
CDM,7611006001,HC I&D ABSCESS SIMPLE OR SINGLE,543.45,407.59,6.52,489.11,119
CDM,7611006101,HC I&D ABSC; COMPL OR MULTI,865.38,649.04,10.38,778.84,119
CDM,7611008001,HC I/D PILONID CYST SIMPLE,2280.26,1710.2,27.36,2052.23,119
CDM,7611008101,HC I&D PILONID CYST; CPLX,643.27,482.45,7.72,578.94,119
CDM,7611012001,"HC INC & REM FB, SQ; SMPL",3983.21,2987.41,47.8,3584.89,119
CDM,7611012101,"HC INC & REM FB, SQ; COMPL",6292.31,4719.23,75.51,5663.08,119
CDM,7611014001,"HC I&D HEMATOMA,SEROMA OR FLUID",3509.44,2632.08,42.11,3158.5,119
CDM,7611016001,"HC PUNCT ASP - ABSC,HEMAT,CYST",1150.96,863.22,13.81,1035.86,119
CDM,7611017797,HC WOUND TOE AMPUTATION,627.05,470.29,7.52,564.34,119
CDM,7611018001,"HC I&D,COMPLEX,POSTOP WOUND INF",6974.1,5230.58,83.69,6276.69,119
CDM,7611024397,HC KIDNEY BIOPSY - CPC,2211.62,1658.72,26.54,1990.46,119
CDM,7611033097,HC DIGITAL OR FACIAL/CRANIAL NERVE BLOCK INJECTION,888.06,666.04,10.66,799.25,119
CDM,7611033197,HC SPINAL/TRUNK NERVE BLOCK INJECTION,1341.3,1005.98,16.1,1207.17,119
CDM,7611033297,HC JOINT/EXTREMITY NERVE BLOCK INJECTION,1341.3,1005.98,16.1,1207.17,119
CDM,7611033397,HC SPINAL/TRUNK W CONT INFUSION NERVE BLOCK INJECTION,1491.16,1118.37,17.89,1342.04,119
CDM,7611033497,HC TRANSF/FACET/BRACHIAL NERVE BLOCK INJECTION,1458.16,1093.62,17.5,1312.34,119
CDM,7611033597,HC AXILLARY/PUDENDAL NERVE BLOCK INJECTION,1341.3,1005.98,16.1,1207.17,119
CDM,7611033697,HC SPINAL/TRUNK VIA TRANSF/FACET W/ IMAGING NERVE BLOCK INJECTION,1458.16,1093.62,17.5,1312.34,119
CDM,7611033797,HC NERVE BLOCK INJECTION EA ADDITIONAL LEVEL,670.65,502.99,8.05,603.58,119
CDM,7611033897,HC TAP BLOCK INJECTION UNILATERAL NERVE BLOCK INJECTION,671.43,503.57,8.06,604.29,119
CDM,7611033997,HC TAP BLOCK INJECTION BILATERAL NERVE BLOCK INJECTION,671.43,503.57,8.06,604.29,119
CDM,7611100001,HC DEBR EXZ/INF SKIN; 10% BS,643.27,482.45,7.72,578.94,119
CDM,7611104201,HC DEB SUBQ TISSUE 20 SQ CM/<,973.55,730.16,11.68,876.2,119
CDM,7611104301,HC DEB MUSC/FASCIA 20SQ CM/<,1345.55,1009.16,16.15,1210.99,119
CDM,7611104401,HC DEB BONE 20SQ CM/<,2735.6,2051.7,32.83,2462.04,119
CDM,7611104501,HC DEB SUBQ TISSUE ADD-ON=<20SQ CM,625.16,468.87,7.5,562.64,119
CDM,7611104601,HC DEB MUSC/FASCIA ADD-ON =<20 SQ CM; EACH ADDL,452.49,339.37,5.43,407.24,119
CDM,7611104701,HC DEB BONE ADD-ON=<20SQ CM,1953.75,1465.31,23.44,1758.38,119
CDM,7611105501,HC PARE BENIGN LES SGL,338.66,254.0,4.06,304.79,119
CDM,7611105601,HC TRIM SKIN LESIONS 2 TO 4,864.98,648.74,10.38,778.48,119
CDM,7611105701,HC TRIM SKIN LESIONS OVER 4,772.03,579.02,9.26,694.83,119
CDM,7611110401,HC PUNCH BX SKIN; SINGLE LESION,570.59,427.94,6.85,513.53,119
CDM,7611110501,HC PUNCH BX SKIN; EA SEP/ADDL LESION,222.33,166.75,2.67,200.1,119
CDM,7611110601,HC INCISIONAL BX SKIN; SINGLE LESION,868.57,651.43,10.42,781.71,119
CDM,7611110701,HC INCISIONAL BX SKIN; EA SEP/ADDL LESION,304.72,228.54,3.66,274.25,119
CDM,7611120001,HC SKIN TAG REMOVAL UP TO 15 LESIONS,588.92,441.69,7.07,530.03,119
CDM,7611139597,HC BOTOX INJECTION W/O ANESTHESIA,2166.0,1624.5,25.99,1949.4,119
CDM,7611139697,HC BOTOX/BUPIVICAINE INJ W/O ANESTHESIA,662.21,496.66,7.95,595.99,119
CDM,7611140101,HC EXCISION BENIGN TRUNK/ARMS/LEGS 0.6-1.0CM,767.31,575.48,9.21,690.58,119
CDM,7611140201,HC EXC TR-EXT B9+MARG 1.1-2 CM,1523.98,1142.98,18.29,1371.58,119
CDM,7611142001,HC EXC BLES S/N/EX G; 0.5CM/<,3509.44,2632.08,42.11,3158.5,119
CDM,7611142201,HC EXCISION BENIGN LESION S/N/EX G: 1.1-2.0 CM,96.47,72.35,1.16,86.82,119
CDM,7611171901,HC TRIM NONDYSTROPHIC NAILS ANY NUMBER,175.89,131.92,2.11,158.3,119
CDM,7611172001,HC DEBRIDE NAIL ANY MEHOD 1TO 5,542.93,407.2,6.52,488.64,119
CDM,7611172101,HC DEBRIDE NAIL ANY METHOD 6 OR MORE,292.6,219.45,3.51,263.34,119
CDM,7611173001,HC AVLSION NAIL PLATE PARTL/COMPL SGL,572.41,429.31,6.87,515.17,119
CDM,7611174001,HC EVAC SUBUNGUAL HEMATOMA,371.33,278.5,4.46,334.2,119
CDM,7611175001,HC REMOVAL NAILBED PARTL/COMPLETE,726.31,544.73,8.72,653.68,119
CDM,7611176001,HC REPAIR NAIL BED,1983.84,1487.88,23.81,1785.46,119
CDM,7611176501,HC WEDGE EXC NAIL FOLD,546.11,409.58,6.55,491.5,119
CDM,7611190101,HC INTRALESIONAL INJECTION; 8 OR MORE LESIONS,501.85,376.39,6.02,451.66,119
CDM,7611198101,"HC INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",217.02,162.76,2.6,195.32,119
CDM,7611198201,HC REMOVE DRUG IMPLANT DEVICE,643.27,482.45,7.72,578.94,119
CDM,7611200101,HC REPAIR SIMPLE S/N/A/G/TR/E TO 2.5CM,572.41,429.31,6.87,515.17,119
CDM,7611200201,HC REPAIR SIMP 2.6-7.5CM (SUPERFICIAL) S/N/A/G/TR/E,572.41,429.31,6.87,515.17,119
CDM,7611200401,HC REPAIR SIMP 7.6-12.5CM (SUPERFICIAL) S/N/A/G/TR/E,643.97,482.98,7.73,579.57,119
CDM,7611200501,HC REPAIR SIMP 12.6-20.0 CM (SUPERFICIAL) S/N/A/G/TR/E,1294.82,971.12,15.54,1165.34,119
CDM,7611200601,HC SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1294.82,971.12,15.54,1165.34,119
CDM,7611200701,HC RESUPERF WND BODY >30 CM,726.31,544.73,8.72,653.68,238
CDM,7611201101,HC REPAIR SIMP WOUND <=2.5CM FACE,643.97,482.98,7.73,579.57,119
CDM,7611201301,HC REPAIR SIMPLE  FACE 2.6-5.0CM,643.97,482.98,7.73,579.57,119
CDM,7611201401,HC REPAIR SIMPLE FACE 5.1-7.5 CM,643.97,482.98,7.73,579.57,119
CDM,7611201501,HC REPAIR SIMPLE FACE 7.6-12.5CM,643.97,482.98,7.73,579.57,119
CDM,7611201601,HC REPAR SIMPL FACE 12.6 - 20.0CM,1294.82,971.12,15.54,1165.34,119
CDM,7611201701,HC SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,726.31,544.73,8.72,653.68,119
CDM,7611201801,HC SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,726.31,544.73,8.72,653.68,119
CDM,7611202001,HC TREATMENT OF SUPERFICIAL WOUND DEHISCENCE,1983.84,1487.88,23.81,1785.46,119
CDM,7611202101,HC TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,998.8,749.1,11.99,898.92,119
CDM,7611203101,HC REPR INTMD WOUND SCALP <2.5 CM,1294.82,971.12,15.54,1165.34,119
CDM,7611203201,HC REPR INTMD WOUND SCALP 2.6-7.5,1294.82,971.12,15.54,1165.34,119
CDM,7611203401,HC REPR INTMD WND SCALP  7.6-12.5,1294.82,971.12,15.54,1165.34,119
CDM,7611203501,HC REPR INTMD WOUND SCALP 12.6-20,1294.82,971.12,15.54,1165.34,119
CDM,7611203611,HC REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1983.84,1487.88,23.81,1785.46,119
CDM,7611203701,HC REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5928.31,4446.23,71.14,5335.48,119
CDM,7611204101,HC REPR INTM WND N-HF/GENT =< 2.5,1150.96,863.22,13.81,1035.86,119
CDM,7611204201,HC INTMD WND REP N-HF/GEN 2.6-7.5,1294.82,971.12,15.54,1165.34,119
CDM,7611204401,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1983.84,1487.88,23.81,1785.46,119
CDM,7611204501,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,998.8,749.1,11.99,898.92,119
CDM,7611204601,HC RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,583.94,437.96,7.01,525.55,119
CDM,7611204701,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,583.94,437.96,7.01,525.55,119
CDM,7611205101,HC REPR INTM WND FACE/MM =< 2.5CM,583.94,437.96,7.01,525.55,119
CDM,7611205201,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1294.82,971.12,15.54,1165.34,119
CDM,7611205301,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1294.82,971.12,15.54,1165.34,119
CDM,7611205401,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1294.82,971.12,15.54,1165.34,119
CDM,7611205501,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,998.8,749.1,11.99,898.92,119
CDM,7611205601,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1294.82,971.12,15.54,1165.34,119
CDM,7611205701,"HC LAYR CLOS WND FACE,FACIAL >30 CM",125.29,93.97,1.5,112.76,119
CDM,7611310001,HC CMPLX RPR TRUNK 1.1-2.5 CM,998.8,749.1,11.99,898.92,119
CDM,7611310101,HC CMPLX RPR TRUNK 2.6-7.5 CM,998.8,749.1,11.99,898.92,119
CDM,7611310201,HC CMPLX RPR TRUNK ADDL 5CM/<,998.8,749.1,11.99,898.92,119
CDM,7611312001,HC CMPLX RPR S/A/L 1.1-2.5 CM,1983.84,1487.88,23.81,1785.46,119
CDM,7611312101,HC REP COMPLEX S/A/L; 2.6-7.5CM,1983.84,1487.88,23.81,1785.46,119
CDM,7611312201,HC REP CPLX S/A/L; EA ADD 5 CM/<,1325.87,994.4,15.91,1193.28,119
CDM,7611313101,"HC RECMPL WND HEAD,FAC,HAND 1.1-2.5 CM",998.8,749.1,11.99,898.92,119
CDM,7611313201,"HC RECMPL WND HEAD,FAC,HAND 2.6-7.5 CM",1983.84,1487.88,23.81,1785.46,119
CDM,7611313301,HC CMPLX RPR F/C/C/M/N/AX/G/H/F,998.8,749.1,11.99,898.92,119
CDM,7611315101,"HC RECMPL WND LID,NOS,EAR 1.1-2.5 CM",1983.84,1487.88,23.81,1785.46,119
CDM,7611315201,"HC RECMPL WND LID,NOS,EAR 2.5-7.5 CM",1983.84,1487.88,23.81,1785.46,119
CDM,7611315301,HC CMPLX RPR E/N/E/L ADDL 5CM/<,998.8,749.1,11.99,898.92,119
CDM,7611511001,HC EPIDRM AUTOGRFT TRNK/ARM/LEG,7495.06,5621.3,89.94,6745.55,119
CDM,7611511101,HC EPIDRM AUTOGRFT T/A/L ADD-ON,2718.91,2039.18,32.63,2447.02,119
CDM,7611511501,HC EPIDRM A-GRFT FACE/NCK/HF/G,4107.13,3080.35,49.29,3696.42,119
CDM,7611511601,HC EPIDRM A-GRFT F/N/HF/G ADDL,1549.76,1162.32,18.6,1394.78,119
CDM,7611527106,HC SKIN SUB GRAFT TRNK/ARM/LEG UP TO 100CM (HIGH),3783.31,2837.48,45.4,3404.98,119
CDM,7611527107,HC SKIN SUB GRAFT TRNK/ARM/LEG UP TO 100CM (LOW),3783.31,2837.48,45.4,3404.98,119
CDM,7611527206,HC SKIN SUB GRAFT T/A/L ADD-ON ADDL 25 SQ CM (HIGH),430.5,322.88,5.17,387.45,119
CDM,7611527207,HC SKIN SUB GRAFT T/A/L ADD-ON ADDL 25 SQ CM (LOW),430.5,322.88,5.17,387.45,119
CDM,7611527506,HC SKIN SUB GRAFT FACE/NK/HF/G UP TO 100CM (HIGH),3753.46,2815.1,45.04,3378.11,119
CDM,7611527507,HC SKIN SUB GRAFT FACE/NK/HF/G UP TO 100CM (LOW),3753.46,2815.1,45.04,3378.11,119
CDM,7611527606,HC SKIN SUB GRAFT F/N/HF/G ADDL 25 SQ CM (HIGH),465.93,349.45,5.59,419.34,119
CDM,7611527706,HC SKIN SUB GRFT F/N/HF/G  CHILD=/> TO 100CM (HIGH),3433.26,2574.95,41.2,3089.93,119
CDM,7611527806,HC SKIN SUB GRFT F/N/HF/G CHILD  ADD 100CM (HIGH),1573.85,1180.39,18.89,1416.46,119
CDM,7611600001,HC INITIL TREATMENT 1ST DEGR BURN,572.41,429.31,6.87,515.17,119
CDM,7611602001,HC DRSG/DEBRIDE PARTL THICK BURN-SMALL,572.41,429.31,6.87,515.17,119
CDM,7611602501,HC DRSG/DEBRIDE PARTL THICK BURN-MEDIUM,588.64,441.48,7.06,529.78,119
CDM,7611603001,HC DRSG/DEBRIDE PARTL THICK BURN-LARGE,822.12,616.59,9.87,739.91,119
CDM,7611603611,HC ESCHAROTOMY EACH ADDITIONAL INCISION,125.29,93.97,1.5,112.76,119
CDM,7611710601,HC SKIN LESION DESTRUCTION <10 SQ CM,7247.77,5435.83,86.97,6522.99,119
CDM,7611710701,HC SKIN LESN DESTRCTN 10-50 SQ CM,685.85,514.39,8.23,617.26,119
CDM,7611710801,HC SKIN LESION DESTRUCTION >50 SQ CM,8163.38,6122.54,97.96,7347.04,119
CDM,7611711001,HC DESTRUCT BENIGN LESION 1-14,620.22,465.16,7.44,558.2,119
CDM,7611725001,HC CHEM CAUT GRANULATION TISS,789.89,592.42,9.48,710.9,119
CDM,7611799901,HC UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,737.96,553.47,8.86,664.16,119
CDM,7611799941,HC CT SUBCUTANEOUS TISSUE RF ABLATION,726.31,544.73,8.72,653.68,119
CDM,7611900001,HC PUNCT ASP BREAST CYST - INITIAL,1098.29,823.72,13.18,988.46,119
CDM,7611900101,HC PUNCT ASP BREAST CYST EACH ADDL,310.28,232.71,3.72,279.25,119
CDM,7611902001,HC MASTOTOMY EXPL DRG ABSC DP,726.31,544.73,8.72,653.68,119
CDM,7611903002,HC INJECTION DUCTOGRAM UNILATERAL,1303.83,977.87,15.65,1173.45,119
CDM,7611903003,HC INJECTION DUCTOGRAM BILATERAL,2607.67,1955.75,31.29,2346.9,119
CDM,7611908101,HC BX BREAST 1ST LESION STEREO,5592.33,4194.25,67.11,5033.1,119
CDM,7611908201,HC BX BREAST ADD LESION STEREO,4425.45,3319.09,53.11,3982.9,119
CDM,7611908301,HC BX BREAST 1ST LESION US GUIDE,3185.67,2389.25,38.23,2867.1,119
CDM,7611908401,HC BX BREAST ADD LESION US GUIDE,2860.57,2145.43,34.33,2574.51,119
CDM,7611908501,HC BX BREAST 1ST LESION MRI GUIDE,6555.31,4916.48,78.66,5899.78,119
CDM,7611908601,HC BX BREAST ADD LESION MRI GUIDE,3468.37,2601.28,41.62,3121.53,119
CDM,7611928101,HC PL NDL LOC 1ST LESION MAMMO GUIDE,1980.55,1485.41,23.77,1782.5,119
CDM,7611928201,HC PL NDL LOC EA  ADD LESION MAMMO GUIDE,1237.76,928.32,14.85,1113.98,119
CDM,7611928301,HC PL NDL LOC 1ST LESION STEREO,1925.3,1443.98,23.1,1732.77,119
CDM,7611928401,HC PL NDL LOC EA  ADD LESION STEREO,1497.89,1123.42,17.97,1348.1,119
CDM,7611928501,HC PL NEEDLE LOC 1ST LESION US GUIDE,2015.01,1511.26,24.18,1813.51,119
CDM,7611928601,HC PL NDL LOC EA  ADD LESION US GUIDE,1979.76,1484.82,23.76,1781.78,119
CDM,7612020601,HC MUSCLE BX PERC NEEDLE,1374.49,1030.87,16.49,1237.04,119
CDM,7612022001,HC BONE BIOPSY SUPERFICIAL,1740.63,1305.47,20.89,1566.57,119
CDM,7612022501,HC BIOPSY BONE PERCUTAN DEEP,2095.77,1571.83,25.15,1886.19,119
CDM,7612050001,HC INJECT SINUS TRACT THERAPEUTIC,1806.44,1354.83,21.68,1625.8,119
CDM,7612050101,HC INJECT SINUS TRACT DIAGNOSTIC,1443.68,1082.76,17.32,1299.31,119
CDM,7612052001,HC REMOVE FB MUSCLE SIMPLE,726.31,544.73,8.72,653.68,119
CDM,7612052501,HC RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1701.62,1276.21,20.42,1531.46,119
CDM,7612052601,HC THER INJECTION CARP TUNNEL,569.94,427.46,6.84,512.95,119
CDM,7612055001,HC INJ SGL TENDON SHTH OR LIGAMENT,470.27,352.7,5.64,423.24,119
CDM,7612055101,HC INJ SINGLE TENDON ORIGIN,942.56,706.92,11.31,848.3,119
CDM,7612055201,"HC INJECT TRIGGER POINT(S), 1 - 2 MUSCLE",553.0,414.75,6.64,497.7,119
CDM,7612055301,HC INJECT TRIGGER POINTS 3+ MUSCLE,794.79,596.09,9.54,715.31,119
CDM,7612056008,HC PT NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,50.78,38.08,0.61,45.7,119
CDM,7612056106,HC PERF BY CERT ACUPUNCT PT NDL INSERT W/O INJECTN 3 + MUSCLS,71.07,53.3,0.85,63.96,119
CDM,7612056108,HC PT NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,71.07,53.3,0.85,63.96,119
CDM,7612060002,HC SMALL JOINT ASPRNT/INJECT UNILATERAL W/O US GUIDE,769.36,577.02,9.23,692.42,119
CDM,7612060003,HC SMALL JOINT ASPRNT/INJECT BILATERAL W/O US GUIDE,1538.94,1154.2,18.47,1385.05,119
CDM,7612060401,HC SMALL JT ASPRNT/INJECT UNILATERAL INCLUD US GUIDE,1502.51,1126.88,18.03,1352.26,119
CDM,7612060403,HC SMALL JT ASPRNT/INJECT BILATERAL INCLUDE US GUIDE,3005.33,2254.0,36.06,2704.8,119
CDM,7612060502,HC MEDIUM JOINT ASPIRTN/INJECT UNILATERAL W/O US GUIDE,666.58,499.94,8.0,599.92,119
CDM,7612060503,HC MEDIUM JOINT ASPIRTN/INJECT BILATERAL W/O US GUIDE,1333.17,999.88,16.0,1199.85,119
CDM,7612060601,HC MEDIUM  JT ASPRNT/INJECT UNILATERAL INCLUD US GUIDE,1910.7,1433.02,22.93,1719.63,119
CDM,7612061002,HC MAJOR JOINT ASPRTN/INJ UNILATERAL W/O US GUIDE,925.4,694.05,11.1,832.86,119
CDM,7612061003,HC MAJOR JOINT ASPRTN/INJ BILATERAL W/O US GUIDE,1850.85,1388.14,22.21,1665.76,119
CDM,7612061102,HC MAJOR JT ASPRNT/INJECT UNILATERAL INCLUD  US GUIDE,1797.97,1348.48,21.58,1618.17,119
CDM,7612061103,HC MAJOR JT ASPRNT/INJECT BILATERAL INCLUD  US GUIDE,3595.56,2696.67,43.15,3236.0,119
CDM,7612061201,HC ASPIRATE/INJ GANGLION CYST,877.75,658.31,10.53,789.98,119
CDM,7612098201,HC ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,12396.44,9297.33,148.76,11156.8,119
CDM,7612098301,HC CT BONE CRYO ABLATION INCLUDE GUIDANCE,10301.75,7726.31,123.62,9271.58,119
CDM,7612131501,HC CLSD TX NSL FX MNPJ WO STBLJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612132001,HC CLSD TX NSL FX W/MNPJ&STABLJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612133701,HC CLOSED TX SEPTAL&NOSE FX,1701.62,1276.21,20.42,1531.46,119
CDM,7612134501,HC CLOSED TX NOSE/JAW FX,1701.62,1276.21,20.42,1531.46,119
CDM,7612140002,HC CLOSED TX ORBIT W/O MANIPULJ UNILAT,583.94,437.96,7.01,525.55,119
CDM,7612142101,HC TREAT MOUTH ROOF FRACTURE,1701.62,1276.21,20.42,1531.46,119
CDM,7612143101,HC TREAT CRANIOFACIAL FRACTURE,1701.62,1276.21,20.42,1531.46,119
CDM,7612144001,HC TREAT DENTAL RIDGE FRACTURE,1701.62,1276.21,20.42,1531.46,119
CDM,7612145001,HC CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,583.94,437.96,7.01,525.55,119
CDM,7612145101,HC CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,1701.62,1276.21,20.42,1531.46,119
CDM,7612145301,HC CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,643.27,482.45,7.72,578.94,119
CDM,7612148002,HC REDUCE TEMPOROMANDIBL DISLOC UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612148003,HC REDUCE TEMPOROMANDIBL DISLOC BILAT,643.27,482.45,7.72,578.94,119
CDM,7612148502,HC RESET DISLOCATED JAW UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612148503,HC RESET DISLOCATED JAW BILAT,583.94,437.96,7.01,525.55,119
CDM,7612150101,HC I&D DEEP ABSC SFT TISS NK/THOR,9275.55,6956.66,111.31,8347.99,119
CDM,7612155001,HC SOFT TISS BX NECK/THORAX,1904.8,1428.6,22.86,1714.32,119
CDM,7612182001,HC TREAT STERNUM,643.27,482.45,7.72,578.94,238
CDM,7612231501,HC CLOSED TX VERT FX W/MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612251001,HC PERC VERTEBROPLAST CERV/THORAC INCL IMAGING,11470.83,8603.12,137.65,10323.75,119
CDM,7612251101,HC PERC VERTEBROPLAST LUMBOSACRAL INCL IMAGING,12055.07,9041.3,144.66,10849.56,119
CDM,7612251201,HC PERC VERTEBROPLAST EACH ADDED LEVEL,9415.09,7061.32,112.98,8473.58,119
CDM,7612251301,HC PERC VERTEBRAL AUGMENTATION THORACIC,22711.19,17033.39,272.53,20440.07,119
CDM,7612251401,HC PERC VERTEBRAL AUGMENTATION LUMBAR,23021.87,17266.4,276.26,20719.68,119
CDM,7612251501,HC PERC VERTEBRAL AUGMENTATION EA ADD ALL SITES,19484.31,14613.23,233.81,17535.88,119
CDM,7612303001,HC DRAIN SHOULDER LESION,726.31,544.73,8.72,653.68,119
CDM,7612333002,HC REMOVE SHOULDER FOREIGN BODY UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612333003,HC REMOVE SHOULDER FOREIGN BODY BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612333302,HC REMOVE SHOULDER FB DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612333303,HC REMOVE SHOULDER FB DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612335002,HC SHOULDER INJ ARTHROGRAPHY UNILATERAL,662.16,496.62,7.95,595.94,119
CDM,7612335003,HC SHOULDER INJ ARTHROGRAPHY BILATERAL,1324.31,993.23,15.89,1191.88,119
CDM,7612350001,HC CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612350502,HC CLTX CLAVICULAR FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612350503,HC CLTX CLAVICULAR FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612352002,HC CLTX STRNCLAV DISLC W/O MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612352003,HC CLTX STRNCLAV DISLC W/O MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612352502,HC CLTX STRNCLAV DISLC W/MNPJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612352503,HC CLTX STRNCLAV DISLC W/MNPJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612354001,HC CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612354502,HC CLTX ACROMCLAV DISLC W/MNPJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612354503,HC CLTX ACROMCLAV DISLC W/MNPJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612357001,HC CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612357502,HC CLTX SCAP FX W/MNPJ +-TRACTJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612357503,HC CLTX SCAP FX W/MNPJ +-TRACTJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612360001,HC CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612360502,HC CLTX PRX HMRL FX MNPJ+-TRACT UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612360503,HC CLTX PRX HMRL FX MNPJ+-TRACT BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612362001,HC CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ,643.27,482.45,7.72,578.94,119
CDM,7612362502,HC CLTX GR HMRL TBRS FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612362503,HC CLTX GR HMRL TBRS FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612365002,HC CLOSED RX SHLDR DISLOCATION UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612365003,HC CLOSED RX SHLDR DISLOCATION BILAT,643.27,482.45,7.72,578.94,119
CDM,7612365502,"HC CLOSED RX SHLDR DISLOC,ANESTHESIA UNILAT",1701.62,1276.21,20.42,1531.46,119
CDM,7612365503,"HC CLOSED RX SHLDR DISLOC,ANESTHESIA BILAT",1701.62,1276.21,20.42,1531.46,119
CDM,7612366502,HC CLTX SHO DSLC FX GR HMRL TBR UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612366503,HC CLTX SHO DSLC FX GR HMRL TBR BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612393002,HC I&D UPR A/E DP ABSC/HMTMA UNILAT,6974.1,5230.58,83.69,6276.69,119
CDM,7612393003,HC I&D UPR A/E DP ABSC/HMTMA BILAT,6974.1,5230.58,83.69,6276.69,119
CDM,7612393102,HC I&D UPR A/E BURSA UNILAT,5251.0,3938.25,63.01,4725.9,119
CDM,7612393103,HC I&D UPR A/E BURSA BILAT,5251.0,3938.25,63.01,4725.9,119
CDM,7612420001,HC REMOVE F.B. UP ARM OR ELBOW; SQ,643.27,482.45,7.72,578.94,119
CDM,7612420102,HC RMVL FB UPPER ARM/ELBW DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612420103,HC RMVL FB UPPER ARM/ELBW DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612422002,HC ELBOW ARTHRO INJECT UNILATERAL,634.66,476.0,7.62,571.19,119
CDM,7612422003,HC ELBOW ARTHRO INJECT BILATERAL,1269.32,951.99,15.23,1142.39,119
CDM,7612434102,HC RPR TDN/MUSC UPR A/E EACH UNILAT,125.29,93.97,1.5,112.76,119
CDM,7612434103,HC RPR TDN/MUSC UPR A/E EACH BILAT,125.29,93.97,1.5,112.76,119
CDM,7612450001,HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612450502,HC CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612453001,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,643.27,482.45,7.72,578.94,119
CDM,7612453502,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612453503,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612456001,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612456502,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612456503,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612457601,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612457702,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ UNILAT,3120.12,2340.09,37.44,2808.11,119
CDM,7612457703,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ BILAT,6240.25,4680.19,74.88,5616.22,119
CDM,7612460001,HC TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CDM,7612460502,"HC CLOSED RX ELBOW DISLOCATN,ANESTHESIA UNILAT",1701.62,1276.21,20.42,1531.46,119
CDM,7612460503,"HC CLOSED RX ELBOW DISLOCATN,ANESTHESIA BILAT",1701.62,1276.21,20.42,1531.46,119
CDM,7612462002,HC CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612462003,HC CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612464001,HC REDUCE ELBOW DISLOCATION,643.27,482.45,7.72,578.94,119
CDM,7612465001,HC CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612465502,HC CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612465503,HC CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612467001,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612467502,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612467503,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612502802,HC DRAINAGE OF FOREARM LESION UNILAT,125.29,93.97,1.5,112.76,238
CDM,7612502803,HC DRAINAGE OF FOREARM LESION BILAT,125.29,93.97,1.5,112.76,119
CDM,7612503102,HC DRAINAGE OF FOREARM BURSA UNILAT,726.31,544.73,8.72,653.68,119
CDM,7612503103,HC DRAINAGE OF FOREARM BURSA BILAT,726.31,544.73,8.72,653.68,238
CDM,7612524602,HC WRIST INJ ARTHOGRAPHY UNILATERAL,354.63,265.97,4.26,319.17,119
CDM,7612524603,HC WRIST INJ ARTHOGRAPHY BILATERAL,709.26,531.95,8.51,638.33,119
CDM,7612524802,HC REMOVE FOREARM FOREIGN BODY UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612524803,HC REMOVE FOREARM FOREIGN BODY BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612526001,HC RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,10515.38,7886.54,126.18,9463.84,119
CDM,7612527001,HC RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,125.29,93.97,1.5,112.76,119
CDM,7612550001,HC CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612550501,HC CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,1701.62,1276.21,20.42,1531.46,119
CDM,7612552002,HC TREAT FRACTURE OF RADIUS UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612552003,HC TREAT FRACTURE OF RADIUS BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612553001,HC CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612553502,HC TREAT FRACTURE OF ULNA UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612553503,HC TREAT FRACTURE OF ULNA BILAT,643.27,482.45,7.72,578.94,119
CDM,7612556001,HC CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,643.27,482.45,7.72,578.94,119
CDM,7612556501,HC CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612560001,HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612560501,HC CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,1701.62,1276.21,20.42,1531.46,119
CDM,7612562201,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612562402,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612562403,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612563001,HC CLTX CARPAL BONE FX W/O MANJ EACH BONE,643.27,482.45,7.72,578.94,119
CDM,7612563502,HC CLTX CARPAL BONE FX W/MANJ EACH BONE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612563503,HC CLTX CARPAL BONE FX W/MANJ EACH BONE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612565001,HC CLOSED TREATMENT ULNAR STYLOID FRACTURE,643.27,482.45,7.72,578.94,119
CDM,7612566002,HC CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612566003,HC CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612567502,HC CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612567503,HC CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612568002,HC TREAT WRIST FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612568003,HC TREAT WRIST FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CDM,7612569002,HC TREAT WRIST DISLOCATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612569003,HC TREAT WRIST DISLOCATION BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612601001,HC DRAINAGE FINGER ABSCESS SIMPLE,643.97,482.98,7.73,579.57,119
CDM,7612601101,"HC DRAIN FINGER ABSCESS,COMPLICATED",5251.0,3938.25,63.01,4725.9,119
CDM,7612641801,HC REPAIR EXTENSOR TENDON FINGER,5186.73,3890.05,62.24,4668.06,119
CDM,7612660001,HC TREAT METACARPEL FX EACH,643.27,482.45,7.72,578.94,119
CDM,7612660501,HC CLTX METACARPAL FX W/MANIPULATION EACH BONE,643.27,482.45,7.72,578.94,119
CDM,7612664101,HC CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612664502,HC TREAT THUMB FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612664503,HC TREAT THUMB FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612667001,HC CL TX CMC DISL NON THUMB,643.27,482.45,7.72,578.94,119
CDM,7612670001,HC CLOSED RX MC-P DISLOC,643.27,482.45,7.72,578.94,119
CDM,7612672001,HC CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,643.27,482.45,7.72,578.94,119
CDM,7612672501,HC CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,643.27,482.45,7.72,578.94,119
CDM,7612674001,HC CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612674201,HC CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612675001,HC CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,643.27,482.45,7.72,578.94,119
CDM,7612675501,"HC CLOSE RX DIST FINGER FX, MANIPULATION",643.27,482.45,7.72,578.94,119
CDM,7612677001,HC CLOSED RX IP JT DISLOCATION,643.27,482.45,7.72,578.94,119
CDM,7612699001,HC DRAINAGE PELVIC/HIP AREA DEEP,726.31,544.73,8.72,653.68,119
CDM,7612704001,HC BX PELV/HIP SFT TISS SUPERF,1539.27,1154.45,18.47,1385.34,119
CDM,7612708602,HC RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612708603,HC RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612708702,HC REMOVAL FOREIGN BODY PELVIS/HIP DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612708703,HC REMOVAL FOREIGN BODY PELVIS/HIP DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612709302,HC HIP INJ ARTHOGRAPHY UNILATERAL,680.81,510.61,8.17,612.73,119
CDM,7612709303,HC HIP INJ ARTHOGRAPHY BILATERAL,1361.61,1021.21,16.34,1225.45,119
CDM,7612709601,HC SI JOINT INJECTION - ARTHROGRAM/ANESTHETIC UNILATERAL,2146.78,1610.08,25.76,1932.1,119
CDM,7612709603,HC SI JOINT INJECTION - ARTHROGRAM/ANESTHETIC BILATERAL,4293.55,3220.16,51.52,3864.2,119
CDM,7612719701,HC CLSD TX PELVIC RING FX,643.27,482.45,7.72,578.94,119
CDM,7612719801,HC CLSD TX PELVIC RING FX,643.27,482.45,7.72,578.94,119
CDM,7612720001,HC TREAT TAIL BONE FRACTURE,643.27,482.45,7.72,578.94,119
CDM,7612722002,HC CLTX ACETABULUM HIP/SOCKT FX W/O MANJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612722003,HC CLTX ACETABULUM HIP/SOCKT FX W/O MANJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612722202,HC CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612722203,HC CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612723002,HC CLTX FEM FX PROX END NCK W/O MANJ UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612723003,HC CLTX FEM FX PROX END NCK W/O MANJ BILAT,643.27,482.45,7.72,578.94,119
CDM,7612723202,HC CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ UNILAT,583.94,437.96,7.01,525.55,119
CDM,7612723203,HC CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ BILAT,583.94,437.96,7.01,525.55,119
CDM,7612723802,HC CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612723803,HC CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612724002,HC CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612724003,HC CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612724601,HC CLSD TX TROCHANTRIC FX W/O MAN,643.27,482.45,7.72,578.94,119
CDM,7612725002,HC CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612725003,HC CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA BILAT,643.27,482.45,7.72,578.94,119
CDM,7612725202,HC CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612725203,HC CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612726502,HC CLTX POST HIP ARTHRP DISLC W/O ANES UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612726503,HC CLTX POST HIP ARTHRP DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CDM,7612726602,HC CLTX POST HIP ARTHRP DISLC REQ ANES UNILAT,583.94,437.96,7.01,525.55,119
CDM,7612726603,HC CLTX POST HIP ARTHRP DISLC REQ ANES BILAT,583.94,437.96,7.01,525.55,119
CDM,7612726702,HC CLTX THIGH FX UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612726703,HC CLTX THIGH FX BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612726802,HC CLTX THIGH FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612726803,HC CLTX THIGH FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612730101,HC I/D DEEP ABSC BURSA THIGH/KNEE,9275.55,6956.66,111.31,8347.99,119
CDM,7612736901,HC INJ CONT KNEE OR ENHANCED CT/MRI ARTHRO,740.31,555.23,8.88,666.28,119
CDM,7612750001,HC CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612750101,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612750202,HC CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612750203,HC CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612750302,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612750303,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612750801,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612751002,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612751003,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612751601,HC CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612751702,HC TREAT THIGH FX GROWTH PLATE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612751703,HC TREAT THIGH FX GROWTH PLATE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612752001,HC CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612753001,HC CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612753202,HC TREAT KNEE FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612753203,HC TREAT KNEE FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612753801,HC CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,643.27,482.45,7.72,578.94,119
CDM,7612755002,HC CLOSED RX KNEE DISLOCATN UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612755003,HC CLOSED RX KNEE DISLOCATN BILAT,643.27,482.45,7.72,578.94,119
CDM,7612755202,HC CLOSED RX KNEE DISLOC+ANESTH UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612755203,HC CLOSED RX KNEE DISLOC+ANESTH BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612756001,HC CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,643.27,482.45,7.72,578.94,119
CDM,7612756202,HC TREAT KNEECAP DISLOCATION UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612756203,HC TREAT KNEECAP DISLOCATION BILAT,643.27,482.45,7.72,578.94,119
CDM,7612760302,HC DRAIN LOWER LEG LESION,6199.2,4649.4,74.39,5579.28,119
CDM,7612764802,HC INJECTION ANKLE ARTHROGRAM UNILATERAL,919.38,689.54,11.03,827.44,119
CDM,7612764803,HC INJECTION ANKLE ARTHROGRAM BILATERAL,1838.76,1379.07,22.07,1654.88,119
CDM,7612775001,HC CLTX TIBIAL SHAFT FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612775201,HC CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612776001,HC CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612776202,HC CLTX MED ANKLE FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612776203,HC CLTX MED ANKLE FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,238
CDM,7612776701,HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612776801,HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612778001,HC CLTX PROX FIBULA/SHFT FX W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612778102,HC TREATMENT OF FIBULA FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612778103,HC TREATMENT OF FIBULA FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612778601,HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612778801,HC CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612780801,HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612781001,HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,1701.62,1276.21,20.42,1531.46,119
CDM,7612781601,HC CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612781802,HC TREATMENT OF ANKLE FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612781803,HC TREATMENT OF ANKLE FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612782401,HC CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612782502,HC TREAT LOWER LEG FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612782503,HC TREAT LOWER LEG FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612783002,HC CLTX PROX TIBFIB JT DISLC W/O ANES UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612783003,HC CLTX PROX TIBFIB JT DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CDM,7612783102,HC CLTX PROX TIBFIB JT DISLC REQ ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612783103,HC CLTX PROX TIBFIB JT DISLC REQ ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612784001,HC CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,643.27,482.45,7.72,578.94,119
CDM,7612784202,HC TREAT ANKLE DISLOCATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612784203,HC TREAT ANKLE DISLOCATION BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612800101,HC DRAINAGE OF BURSA OF FOOT,726.31,544.73,8.72,653.68,119
CDM,7612819001,HC REMOVAL FOREIGN BODY FOOT SQ,2026.89,1520.17,24.32,1824.2,119
CDM,7612819201,HC REMOVAL FOREIGN BODY FOOT DEEP,1701.62,1276.21,20.42,1531.46,119
CDM,7612819302,HC REMOVAL OF FOOT FOREIGN BODY UNILAT,583.94,437.96,7.01,525.55,119
CDM,7612819303,HC REMOVAL OF FOOT FOREIGN BODY BILAT,583.94,437.96,7.01,525.55,119
CDM,7612840001,HC CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612840502,HC TREATMENT OF HEEL FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612840503,HC TREATMENT OF HEEL FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CDM,7612843002,HC CLOSED TX TALUS FRACTURE W/O MANIPULATION UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612843003,HC CLOSED TX TALUS FRACTURE W/O MANIPULATION BILAT,643.27,482.45,7.72,578.94,119
CDM,7612843502,HC CLOSED TX TALUS FRACTURE W/MANIPULATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612843503,HC CLOSED TX TALUS FRACTURE W/MANIPULATION BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612845001,HC TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612845501,HC TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612847001,HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CDM,7612847501,HC CLTX METAR FX W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612849001,HC CLTX FX GRT TOE PHLX/PHLG W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612849501,HC CLTX FX GRT TOE PHLX/PHLG W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612851001,HC CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,643.27,482.45,7.72,578.94,119
CDM,7612851501,HC CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,643.27,482.45,7.72,578.94,119
CDM,7612853002,HC TREAT SESAMOID BONE FRACTURE,643.27,482.45,7.72,578.94,119
CDM,7612853003,HC TREAT SESAMOID BONE FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CDM,7612854002,HC TREAT SESAMOID BONE FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612854003,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CDM,7612854502,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612854503,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612857002,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612857003,HC CLOSED TX TALOTARSAL JOINT DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CDM,7612857502,HC CLOSED TX TALOTARSAL JOINT DISLC W/O ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612857503,HC CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CDM,7612860001,HC CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CDM,7612860501,HC CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612863001,HC CLTX METATARSOPHLNGL JT DISLC W/O ANES,643.27,482.45,7.72,578.94,119
CDM,7612863501,HC CLTX METATARSOPHLNGL JT DISLC REQ ANES,1701.62,1276.21,20.42,1531.46,119
CDM,7612866001,HC CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CDM,7612866501,HC CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,643.27,482.45,7.72,578.94,119
CDM,7612882001,HC AMPUTATION TOE METATARSOPHALANGEAL JOINT,9347.0,7010.25,112.16,8412.3,119
CDM,7612882501,HC PARTIAL AMPUTATION OF TOE,7027.83,5270.87,84.33,6325.05,119
CDM,7612906501,HC APPLY LONG ARM CAST,836.83,627.62,10.04,753.15,119
CDM,7612907501,HC APPLY FOREARM CAST,726.31,544.73,8.72,653.68,119
CDM,7612908501,HC APPLY CAST HAND & LOWER FOREARM,643.27,482.45,7.72,578.94,119
CDM,7612908601,HC APPLY CAST FINGER,643.27,482.45,7.72,578.94,119
CDM,7612910501,HC APPLY LONG ARM SPLINT,644.47,483.35,7.73,580.02,119
CDM,7612912501,HC APPLY FOREARM SPLINT STATIC,578.95,434.21,6.95,521.06,119
CDM,7612912601,HC APPLY SPLINT FOREARM TO HAND (SHORT ARM-DYNAMIC),225.66,169.24,2.71,203.09,119
CDM,7612913001,HC APPLY FINGER SPLINT STATIC,238.03,178.52,2.86,214.23,119
CDM,7612913101,HC APPLY SPLINT FINGER (DYNAMIC),162.71,122.03,1.95,146.44,119
CDM,7612920001,HC APPLY STRAPPING THORAX,347.34,260.5,4.17,312.61,119
CDM,7612924001,HC APPLY STRAPPING SHOULDER,643.27,482.45,7.72,578.94,119
CDM,7612926001,HC STRAPPING ELBOW TO WRIST,643.27,482.45,7.72,578.94,119
CDM,7612928001,HC STRAPPING; HAND OR FINGER,643.27,482.45,7.72,578.94,119
CDM,7612934501,HC APPLY CAST THIGH TO TOES (LONG LEG),643.27,482.45,7.72,578.94,119
CDM,7612935502,HC APPLICATION OF LONG LEG CAST UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612935503,HC APPLICATION OF LONG LEG CAST BILAT,643.27,482.45,7.72,578.94,119
CDM,7612940501,HC APPLY CAST BELOW KNEE TO TOES (SHORT LEG),670.71,503.03,8.05,603.64,119
CDM,7612942501,HC APPLY WLKR SH LEG CAST,643.27,482.45,7.72,578.94,119
CDM,7612944501,HC APPLICATION RIGID TOTAL CONTACT LEG CAST,1027.71,770.78,12.33,924.94,119
CDM,7612944502,HC APPLY RIGID CONTACT TOTAL LEG CAST UNILATERAL,1045.61,784.21,12.55,941.05,119
CDM,7612944503,HC APPLY RIGID CONTACT TOTAL LEG CAST BILATERAL,2091.23,1568.42,25.09,1882.11,119
CDM,7612950501,HC APPLY LONG LEG SPLINT,292.09,219.07,3.51,262.88,119
CDM,7612951501,HC APPLY LOWER LEG SPLINT,499.21,374.41,5.99,449.29,119
CDM,7612952002,HC STRAPPING OF HIP UNILAT,643.27,482.45,7.72,578.94,119
CDM,7612952003,HC STRAPPING OF HIP BILAT,643.27,482.45,7.72,578.94,119
CDM,7612953001,HC APPLY STRAPPING KNEE,643.27,482.45,7.72,578.94,119
CDM,7612954001,HC APPLY STRAPPING ANKLE AND/OR FOOT,377.76,283.32,4.53,339.98,119
CDM,7612955001,HC STRAPPING OF TOES,643.27,482.45,7.72,578.94,119
CDM,7612958001,HC STRAPPING; UNNA BOOT,154.4,115.8,1.85,138.96,119
CDM,7612958102,HC COMPRESSION WRAP LWR LEG UNILATERAL,425.9,319.42,5.11,383.31,119
CDM,7612958103,HC COMPRESSION WRAP LWR LEG BILATERAL,847.07,635.3,10.16,762.36,119
CDM,7612958403,HC APPL MULTLAY COMPRS ARM/HAND BIL,828.65,621.49,9.94,745.78,238
CDM,7613000001,HC DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,643.27,482.45,7.72,578.94,119
CDM,7613002001,HC DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,726.31,544.73,8.72,653.68,119
CDM,7613030001,HC REM FOREIGN BODY INTRANASAL,643.27,482.45,7.72,578.94,119
CDM,7613090101,HC CONTROL NASAL HEMORRHAGE,417.76,313.32,5.01,375.98,119
CDM,7613090301,"HC CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX",643.27,482.45,7.72,578.94,119
CDM,7613090501,HC CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,1701.62,1276.21,20.42,1531.46,119
CDM,7613090601,HC CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,643.27,482.45,7.72,578.94,119
CDM,7613150001,HC INTUBATION ET EMERGENT,599.36,449.52,7.19,539.42,119
CDM,7613150041,HC FIBROSCOPY INTUBATION ASSIST,752.61,564.46,9.03,677.35,119
CDM,7613150201,HC TRACH TUBE CHANGE - SCOOP,1701.62,1276.21,20.42,1531.46,119
CDM,7613150501,HC LARYNGOSCOPY INDIRECT DIAGNOSTIC (MIRROR),436.75,327.56,5.24,393.08,119
CDM,7613153001,HC LARYNGOSCOPY W/FOREIGN BODY REMOVAL,125.29,93.97,1.5,112.76,119
CDM,7613157501,HC ST LARYNGOSCOPY FLEX FIBEROPTIC DIAGNOSTIC,1106.34,829.76,13.28,995.71,119
CDM,7613157701,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),125.29,93.97,1.5,112.76,119
CDM,7613157901,HC ST VIDEOSTROBOSCOPY,1105.37,829.03,13.26,994.83,119
CDM,7613162201,HC BRONCH DIAGNOSTIC,125.29,93.97,1.5,112.76,119
CDM,7613162202,HC BRONCH DIAGNOSTIC ADDTL PROCEDURE,1701.62,1276.21,20.42,1531.46,119
CDM,7613162701,HC BRONCHOSCOPY W/FLUORO & 3D NAVIGATION,4283.85,3212.89,51.41,3855.47,119
CDM,7613163501,HC BRONCHOSCOPY W/FB REMOVAL,1701.62,1276.21,20.42,1531.46,119
CDM,7613163582,HC NJH BRONCH W/FOREIG BODY REM ADDTL PROCEDURE,3735.2,2801.4,44.82,3361.68,119
CDM,7613173001,HC TRANSTRACHEAL STENT INSERTION,7472.7,5604.52,89.67,6725.43,119
CDM,7613189901,HC NBAL,1216.43,912.32,14.6,1094.79,119
CDM,7613240001,HC BX PLEURA PERCUT NEEDLE,1731.07,1298.3,20.77,1557.96,119
CDM,7613240801,HC CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,1845.85,1384.39,22.15,1661.26,119
CDM,7613255001,HC INSERT PLEURAL CATH W/CUFF,5739.84,4304.88,68.88,5165.86,119
CDM,7613255101,HC TUBE THORACOSTOMY W/WATER,4475.12,3356.34,53.7,4027.61,119
CDM,7613255201,HC PLEURAL CATH W/CUFF REMOVAL,632.58,474.44,7.59,569.32,119
CDM,7613255402,HC THORACENTESIS/ASPIRATION W/O IMAGING UNILATERAL,1502.79,1127.09,18.03,1352.51,119
CDM,7613255403,HC THORACENTES/ASPIRTN W/O IMAGING BILATERAL,3005.58,2254.18,36.07,2705.02,119
CDM,7613255501,HC THORACENTES/ASPIRTN W/O IMAGING BILAT,1337.72,1003.29,16.05,1203.95,119
CDM,7613255502,HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL,2529.28,1896.96,30.35,2276.35,119
CDM,7613255503,HC THORACENTESIS/ASPIRATION WITH IMAGING BILATERAL,5058.56,3793.92,60.7,4552.7,119
CDM,7613255602,HC PLEURAL DRAINAGE W CATHETER W/O IMAGING UNILATERAL,4108.88,3081.66,49.31,3697.99,119
CDM,7613255603,HC PLEURAL DRAIN W CATHETER W/O IMAGING BILATERAL,8217.76,6163.32,98.61,7395.98,119
CDM,7613255702,HC PLEURAL DRAINAGE W CATHETER W IMAGING UNILATERAL,4173.63,3130.22,50.08,3756.27,119
CDM,7613255703,HC PLEURAL DRAINAGE W CATHETER W IMAGING BILATERAL,8347.27,6260.45,100.17,7512.54,119
CDM,7613299401,HC LUNG ABLATION CRYO UNILATERAL INC IMAGE GUIDE,9591.08,7193.31,115.09,8631.97,119
CDM,7613299801,HC ABLATE PULM TUMOR PERQ RF,14181.51,10636.13,170.18,12763.36,119
CDM,7613299802,HC CT LUNG RF ABLATION UNILATERAL INC IMAGE GUIDE,13094.65,9820.99,157.14,11785.18,119
CDM,7613299803,HC CT LUNG RF ABLATION BILATERAL INC IMAGE GUIDE,28363.01,21272.26,340.36,25526.71,119
CDM,7613301601,HC PERICARDIOCENTESIS W/IMAGING,3041.84,2281.38,36.5,2737.66,119
CDM,7613301801,HC PERICARD DRAINAGE W/IMAGE -5 W CONGENTIAL ISSUE,4164.81,3123.61,49.98,3748.33,119
CDM,7613327901,HC RMVL PHRNC NRV STIMULATOR TRANSVNS STIMJ/SNSG LD,9127.17,6845.38,109.53,8214.45,119
CDM,7613328001,HC RMVL PHRENIC NRV STIMULATOR PULSE GENERATOR ONLY,26713.29,20034.97,320.56,24041.96,119
CDM,7613328801,HC RMVL&RPLCMT PHRNC NRV STIM TRNSVNS STIMJ/SNSG LD,9329.89,6997.42,111.96,8396.9,119
CDM,7613337001,HC TRANSCATH PLACE/SUB REMOVE CEREBRAL EMBOLIC PRO DEVICE,4230.52,3172.89,50.77,3807.47,119
CDM,7613374101,HC TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,16112.56,12084.42,193.35,14501.3,119
CDM,7613374501,HC TIS CREATION W/STENT CONGENITAL CARDIAC ANOMAL 1ST SHUNT,54229.86,40672.39,650.76,48806.87,119
CDM,7613389401,HC ENDOVASC STENT RPR THOR/ABD AORTA - MAJOR SIDE BNCHS,43483.92,32612.94,521.81,39135.53,119
CDM,7613389501,HC ENDOVASC STENT RPR THOR/ABD AORTA - NOT X MAJR BNCHS,43483.92,32612.94,521.81,39135.53,119
CDM,7613389701,HC PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECURRNT AORTA,21037.7,15778.28,252.45,18933.93,119
CDM,7613395201,HC ECMO INSERT ART AND/OR VENOUS =>6 YRS,1431.62,1073.71,17.18,1288.46,119
CDM,7613395801,HC ECMO/ECLS CANNULA REPOSITION 6 OR OLDER PERQ,1601.65,1201.24,19.22,1441.48,119
CDM,7613396601,HC ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,7516.4,5637.3,90.2,6764.76,119
CDM,7613481202,HC UNILATERAL FEM ART EXP FOR PROSTH,12839.45,9629.59,154.07,11555.5,119
CDM,7613481203,HC BILATERAL FEM ART EXP FOR PROSTH,25678.9,19259.18,308.15,23111.01,119
CDM,7613483401,HC EXPOSE ENDOPROSTH BRACHIAL,11200.51,8400.38,134.41,10080.46,119
CDM,7613522601,HC REPAIR BLD VESS LWR EXTREM,643.27,482.45,7.72,578.94,119
CDM,7613537101,HC ENDARTERECTOMY COMMON FEMORAL ARTERY,19620.88,14715.66,235.45,17658.79,119
CDM,7613600001,HC INTRO NEEDLE/INTRACATH VEIN,299.89,224.92,3.6,269.9,119
CDM,7613600202,HC THROMBIN INJ PSEUDOANEURYSM EXTREM UNILATERAL,1203.16,902.37,14.44,1082.84,119
CDM,7613600203,HC THROMBIN INJ PSEUDOANEURYSM EXTREM BILATERAL,2406.32,1804.74,28.88,2165.69,119
CDM,7613600502,HC EXTREMITY VENOGRAM INJ UNILATERAL,813.74,610.3,9.76,732.37,119
CDM,7613600503,HC EXTREMITY VENOGRAM INJ BILATERAL,1627.49,1220.62,19.53,1464.74,119
CDM,7613601002,HC VENACAVA CATH PLACEMENT UNILATERAL,2544.56,1908.42,30.53,2290.1,119
CDM,7613601003,HC VENACAVA CATH PLACEMENT BILATERAL,5089.13,3816.85,61.07,4580.22,119
CDM,7613601102,HC CATH PLCMNT 1ST ORDER VENOUS UNILATERAL,1498.32,1123.74,17.98,1348.49,119
CDM,7613601103,HC CATH PLCMNT 1ST ORDER VENOUS BILATERAL,2996.64,2247.48,35.96,2696.98,119
CDM,7613601202,HC CATH PLCMNT 2ND ORDER VENOUS UNILATERAL,1495.82,1121.86,17.95,1346.24,119
CDM,7613601203,HC CATH PLCMNT 2ND ORDER VENOUS BILATERAL,2991.64,2243.73,35.9,2692.48,119
CDM,7613601502,HC CATH PLACEMENT SEG PUL ART UNILATERAL,1845.16,1383.87,22.14,1660.64,119
CDM,7613601503,HC CATH PLACEMENT SEG PUL ART BILATERAL,3690.32,2767.74,44.28,3321.29,119
CDM,7613614001,"HC NEEDLE/INTRACATH INTRO, UPR OR LWR EXTREM ARTERY",1462.88,1097.16,17.55,1316.59,119
CDM,7613616001,HC CATH PLACEMENT AORTA TRANSLUM,1350.2,1012.65,16.2,1215.18,119
CDM,7613620001,HC INTRODUCTION CATH AORTA,2518.64,1888.98,30.22,2266.78,119
CDM,7613620003,HC INTRODUCTION CATH AORTA BILATERAL ACCESS,2518.64,1888.98,30.22,2266.78,119
CDM,7613621501,HC CATH 1ST ORDER THORAC/BRACHIO,3859.56,2894.67,46.31,3473.6,119
CDM,7613621601,HC CATH 2ND THORAC/BRACHIO,3519.89,2639.92,42.24,3167.9,119
CDM,7613621701,HC CATH 3RD THORAC/BRACHIO,4093.55,3070.16,49.12,3684.2,119
CDM,7613621801,HC CATH ADDL 3RD THOR/BRACHIO,2067.25,1550.44,24.81,1860.52,119
CDM,7613622101,HC CATH AORTA ANGIO CERV/VERTEB/CEREB UNILATERAL OR BILATERAL,7436.71,5577.53,89.24,6693.04,119
CDM,7613622202,HC FIRST ORDER CATH CERVICAL CAROTID ANGIO UNILATERAL,9869.58,7402.18,118.43,8882.62,119
CDM,7613622203,HC FIRST ORDER CATHETER CERVICAL CAROTID ANGIO BILATERAL,19739.17,14804.38,236.87,17765.25,119
CDM,7613622302,HC FIRST ORDER CERV/CEREB CAROTID ANGIO UNILATERAL,12926.73,9695.05,155.12,11634.06,119
CDM,7613622303,HC FIRST ORDER CERV/CEREB CAROTID ANGIO BILATERAL,16570.5,12427.88,198.85,14913.45,119
CDM,7613622402,HC INTERN CAROTID CATH W CERV/CEREB ANGIO UNILATERAL,17634.12,13225.59,211.61,15870.71,119
CDM,7613622403,HC INTERN CAROTID CATH W CERV/CEREB ANGIO BILATERAL,35268.24,26451.18,423.22,31741.42,119
CDM,7613622502,HC FIRST ORDER CATH W VERTEBRAL ANGIO UNILATERAL,14317.34,10738.0,171.81,12885.61,119
CDM,7613622503,HC FIRST ORDER CATH W VERTEBRAL ANGIO BILATERAL,9522.59,7141.94,114.27,8570.33,119
CDM,7613622602,HC VERTEBRAL CATH PLCMT ANGIO UNILATERAL,9752.12,7314.09,117.03,8776.91,119
CDM,7613622603,HC VERTEBRAL CATH PLCMNT ANGIO BILATERAL,19504.25,14628.19,234.05,17553.82,119
CDM,7613622702,HC EXTERNAL CAROTID CATHETER PLACEMNT ANGIO UNILATERAL,12774.03,9580.52,153.29,11496.63,119
CDM,7613622801,HC CATH PLCMNT EACH ADDL INTRACRAN/VERT ANGIO-LIMIT 2,3718.69,2789.02,44.62,3346.82,119
CDM,7613624502,HC ABDOMEN 1ST ORDER CATH PLACE UNILATERAL,2476.55,1857.41,29.72,2228.9,119
CDM,7613624503,HC ABDOMEN 1ST ORDER CATH PLACE BILATERAL,4953.1,3714.82,59.44,4457.79,119
CDM,7613624602,HC CATH PLACEMENT 2ND ORDER ABD UNILATERAL,2471.99,1853.99,29.66,2224.79,119
CDM,7613624603,HC CATH PLACEMENT 2ND ORDER ABD BILATERAL,4934.98,3701.24,59.22,4441.48,119
CDM,7613624702,HC CATH PLACEMENT 3RD ORDER ABD UNILATERAL,2521.26,1890.94,30.26,2269.13,119
CDM,7613624703,HC CATH PLACEMENT 3RD ORDER ABD BILATERAL,5042.51,3781.88,60.51,4538.26,119
CDM,7613624801,HC ABDOMEN ADD 2/3 ORDER CATH PLACE,1232.42,924.32,14.79,1109.18,119
CDM,7613625101,HC RENAL ANGIOGRAPHY UNILATERAL,6407.94,4805.96,76.9,5767.15,119
CDM,7613625201,HC RENAL ANGIOGRAPHY BILATERAL,7340.34,5505.26,88.08,6606.31,119
CDM,7613625301,HC RENAL ANGIO UNILATERAL-SUPERSELECT,7198.99,5399.24,86.39,6479.09,119
CDM,7613625401,HC RENAL ANGIO BILATERAL-SUPERSELECT,11133.85,8350.39,133.61,10020.46,119
CDM,7613629943,HC PERC SCLERO VASC LOW,1282.26,961.7,15.39,1154.03,119
CDM,7613629944,HC PERC SCLERO VASC MODERATE,2479.78,1859.84,29.76,2231.8,119
CDM,7613629945,HC PERC SCLERO VASC HIGH,2479.26,1859.44,29.75,2231.33,119
CDM,7613647101,HC INJ SCLEROSING SOLN:MULTI SAME LEG OTR THAN TELANGIECTASIA,1732.8,1299.6,20.79,1559.52,119
CDM,7613647801,HC IR ABLTN EXTM INCOMP VEIN INTL,6340.91,4755.68,76.09,5706.82,119
CDM,7613648101,HC PORTAL VEIN ACCESS,2999.03,2249.27,35.99,2699.13,119
CDM,7613650001,HC VENOUS CATH BLOOD SAMPLE,953.83,715.37,11.45,858.45,119
CDM,7613651001,HC UMBILICAL VEIN CATH NEWB FOR DIAGN/THERAP,4571.38,3428.54,54.86,4114.24,119
CDM,7613651101,HC THERAPEUTIC APHERESIS WBC,7912.46,5934.34,94.95,7121.21,119
CDM,7613651201,HC THERAPEUTIC APHERESIS RBC,8954.34,6715.76,107.45,8058.91,119
CDM,7613651401,HC PLASMAPHERESIS,10967.35,8225.51,131.61,9870.62,119
CDM,7613655501,HC CENTRAL VENOUS CATH INSERT <5YRS,3771.77,2828.83,45.26,3394.59,119
CDM,7613655601,HC CENTRAL VENOUS CATH INSERT >5YRS,1885.86,1414.4,22.63,1697.27,119
CDM,7613655701,HC INSRT TUNNL CVC NO PORT/PUMP,3150.22,2362.66,37.8,2835.2,119
CDM,7613655801,HC TUNNEL CATH INSERT W/O PORT>5YRS,3852.5,2889.38,46.23,3467.25,119
CDM,7613656001,HC INSRT TUNNEL CATH W/PORT <5YRS,3411.81,2558.86,40.94,3070.63,119
CDM,7613656101,HC PORT INSERTION W/SUBCUTAN PORT >5YRS,4968.15,3726.11,59.62,4471.34,119
CDM,7613656801,HC INS PICC W/O PORT W/O IMG GDN <5 YRS,3322.96,2492.22,39.88,2990.66,119
CDM,7613656901,HC PERIPHERALLY INSERTED CENTRAL CATHETER > 5YRS,4475.12,3356.34,53.7,4027.61,119
CDM,7613657001,HC INSERT PERIPH  CVAD W/PORT <5YRS,4485.39,3364.04,53.82,4036.85,119
CDM,7613657101,HC INSERT PERIP CVC W PORT >5YRS,4485.14,3363.86,53.82,4036.63,119
CDM,7613657201,HC PERIPHERALLY INSERTED CENTRAL CATHETER W/O PORT >5YRS,5011.74,3758.8,60.14,4510.57,119
CDM,7613657301,HC PERIPHERALLY INSERTED CENTRAL CATHETER W/IMAGE >5YRS,4051.82,3038.86,48.62,3646.64,119
CDM,7613657501,HC REPAIR CV CATHETER W/O PORT,4290.66,3218.0,51.49,3861.59,119
CDM,7613658001,HC REPLACE NON-TUNNEL CVC W/O PORT,3253.13,2439.85,39.04,2927.82,119
CDM,7613658101,HC REPLACE TUNNEL CATH W/O PORT,4788.89,3591.67,57.47,4310.0,119
CDM,7613658201,HC REPLACE TUNNEL CATH W/PORT,4781.81,3586.36,57.38,4303.63,119
CDM,7613658401,HC COMPLETE REPLACEMENT PICC RS&I,3025.06,2268.8,36.3,2722.55,119
CDM,7613658901,HC TUNNEL CATH REMOVAL W/O PORT,1833.61,1375.21,22.0,1650.25,119
CDM,7613659001,HC REMOVAL TUNNEL CATH W/PORT,2186.34,1639.76,26.24,1967.71,119
CDM,7613659301,HC THROMBOLYSIS VAD/CATHETER,693.02,519.76,8.32,623.72,119
CDM,7613659501,HC CATHETER STRIPPING,1725.84,1294.38,20.71,1553.26,119
CDM,7613659601,HC INTRALUMINAL CATHETER STRIPPING,1897.97,1423.48,22.78,1708.17,119
CDM,7613659701,HC REPOSITION CENTRAL VENOUS CATH,2107.95,1580.96,25.3,1897.16,119
CDM,7613659801,HC INJECTION CV CATHETER PATENCY,720.28,540.21,8.64,648.25,119
CDM,7613662001,HC ARTERIAL CATHETERIZATION FOR MONITORING,44.63,33.47,0.54,40.17,119
CDM,7613662501,HC INSERTION CATHETER ARTERY,1701.62,1276.21,20.42,1531.46,119
CDM,7613666001,HC CATH UMBCL ARTRY NB DX/THER,439.7,329.78,5.28,395.73,119
CDM,7613668001,HC PLCMNT NEEDLE INTRAOSS INF,611.49,458.62,7.34,550.34,119
CDM,7613683601,HC FISTULA UPPR PERIPHERAL SINGLE ARTERY/VEIN ACCESS,40081.4,30061.05,480.98,36073.26,119
CDM,7613683701,HC FISTULA UPPR PERIPHERAL 2 SEPARATE ARTERY/VEIN ACCESS,40081.4,30061.05,480.98,36073.26,119
CDM,7613690101,HC AV FISTULAGRAM,8277.37,6208.03,99.33,7449.63,119
CDM,7613690201,HC AV FIST W PERIPH PTA,19042.24,14281.68,228.51,17138.02,119
CDM,7613690301,HC AV FIST W PERIPH STENT,30030.14,22522.6,360.36,27027.13,119
CDM,7613690401,HC AV FIST W MECH/LYTIC THROMBECTOMY,14447.48,10835.61,173.37,13002.73,119
CDM,7613690501,HC AV FIST W MECH/LYTIC THROMB W PERIPH PTA,17963.69,13472.77,215.56,16167.32,119
CDM,7613690601,HC AV FIST W/MECH/LYTIC THROMB W PERIPH STENTING,38287.8,28715.85,459.45,34459.02,119
CDM,7613690701,HC DIALYSIS CENTRAL VN PTA,13127.94,9845.96,157.54,11815.15,119
CDM,7613690801,HC DIALYSIS CENTRAL VN STENT,24349.27,18261.95,292.19,21914.34,119
CDM,7613690901,HC DIALYSIS EMBO ANY VEIN(S),29111.1,21833.32,349.33,26199.99,119
CDM,7613718201,HC TIPS PROCEDURE,34614.59,25960.94,415.38,31153.13,119
CDM,7613718301,HC TIPS REVISION,25835.83,19376.87,310.03,23252.25,119
CDM,7613718402,HC THROMBECTOMY ARTERY NON INTRACRANIAL INITIAL W FLUORO UNILATERAL,7663.71,5747.78,91.96,6897.34,119
CDM,7613718403,HC THROMBECTOMY ARTERY NON INTRACRANIAL INITIAL W FLUORO BILATERAL,14999.46,11249.6,179.99,13499.51,119
CDM,7613718501,HC THROMBECTOMY ARTERY NON INTRACRANIAL ADDL VESSELS W FLUORO,4353.57,3265.18,52.24,3918.21,119
CDM,7613718601,HC THROMBECTOMY 2ND ARTERY NON INTRACRANIAL W FLUORO,7737.81,5803.36,92.85,6964.03,119
CDM,7613718702,HC VENOUS MECH THROMBECTOMY W/INJ UNILATERAL,8653.88,6490.41,103.85,7788.49,119
CDM,7613718802,HC VENOUS MECH THROMBEC REPEAT UNILATERAL,7355.37,5516.53,88.26,6619.83,119
CDM,7613718803,HC VENOUS MECH THROMBEC REPEAT BILATERAL,14710.74,11033.06,176.53,13239.67,119
CDM,7613719101,HC IVC FILTER PLACEMENT,13049.73,9787.3,156.6,11744.76,119
CDM,7613719201,HC IVC FILTER REPOSITION,5957.55,4468.16,71.49,5361.8,119
CDM,7613719301,HC IVC FILTER REMOVAL,9729.21,7296.91,116.75,8756.29,119
CDM,7613719501,HC THROMBOLYSIS CERBRL IV INFUS,1074.96,806.22,12.9,967.46,119
CDM,7613719701,HC REMOVAL INTRAVASC FOREIGN BODY,7977.39,5983.04,95.73,7179.65,119
CDM,7613720001,HC TRANSCATHETER BIOPSY,3106.22,2329.66,37.27,2795.6,119
CDM,7613721102,HC THROMBOLYSIS ARTERIAL NON INTRACRANIAL INITIAL UNILATERAL,7514.57,5635.93,90.17,6763.11,119
CDM,7613721103,HC THROMBOLYSIS ARTERIAL NON INTRACRANIAL INITIAL BILATERAL,15222.14,11416.6,182.67,13699.93,119
CDM,7613721202,HC THROMBOLYSIS VENOUS INITIAL DAY UNILATERAL,7117.48,5338.11,85.41,6405.73,119
CDM,7613721203,HC THROMBOLYSIS VENOUS INITIAL DAY BILATERAL,14234.95,10676.21,170.82,12811.46,119
CDM,7613721301,HC THROMBOLYSIS FOLLOW-UP ART/VEIN INCL CATH EXCH,9961.01,7470.76,119.53,8964.91,119
CDM,7613721401,HC THROMBOLYSIS CESSATION W CATH REMOVAL,10359.1,7769.32,124.31,9323.19,119
CDM,7613721502,HC CERV CAROTID STENT W/DEP UNILATERAL,14519.58,10889.68,174.23,13067.62,119
CDM,7613721601,HC CERV CAROTID STENT OPEN/PERC INCL PTA W/O DEP,18141.73,13606.3,217.7,16327.56,119
CDM,7613722002,HC REVASC ILIAC INITIAL W/PTA UNILATERAL,12921.37,9691.03,155.06,11629.23,119
CDM,7613722003,HC REVASC ILIAC INITIAL W/PTA BILATERAL,13696.48,10272.36,164.36,12326.83,119
CDM,7613722102,HCD REVASC ILIAC W/STENT PTA UNILATERAL,30375.88,22781.91,364.51,27338.29,119
CDM,7613722103,HCD REVASC ILIAC W/STENT PTA BILATERAL,30375.88,22781.91,364.51,27338.29,119
CDM,7613722202,HCD REVASC ILIAC EACH ADDL W/PTA UNILATERAL,12384.07,9288.05,148.61,11145.66,119
CDM,7613722203,HCD REVASC ILIAC EACH ADDL W/PTA BILATERAL,12383.38,9287.54,148.6,11145.04,119
CDM,7613722302,HCD REVASC ILIAC EACH ADDL W/STENT PTA UNILATERAL,35958.37,26968.78,431.5,32362.53,119
CDM,7613722402,HC REVASC FEM-POP W/PTA UNILATERAL,17457.73,13093.3,209.49,15711.96,119
CDM,7613722502,HC IR REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIO SM VESSEL UNILATERAL,44287.06,33215.3,531.44,39858.35,119
CDM,7613722602,HCD REVASC FEM-POP W/STENT PTA UNILATERAL,30542.99,22907.24,366.52,27488.69,119
CDM,7613722702,HC REVAS FEM-POP W/ATHER W STNT/PTA UNILATERAL,62527.94,46895.96,750.34,56275.15,119
CDM,7613722802,HCD REVASC TIB-PERO INITIAL PTA UNILATERAL,33835.29,25376.47,406.02,30451.76,119
CDM,7613722902,HC REVASC TIB PERO ARTHER PTA/INITIAL UNILATERAL,66279.61,49709.71,795.36,59651.65,119
CDM,7613723002,HC REVASC TIB PERO W/STENT PTA INITIAL UNILATERAL,14975.63,11231.72,179.71,13478.07,119
CDM,7613723102,HC REVASC TIB/PERO STNT ATHER UNILATERAL,39487.36,29615.52,473.85,35538.62,119
CDM,7613723103,HC REVASC TIB/PERO STNT ATHER BILATERAL,39487.36,29615.52,473.85,35538.62,119
CDM,7613723202,HC REVASC TIB PER EA ADD W/PTA UNILATERAL,16708.29,12531.22,200.5,15037.46,119
CDM,7613723302,HC REVASC TIB/PER W/ATHR/PTA ADD UNILATERAL,25723.99,19292.99,308.69,23151.59,119
CDM,7613723303,HC REVASC TIB/PER W/ATHR/PTA ADD BILATERAL,12111.0,9083.25,145.33,10899.9,119
CDM,7613723402,HC REVASC TIB-PER ADD W/STENT PTA UNILATERAL,24635.34,18476.5,295.62,22171.81,119
CDM,7613723502,HC REVAS TIB-PER ADD W/ST/PTA/ATHER UNILATERAL,30718.05,23038.54,368.62,27646.24,119
CDM,7613723601,HC STENT PLACEMT ARTERY W PTA INIT UNILATERAL,36252.85,27189.64,435.03,32627.56,119
CDM,7613723701,HC STENT PLACE ARTERY STENOSIS INC PTA EACH ADDL,13847.25,10385.44,166.17,12462.52,119
CDM,7613723801,HC STENT PLACEMT VEIN INC PTA 1ST VEIN UNILATERAL,24275.41,18206.56,291.3,21847.87,119
CDM,7613723901,HC STENT PLACEMT EA ADD VEIN INC PTA,7930.51,5947.88,95.17,7137.46,119
CDM,7613724101,HC VASC EMBOLIZE/OCCLUDE VENOUS,26604.41,19953.31,319.25,23943.97,119
CDM,7613724201,HC VASC EMBOLIZE/OCCLUDE ARTERY,37931.72,28448.79,455.18,34138.55,119
CDM,7613724301,HC VASC EMBOLIZE/OCCLUDE ORGAN,21081.23,15810.92,252.97,18973.11,119
CDM,7613724401,HC VASC EMBOLIZE/OCCLUDE BLEED,31013.39,23260.04,372.16,27912.05,119
CDM,7613724601,HC TRULUML BALO ANGIOP 1ST ART,10830.63,8122.97,129.97,9747.57,119
CDM,7613724701,HC TRULUML BALO ANGIOP ADDL ART,8819.34,6614.5,105.83,7937.41,119
CDM,7613724801,HC TRULUML BALO ANGIOP 1ST VEIN,13123.45,9842.59,157.48,11811.11,119
CDM,7613724901,HC TRULUML BALO ANGIOP ADDL VEIN,13104.55,9828.41,157.25,11794.1,119
CDM,7613779941,HC VASCULAR SURGERY PROCEDURE,395.41,296.56,4.74,355.87,119
CDM,7613820001,HC INJECTION PROC SPLENOPORTOGRAPHY,3016.65,2262.49,36.2,2714.98,119
CDM,7613820601,HC HARVEST AUTO STEM CELLS,10485.03,7863.77,125.82,9436.53,119
CDM,7613822002,HC BONE MARROW ASPIRATION ONLY UNILATERAL,447.45,335.59,5.37,402.7,119
CDM,7613822003,HC BONE MARROW ASPIRATION ONLY BILATERAL,371.85,278.89,4.46,334.66,119
CDM,7613822102,HC BIOPSY BONE MARROW NEEDLE/TROCAR UNILATERAL,1420.06,1065.04,17.04,1278.05,119
CDM,7613822202,HC BONE MARROW DIAGNOSTIC; BIOPSY(IES) & ASPIRATION(S) UNILATERAL,2385.84,1789.38,28.63,2147.26,119
CDM,7613822203,HC BONE MARROW DIAGNOSTIC; BIOPSY(IES) & ASPIRATION(S) BILATERAL,4771.68,3578.76,57.26,4294.51,119
CDM,7613830501,HC DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,1340.5,1005.38,16.09,1206.45,119
CDM,7613850502,HC NEDL BX LYMPH NODE UNILATERAL,1340.58,1005.44,16.09,1206.52,119
CDM,7613850503,HC NEDL BX LYMPH NODE BILATERAL,2681.16,2010.87,32.17,2413.04,119
CDM,7613879002,HC INJECTION LYMPHANGIOGRAM UNILATERAL,2008.75,1506.56,24.1,1807.88,119
CDM,7613879003,HC INJECTION LYMPHANGIOGRAM BILATERAL,4017.5,3013.12,48.21,3615.75,119
CDM,7613879202,HC INJECTION FOR SENTINEL NODE UNILATERAL,521.31,390.98,6.26,469.18,119
CDM,7613879203,HC INJECTION FOR SENTINEL NODE BILATERAL,561.63,421.22,6.74,505.47,119
CDM,7613899901,"HC UNLISTED PROCEDURE, HEMI OR LYMPHATIC SYSTEM",1565.19,1173.89,18.78,1408.67,119
CDM,7614065001,"HC REPAIR LIP,FULL THICK,VERMILION",1650.42,1237.82,19.81,1485.38,119
CDM,7614065201,"HC REPAIR LIP,<1/2 VERT HEIGHT",726.31,544.73,8.72,653.68,119
CDM,7614065401,HC RPR LIP FTH>1HALF VER HT/CPX,4800.65,3600.49,57.61,4320.58,119
CDM,7614080001,HC DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,643.27,482.45,7.72,578.94,119
CDM,7614080101,HC DRAINAGE OF MOUTH LESION,726.31,544.73,8.72,653.68,119
CDM,7614080401,HC REMOVAL FOREIGN BODY MOUTH,643.27,482.45,7.72,578.94,119
CDM,7614080501,HC RMVL EMBEDDED FB VESTIBULE MOUTH COMP,643.27,482.45,7.72,578.94,119
CDM,7614083001,HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,752.61,564.46,9.03,677.35,119
CDM,7614083101,HC CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,726.31,544.73,8.72,653.68,119
CDM,7614100001,HC INTRAORAL I&D TONGUE/FLOOR LINGUAL,726.31,544.73,8.72,653.68,119
CDM,7614100501,HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,726.31,544.73,8.72,653.68,119
CDM,7614100701,HC INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,726.31,544.73,8.72,653.68,119
CDM,7614100801,HC INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,10510.4,7882.8,126.12,9459.36,119
CDM,7614100901,HC INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,726.31,544.73,8.72,653.68,119
CDM,7614101001,HC INCISION OF LINGUAL FRENUM (FRENOTOMY),2386.86,1790.14,28.64,2148.17,119
CDM,7614125001,"HC REPAIR TONGUE LACER,<2.6 CM",1293.24,969.93,15.52,1163.92,119
CDM,7614125101,"HC REPAIR TONGUE LACER,POST 1/3",726.31,544.73,8.72,653.68,119
CDM,7614125201,"HC REPAIR TONGUE LACER,2.6 CM+/COMPLX",752.61,564.46,9.03,677.35,119
CDM,7614180001,HC DRAINAGE OF GUM LESION,643.27,482.45,7.72,578.94,119
CDM,7614180501,HC REMOVAL FOREIGN BODY GUM,643.27,482.45,7.72,578.94,119
CDM,7614200001,HC DRAINAGE MOUTH ROOF LESION,752.61,564.46,9.03,677.35,119
CDM,7614218001,HC REPAIR LAC PALATE<2 CM,726.31,544.73,8.72,653.68,119
CDM,7614218201,HC REPAIR PALATE,1701.62,1276.21,20.42,1531.46,119
CDM,7614240001,HC BIOPSY SALIVARY GLAND,2352.06,1764.04,28.22,2116.85,119
CDM,7614255001,HC SIALOGRAM INJECTION,266.67,200.0,3.2,240.0,119
CDM,7614270001,HC I&D ABSCESS PERITONSILLAR,643.27,482.45,7.72,578.94,119
CDM,7614280901,HC REMOVE PHARYNX FOREIGN BODY,583.94,437.96,7.01,525.55,119
CDM,7614346001,HC ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,2385.78,1789.34,28.63,2147.2,119
CDM,7614375201,HC NASOGASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1185.4,889.05,14.22,1066.86,119
CDM,7614376101,HC REPOSITIONING NASO/OROGASTRIC FEEDING TUBE,1050.75,788.06,12.61,945.68,119
CDM,7614376201,HC RPLC GASTROSTOMY TUBE NO REVISION OF TRC,428.54,321.4,5.14,385.69,119
CDM,7614376301,HC RPLC GASTROSTOMY TUBE W/ REVISION OF TRC,428.54,321.4,5.14,385.69,119
CDM,7614399901,HC LAP BAND INJECTION/EVALUATION,17804.08,13353.06,213.65,16023.67,238
CDM,7614450001,HC LONG GI TUBE PLACEMENT,1338.37,1003.78,16.06,1204.53,119
CDM,7614500501,HC I&D SUBMUCOSAL ABSCESS RECTUM,1481.54,1111.16,17.78,1333.39,119
CDM,7614530701,HC PROCTOSIGMOIDOSCOPY FB,1701.62,1276.21,20.42,1531.46,119
CDM,7614533201,HC SIGMOIDOSCOPY W/FB REMOVAL,583.94,437.96,7.01,525.55,119
CDM,7614599901,"HC RECTAL FB REMOVAL; W/O ANESTH, NOT ANOSCOPY",583.94,437.96,7.01,525.55,119
CDM,7614604001,HC I&D;PERIRECTAL OR ISCHIAL ABSCESS,3821.26,2865.94,45.86,3439.13,119
CDM,7614605001,HC I&D; PERIANAL ABSCESS,2954.75,2216.06,35.46,2659.28,119
CDM,7614608301,"HC INCISE THROMBOSED HEMORRHOID,EXT",788.21,591.16,9.46,709.39,119
CDM,7614632001,HC EXCISION EXTERNAL HEMORROID,643.27,482.45,7.72,578.94,119
CDM,7614660001,HC ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,643.27,482.45,7.72,578.94,119
CDM,7614660801,HC ANOSCOPY REMOVE FOR BODY,643.27,482.45,7.72,578.94,119
CDM,7614700001,HC BIOPSY LIVER NEEDLE,2030.01,1522.51,24.36,1827.01,119
CDM,7614738201,HC RF LIVER ABLATION 1 OR >SITES,12915.84,9686.88,154.99,11624.26,119
CDM,7614738301,HC LIVER ABLATION CRYO  1 OR MORE SITES,12951.77,9713.83,155.42,11656.59,119
CDM,7614749001,HC PERCUTANEOUS CHOLECYSTOSTOMY,4430.0,3322.5,53.16,3987.0,119
CDM,7614753101,HC INJ PERC CHOLANGIO W/IMG EXISTING ACCESS,1565.13,1173.85,18.78,1408.62,119
CDM,7614753201,HC INJ PERC CHOLANGIO W/IMG NEW ACCESS,2666.35,1999.76,32.0,2399.72,119
CDM,7614753301,HC PLMT PERC BILIARY DRAIN CATH INCL DX CHOLANGIO W/IMG EXT,6269.03,4701.77,75.23,5642.13,119
CDM,7614753401,HC PLMT PERC BILIARY DRAIN CATH INCL DX CHOLANGIO W/IMG INT-EXT,6479.08,4859.31,77.75,5831.17,119
CDM,7614753501,HC CONV PERC EXT BILIARY DRAIN CATH TO INT-EXT W/IMG,6488.68,4866.51,77.86,5839.81,119
CDM,7614753601,HC EXCH PERC BILIARY DRAIN CATH W/IMG,4387.81,3290.86,52.65,3949.03,119
CDM,7614753701,HC REM PERC BILIARY DRAIN CAT REQ FLUOR INC DX CHOLANG W/IMG,1676.48,1257.36,20.12,1508.83,119
CDM,7614753801,HC PLMT PERC STENT BILE DUCT W IMG EXIST ACSS,12291.88,9218.91,147.5,11062.69,119
CDM,7614753901,HC PLMT PERC STENT BILE DCT W IMG  NEW ACSS WO PLMT OF DRN CATH,9347.41,7010.56,112.17,8412.67,119
CDM,7614754001,HC PLMT PERC STENT BILE DCT W IMG NEW ACSS W PLMT OF DRN CATH,16449.07,12336.8,197.39,14804.16,119
CDM,7614754101,HC PLMT OF ACCESS BILIARY TREE SM BOWEL PERC W IMG S&I,1535.75,1151.81,18.43,1382.18,119
CDM,7614754201,HC BALLOON DILATE BILIARY DUCT OR AMPUL PERC W IMG S&I,5828.88,4371.66,69.95,5245.99,119
CDM,7614754301,HC ENDOLUMINAL BX BILIARY TREE PERC W IMG S&I SINGL/MULT,3001.05,2250.79,36.01,2700.94,119
CDM,7614754401,HC REM PERC DUCT GLBLDR CALCULI INCL DESTRUC W IMG S&I,4273.96,3205.47,51.29,3846.56,119
CDM,7614755001,HC BILIARY ENDOSCOPY PERC W/O CALCULI REMOVAL,9900.56,7425.42,118.81,8910.5,119
CDM,7614755301,HC BILIARY ENDOSCOPY PERC VIA T-TUBE W BX,2905.49,2179.12,34.87,2614.94,119
CDM,7614755401,HC BILIARY ENDOSCOPY PERC W CALCULI REMOVAL,12375.69,9281.77,148.51,11138.12,119
CDM,7614755501,HC BILIARY DILATION W/O STENT,3023.04,2267.28,36.28,2720.74,119
CDM,7614755601,HC BILIARY DILATION W/STENT,4150.15,3112.61,49.8,3735.14,119
CDM,7614810201,HC PERCUTANEOUS PANCREAS BIOPSY,2620.73,1965.55,31.45,2358.66,119
CDM,7614908201,HC PARACENTESIS,1174.9,881.18,14.1,1057.41,119
CDM,7614908301,HC PARACENTESIS WITH IMAGING,2700.9,2025.68,32.41,2430.81,119
CDM,7614908401,HC PERITONEAL LAVAGE,1706.33,1279.75,20.48,1535.7,119
CDM,7614918001,HC BIOPSY ABD/RETROPERITONEAL,2113.8,1585.35,25.37,1902.42,119
CDM,7614918501,HC SCLEROTHERAPY PERC INCL INJECTIONS W IMG AND S&I,4339.03,3254.27,52.07,3905.13,119
CDM,7614940001,HC INJ AIR/CONTRAST INTO PERITONEAL CAVITY,812.29,609.22,9.75,731.06,119
CDM,7614940501,HC VISCERAL DRAINAGE W IMAGING GUIDE,4465.91,3349.43,53.59,4019.32,119
CDM,7614940601,HC PERITON/RETROPERI DRAINAGE W IMAG,4203.75,3152.81,50.44,3783.38,119
CDM,7614940701,HC TRVAG/TRARECT PERI/RETRO DRAINAGE,3493.62,2620.22,41.92,3144.26,119
CDM,7614941101,HC INS MARK ABD/PEL FOR RT PERC,2360.04,1770.03,28.32,2124.04,119
CDM,7614941801,HC INSERT TUN IP CATH PERC,7475.0,5606.25,89.7,6727.5,119
CDM,7614942101,HC INSERT IP CATH DR/DIALYSIS PERM,7525.83,5644.37,90.31,6773.25,119
CDM,7614942201,HC REM OF TUNNELED INTRAPERITONEAL CATH,5921.95,4441.46,71.06,5329.76,119
CDM,7614942301,HC EXCHANGE DRAINAGE CATHE ABD,3124.16,2343.12,37.49,2811.74,119
CDM,7614942401,HC CONTRAST INJ ABSCESS ASSMT,463.35,347.51,5.56,417.02,119
CDM,7614944001,HC PLACE GASTROSTOMY TUBE PERC,4089.44,3067.08,49.07,3680.5,119
CDM,7614944101,HC INSERTION DUOD OR JEJUNO TUBE,4285.39,3214.04,51.42,3856.85,119
CDM,7614944201,HC PERC CECOSTOMY OR COLONIC TUBE,2175.22,1631.42,26.1,1957.7,119
CDM,7614944601,HC CHANGE G-TUBE TO G-J TUBE PERC,3351.4,2513.55,40.22,3016.26,119
CDM,7614945001,HC REPLACE G/C TUBE PERC,2758.72,2069.04,33.1,2482.85,119
CDM,7614945101,HC DUOD/JEJUNO TUBE REPLACEMENT,2454.41,1840.81,29.45,2208.97,119
CDM,7614945201,HC GASTRO-JEJUNOSTOMY CATH CHANGE,3691.84,2768.88,44.3,3322.66,119
CDM,7614946001,HC CLEAR G/D/J/GJ TUBE ANY METHOD,1257.53,943.15,15.09,1131.78,119
CDM,7614946501,"HC INJECTION OF G,D,J,GJ TUBE",587.3,440.48,7.05,528.57,119
CDM,7614999941,HC ALCOHOL ABLATION PROCEDURE,1641.46,1231.1,19.7,1477.31,119
CDM,7615020002,HC PERCUTANEOUS RENAL BIOPSY UNILATERAL,1925.22,1443.92,23.1,1732.7,119
CDM,7615020003,HC PERCUTANEOUS RENAL BIOPSY BILATERAL,3850.43,2887.82,46.21,3465.39,119
CDM,7615038202,HC CHANGE URETER STENT PERCUT UNILATERAL,4514.71,3386.03,54.18,4063.24,119
CDM,7615038203,HC CHANGE URETER STENT PERCUT BILATERAL,4514.71,3386.03,54.18,4063.24,119
CDM,7615038402,"HC REMOVE URETER STENT, PERCUT UNILATERAL",5037.65,3778.24,60.45,4533.88,119
CDM,7615038702,HC RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH UNILATERAL,4236.04,3177.03,50.83,3812.44,119
CDM,7615038703,HC RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH BILATERAL,8472.07,6354.05,101.66,7624.86,119
CDM,7615038902,HC REMOVE NEPHROSTOMY TUBE UNILATERAL,1670.57,1252.93,20.05,1503.51,119
CDM,7615038903,HC REMOVE NEPHROSTOMY TUBE BILATERAL,3341.14,2505.86,40.09,3007.03,119
CDM,7615039002,HC PERC ASP/INJ RENAL CYST/PELVIS UNILATERAL,2322.17,1741.63,27.87,2089.95,119
CDM,7615039003,HC PERC ASP/INJ RENAL CYST/PELVIS BILATERAL,4644.34,3483.26,55.73,4179.91,119
CDM,7615039601,HC MANOMETRY THRU INDWELLING CATH,748.02,561.02,8.98,673.22,119
CDM,7615043002,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG NEW ACSS UNILATERAL,2935.88,2201.91,35.23,2642.29,119
CDM,7615043003,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG NEW ACSS BILATERAL,5871.77,4403.83,70.46,5284.59,119
CDM,7615043102,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG EXISTNG ACSS UNILATERAL,1512.98,1134.73,18.16,1361.68,119
CDM,7615043103,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG EXISTNG ACSS BILATERAL,3025.97,2269.48,36.31,2723.37,119
CDM,7615043202,HC PLMT PERC NEPHROSTO CATH INCL DX NEPHROS/URETRGRM W/IMG UNILATERAL,6100.24,4575.18,73.2,5490.22,119
CDM,7615043203,HC PLMT PERC NEPHROSTO CATH INCL DX NEPHROS/URETRGRM W/IMG BILATERAL,12200.47,9150.35,146.41,10980.42,119
CDM,7615043302,HC PLMT PERC NEPHROURETRL CATH W IMG NEW ACSS UNILATERAL,7698.17,5773.63,92.38,6928.35,119
CDM,7615043303,HC PLMT PERC NEPHROURETRL CATH W IMG NEW ACSS BILATERAL,15396.34,11547.26,184.76,13856.71,119
CDM,7615043402,HC CONV PERC NEPH CATH TO NEPHURETRL CATH VIA EXIST NEPH TR UNILATERAL,6240.63,4680.47,74.89,5616.57,119
CDM,7615043403,HC CONV PERC NEPH CATH TO NEPHURETRL CATH VIA EXIST NEPH TR BILATERAL,15019.11,11264.33,180.23,13517.2,119
CDM,7615043502,HC EXCH PERC NEPHROSTOMY CATH INCL DX NEPHRO/URETRGRM W IMG UNILATERAL,7731.62,5798.72,92.78,6958.46,119
CDM,7615043503,HC EXCH PERC NEPHROSTOMY CATH INCL DX NEPHRO/URETRGRM W IMG BILATERAL,15463.25,11597.44,185.56,13916.92,119
CDM,7615043702,HC PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS UNILATERAL,7791.45,5843.59,93.5,7012.3,119
CDM,7615059202,HC RENAL TUMOR ABLATION RF UNILATERAL,16531.77,12398.83,198.38,14878.59,119
CDM,7615059302,HC ABLATION RENAL CRYO UNILATERAL,16213.47,12160.1,194.56,14592.12,119
CDM,7615060601,HC ENDOLUMINAL BX OF URETER AND OR RENAL PELVIS,5535.65,4151.74,66.43,4982.08,119
CDM,7615069001,HC LOOPOGRAM INJECTION,669.77,502.33,8.04,602.79,119
CDM,7615069302,HC PLMT PERC URETRL STENT W IMG PRE-EXISTNG NEPHRO TRACT UNILATERAL,7522.62,5641.96,90.27,6770.36,119
CDM,7615069303,HC PLMT PERC URETRL STENT W IMG PRE-EXISTNG NEPHRO TRACT BILATERAL,15045.23,11283.92,180.54,13540.71,119
CDM,7615069402,HC PLMT PERC URETRL STENT W IMG NEW ACSS WO SEP NEPHRO CATH UNILATERAL,8439.5,6329.62,101.27,7595.55,119
CDM,7615069403,HC PLMT PERC URETRL STENT W IMG NEW ACSS WO SEP NEPHRO CATH BILATERAL,16879.01,12659.26,202.55,15191.11,119
CDM,7615069502,HC PLMT PERC URETRL STENT W IMG NEW ACSS W SEP NEPHRO CATH UNILATERAL,8874.15,6655.61,106.49,7986.74,119
CDM,7615069503,HC PLMT PERC URETRL STENT W IMG NEW ACSS W SEP NEPHRO CATH BILATERAL,17748.29,13311.22,212.98,15973.46,119
CDM,7615070501,HC URETERAL EMBOLIZATION/OCCLUSION,7622.03,5716.52,91.46,6859.83,119
CDM,7615070601,HC BALLOON DILATE URTRL STRICTURE W IMG S&I,6116.06,4587.04,73.39,5504.45,119
CDM,7615110001,HC NEEDLE ASPIRATION BLADDER,1617.32,1212.99,19.41,1455.59,119
CDM,7615110101,HC DRAIN BLADDER BY TROCAR/CATH,583.94,437.96,7.01,525.55,119
CDM,7615110201,HC SUPRAPUBIC CATH INSERTION,2962.42,2221.82,35.55,2666.18,119
CDM,7615160001,HC CYSTOGRAPHY INJECTION,509.66,382.24,6.12,458.69,119
CDM,7615161001,HC URETHROCYSTOGRAPHY RETROGRADE INJ,549.23,411.92,6.59,494.31,119
CDM,7615170001,HC BLADDER IRRIGATION,815.6,611.7,9.79,734.04,119
CDM,7615170201,HC FOLEY CATHETER INSERTION,777.86,583.4,9.33,700.07,119
CDM,7615170501,HC CYSTOSTOMY TUBE CHANGE; SIMPLE,583.94,437.96,7.01,525.55,119
CDM,7615171001,HC CHANGE OF CYSTOSTOMY TUBE; COMPLICATED,583.94,437.96,7.01,525.55,119
CDM,7615172001,HC TREATMENT BLADDER LESION; INSTILL ANTICARCINOGENIC,1288.33,966.25,14.85,1205.35,238
CDM,7615172801,HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,2166.0,1624.5,25.99,1949.4,119
CDM,7615178501,HC NDL EMG ANAL/URETHRL SPINCTER,319.34,239.5,3.83,287.41,119
CDM,7615200001,HC CYSTOURETHROSCOPY,2112.35,1584.26,25.35,1901.12,119
CDM,7615422001,HC IRRIGATION CORPORA CAVERNOSA PRIAPISM,747.02,560.26,8.96,672.32,119
CDM,7615470001,HC I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,6638.97,4979.23,79.67,5975.07,119
CDM,7615510001,HC DRAINAGE SCROTAL WALL ABSCESS,5251.0,3938.25,63.01,4725.9,119
CDM,7615512001,HC REMOVAL OF SCROTUM LESION,125.29,93.97,1.5,112.76,119
CDM,7615570001,HCD PROSTATE BIOPSY NEEDLE,952.99,714.74,11.44,857.69,119
CDM,7615587401,HC TRANSPERINEAL PLMT BIODEGRDABL MATRL,12709.01,9531.76,152.51,11438.11,119
CDM,7615587501,HC TRANSPERI NEEDLE PLACE PROS,13763.86,10322.9,165.17,12387.47,119
CDM,7615587601,HC PLACEMENT OF FIDUCIAL MARKERS FOR PROSTATE BRACHYTHERAPY,2683.41,2012.56,32.2,2415.07,119
CDM,7615592001,HC PLACE NEEDLES PELVIC FOR RT,2683.41,2012.56,32.2,2415.07,119
CDM,7615640501,HC VULVA/PERINEAL ABSCESS I/D,985.84,739.38,11.83,887.26,119
CDM,7615642001,HC I/D BARTHOLIN GLAND ABSCESS,651.97,488.98,7.82,586.77,119
CDM,7615715501,HC INSERT UTERI TANDEM/OVOIDS,4068.46,3051.34,48.82,3661.61,119
CDM,7615715601,HC INSERT VAG CYLINDER BRACHYTHERAPY,1125.61,844.21,13.51,1013.05,119
CDM,7615741501,HC REMOVE VAGINAL FOREIGN BODY,1701.62,1276.21,20.42,1531.46,119
CDM,7615830001,HC INSERTION IUD,85.49,64.12,1.03,76.94,119
CDM,7615830101,HC REMOVAL IUD,985.84,739.38,11.83,887.26,119
CDM,7615834001,HC HYSTEROSALPINGOGRAM INJECTION,509.31,381.98,6.11,458.38,119
CDM,7615834502,HC INTRO FALLOPIAN TUBE CATH UNILATERAL,6722.22,5041.66,80.67,6050.0,119
CDM,7615834503,HC INTRO FALLOPIAN TUBE CATH BILATERAL,13444.45,10083.34,161.33,12100.0,119
CDM,7615900001,HC AMNIOCENTESIS DIAGNOSTIC,389.99,292.49,4.68,350.99,119
CDM,7615900101,HC AMNIOCENTESIS THERAPEUTIC,1447.68,1085.76,17.37,1302.91,119
CDM,7615901201,HC CORDOCENTESIS INTRAUTERINE ANY METHOD,1389.76,1042.32,16.68,1250.78,119
CDM,7615901501,HC CHORIONIC VILLUS SAMPLING,777.9,583.42,9.33,700.11,119
CDM,7616105001,HC CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,1407.01,1055.26,16.88,1266.31,119
CDM,7616105501,HC CERVICAL PUNCTURE INJECTION,1659.16,1244.37,19.91,1493.24,119
CDM,7616107001,HC INJ/ASPIRATE CNS SHUNT,961.12,720.84,11.53,865.01,119
CDM,7616162301,HC TEMP CEREB OCCLUS SNGL VESS,23332.24,17499.18,279.99,20999.02,119
CDM,7616162401,HC CENTRAL NERV SYST TRANSCAT EMB,8702.37,6526.78,104.43,7832.13,119
CDM,7616162601,HC TCAT PERM OCCLS/EMBOLJ PERQ NON-CNS HEAD/NECK,6277.24,4707.93,75.33,5649.52,119
CDM,7616163001,HC PTA INTRACRANIAL,6500.6,4875.45,78.01,5850.54,119
CDM,7616163501,HC ANGIO INTRACRANIAL W/STENT,3058.02,2293.52,36.7,2752.22,119
CDM,7616164001,HC VASO BALLOON DILATION INITIAL,7821.95,5866.46,93.86,7039.76,119
CDM,7616164101,HC PERQ BLLN DILAT IC VSPSM EA VSL SAME VASC TER,3968.73,2976.55,47.62,3571.86,119
CDM,7616164501,HC PERC ARTERIAL MECH THROMBECT/INFUSION INTRACRANIAL W FLUORO/CATH/INJ,29274.43,21955.82,351.29,26346.99,119
CDM,7616165001,HC ENDOVASC INTRACRAN PRLNG ADMN RX AGNT W/IMG INITIAL,31806.0,23854.5,381.67,28625.4,119
CDM,7616165101,HC ENDOVASC INTRACRAN PRLNG ADMN RX AGNT W/IMG ADDL,31900.7,23925.52,382.81,28710.63,119
CDM,7616226701,HC PERC INTERVERTEBRAL DISC ASPIRATION,3665.16,2748.87,43.98,3298.64,119
CDM,7616226801,HC PERC CYST ASPIRATE SPINAL CORD,1564.11,1173.08,18.77,1407.7,119
CDM,7616227001,HC LUMBAR PUNCTURE DIAGNOSTIC,1500.0,1125.0,18.0,1350.0,119
CDM,7616227201,HC SPINAL PUNCTURE THERAPEUTIC,1388.85,1041.64,16.67,1249.96,119
CDM,7616227301,HC INJ EPIDURAL BLOOD OR CLOT PATCH,2209.9,1657.42,26.52,1988.91,119
CDM,7616228401,HC SPINAL MYELOGRAM INJECTION NOT C1-C2,1400.84,1050.63,16.81,1260.76,119
CDM,7616228701,HC DCMPRN PERQ NUCLEUS PULPOSUS 1/MLT LEVELS LUMBAR,6892.94,5169.7,82.72,6203.65,119
CDM,7616229001,HC INJ DISKOGRPHY LUMBAR EA LEVEL,5511.46,4133.6,66.14,4960.31,119
CDM,7616229101,HC INJ DISKOGRHY CERVICAL EA LEVEL,4992.95,3744.71,59.92,4493.66,119
CDM,7616230201,HC MYELOGRAM CERVICAL INCLUD LUMBAR INJECTION,2668.57,2001.43,32.02,2401.71,119
CDM,7616230301,HC MYELOGRAM THORACIC INCLUDE LUMBAR  INJECTION,2918.94,2189.2,35.03,2627.05,119
CDM,7616230401,HC MYELOGRAM LUMBOSACRAL INCL LUMBAR INJECTION,3016.17,2262.13,36.19,2714.55,119
CDM,7616230501,HC MYELOGRAM MULT SITES INCL LUMB INJECTION,3269.47,2452.1,39.23,2942.52,119
CDM,7616232101,HC NJX INTERLAMINAR CRV/THRC,2537.98,1903.48,30.46,2284.18,119
CDM,7616232301,HC INJ DX/THER INTRALAMINAR LUMBAR/SACRAL W/IMAGING,2785.15,2088.86,33.42,2506.64,119
CDM,7616232701,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMAGING,2425.25,1818.94,29.1,2182.72,119
CDM,7616232801,HC LMBR SPI PNXR W/FLUOR/CT,1994.99,1496.24,23.94,1795.49,119
CDM,7616232901,HC SPINAL PUNCTURE THERAPEUTIC W/FLUORO OR CT,1388.85,1041.64,16.67,1249.96,119
CDM,7616237001,HC NR PUMP REFILL/ADJ-DONE BY DR,1081.06,810.8,12.97,972.95,119
CDM,7616365001,HC PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,19796.38,14847.28,237.56,17816.74,119
CDM,7616365081,HC COM CON PERC IMPLNT NEUROSTI,19796.38,14847.28,237.56,17816.74,119
CDM,7616440001,HC INJECTION OF ANESTH AGENT; TRIGEMINAL NERVE,719.31,539.48,8.63,647.38,119
CDM,7616440502,"HC INJECTION, GREATER OCCIPITAL NERVE UNILATERAL",807.69,605.77,9.69,726.92,119
CDM,7616440503,"HC INJECTION, GREATER OCCIPITAL NERVE BILATERAL",1615.38,1211.54,19.38,1453.84,119
CDM,7616440801,HC NERVE BLOCK (VAGUS),750.98,563.24,9.01,675.88,119
CDM,7616441501,HC INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,750.98,563.24,9.01,675.88,119
CDM,7616441701,HC INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,750.98,563.24,9.01,675.88,119
CDM,7616441801,HC INJECTION AA&/STRD SUPRASCAPULAR NERVE,1230.6,922.95,14.77,1107.54,119
CDM,7616442001,HC INJECTION ANESTHETIC STEROID INTERCOSTAL 1 LEVEL,1315.67,986.75,15.79,1184.1,119
CDM,7616442101,HC INJECTION ANESTHETIC STEROID INTERCOSTAL EA ADD LEVEL,1639.74,1229.8,19.68,1475.77,119
CDM,7616442501,HC ILIOHYPOGASTRIC NERVE BLOCK,1234.68,926.01,14.82,1111.21,119
CDM,7616443001,HC  INJECTION AA&/STRD PUDENDAL NERVE,750.98,563.24,9.01,675.88,119
CDM,7616443502,HC INJECTION AA&/STRD PARACERVICAL NERVE UNILAT,998.8,749.1,11.99,898.92,119
CDM,7616443503,HC INJECTION AA&/STRD PARACERVICAL NERVE BILAT,998.8,749.1,11.99,898.92,119
CDM,7616444501,HC INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,998.8,749.1,11.99,898.92,119
CDM,7616444701,HC IN FEMORAL NERVE SINGLE,998.8,749.1,11.99,898.92,119
CDM,7616445001,HC INJ OTHR PERIPHRAL NERVE/BRANC,1994.99,1496.24,23.94,1795.49,119
CDM,7616445003,HC INJ OTHR PERIPHRAL NERVE/BRANCH BILATERAL,2206.07,1654.55,26.47,1985.46,119
CDM,7616445006,HC TARSAL TUNNEL INJECTION UNILATERAL,1103.04,827.28,13.24,992.74,119
CDM,7616445007,HC TARSAL TUNNEL INJECTION BILATERAL,2205.96,1654.47,26.47,1985.36,119
CDM,7616446101,HC PARAVERTEBRAL BLOCK THORACIC SINGLE INJ W/IMG,583.94,437.96,7.01,525.55,119
CDM,7616446201,HC PARAVERTEBRAL BLOCK THORACIC 2ND AND ADDL SITES W/IMG,583.94,437.96,7.01,525.55,119
CDM,7616447901,HC NJX AA&/STRD TFRM EPI C/T 1,2123.57,1592.68,25.48,1911.21,119
CDM,7616448001,HC NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,467.63,350.72,5.61,420.87,119
CDM,7616448301,HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL,1909.87,1432.4,22.92,1718.88,119
CDM,7616448401,HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC EA ADDL LVL,781.01,585.76,9.37,702.91,119
CDM,7616448601,HC TAP BLOCK UNILATERAL BY INJECTION(S),1315.67,986.75,15.79,1184.1,119
CDM,7616449001,HC INJ PARAVERT F JNT C/T 1 LEV,2251.2,1688.4,27.01,2026.08,119
CDM,7616449003,HC INJ PARAVERT F JNT C/T 1 LEV BILATERAL,4156.14,3117.1,49.87,3740.53,119
CDM,7616449101,HC INJ PARAVERT F JNT C/T 2 LEV,1508.32,1131.24,18.1,1357.49,119
CDM,7616449103,HC INJ PARAVERT F JNT C/T 2 LEV BILATERAL,3016.63,2262.47,36.2,2714.97,119
CDM,7616449201,HC INJ PARAVERT F JNT C/T 3 LEV,1397.77,1048.33,16.77,1257.99,119
CDM,7616449301,HC INJ PARAVERT F JNT L/S 1 LEV,2878.88,2159.16,34.55,2590.99,119
CDM,7616449303,HC INJ PARAVERT F JNT L/S 1 LEV BILATERAL,5758.09,4318.57,69.1,5182.28,119
CDM,7616449401,HC INJ PARAVERT F JNT L/S 2 LEV,833.31,624.98,10.0,749.98,119
CDM,7616449403,HC INJ PARAVERT F JNT L/S 2 LEV BILATERAL,1628.1,1221.08,19.54,1465.29,119
CDM,7616449501,HC  INJ PARAVERT F JNT L/S 3 LEV,456.67,342.5,5.48,411.0,119
CDM,7616450501,HC INJECTION OF ANESTH AGENT; SPHENOPALATINE NERVE,675.26,506.44,8.1,607.73,119
CDM,7616451001,HC NJX ANES STELLATE GANGLION CRV SYMPATHETIC,1725.28,1293.96,20.7,1552.75,119
CDM,7616451701,HC INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,1940.77,1455.58,23.29,1746.69,119
CDM,7616452001,HC INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,1952.31,1464.23,23.43,1757.08,119
CDM,7616453001,HC CELIAC PLEXUS W/WO RAD MONITOR,1255.21,941.41,15.06,1129.69,119
CDM,7616461602,HC CHEMODENERV MUSC NECK DYSTON UNILATERAL,457.86,343.4,5.49,412.07,119
CDM,7616461603,HC CHEMODENERV MUSC NECK DYSTON BILATERAL,1321.09,990.82,15.85,1188.98,119
CDM,7616462401,HC DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,3673.63,2755.22,44.08,3306.27,119
CDM,7616463302,HC CT FACET RHIZOTOMY C OR T SPINE UNILATERAL SINGLE LEVEL,3042.06,2281.54,36.5,2737.85,119
CDM,7616463303,HC CT FACET RHIZOTOMY C OR T SPINE BILATERAL SINGLE LEVEL,6084.12,4563.09,73.01,5475.71,119
CDM,7616463402,HC CT FACET RHIZOTOMY C OR T SPINE SINGLE LEVEL EACH ADDL UNILATERAL LEVEL,2602.9,1952.18,31.23,2342.61,119
CDM,7616463403,HC CT FACET RHIZOTOMY C OR T SPINE EACH ADDL BILATERAL LEVEL,5205.81,3904.36,62.47,4685.23,119
CDM,7616463502,HC CT FACET RHIZOTOMY L OR SACRAL SPINE UNILATERAL SINGLE LEVEL,3782.91,2837.18,45.39,3404.62,119
CDM,7616463503,HC CT FACET RHIZOTOMY L OR SACRAL SPINE BILATERAL SINGLE LEVEL,7565.82,5674.36,90.79,6809.24,119
CDM,7616463602,HC CT FACET RHIZOTOMY L OR SACRAL SPINE EACH ADDL UNILATERAL SINGLE LEVEL,2919.4,2189.55,35.03,2627.46,119
CDM,7616463603,HC CT FACET RHIZOTOMY L OR SACRAL SPINE EACH ADDL BILATERAL LEVEL,5838.8,4379.1,70.07,5254.92,119
CDM,7616464001,HC DESTROY PERIPH NEVER W/LYTIC,1788.11,1341.08,21.46,1609.3,119
CDM,7616468001,HC CT CELIAC PLEXIS NEUROLYSIS,1308.0,981.0,15.7,1177.2,119
CDM,7616499901,HC RENAL PLEXUS NERVE BLOCK W/ GUIDANCE,1255.21,941.41,15.06,1129.69,119
CDM,7616499941,HC CT FACET JOINT ASPIRATION,4423.69,3317.77,53.08,3981.32,119
CDM,7616499942,HC COM CON UNLISTED PROCEDURE NERVOUS SYSTEM,3586.72,2690.04,43.04,3228.05,119
CDM,7616499943,HC RENAL PLEXUS BLOCK,1255.21,941.41,15.06,1129.69,119
CDM,7616499944,HC GUIDED TISSEEL INJECTION,1255.21,941.41,15.06,1129.69,119
CDM,7616499945,HC DISC BLOCK / INJECTION,3586.72,2690.04,43.04,3228.05,119
CDM,7616499948,HC SPINAL CYST ASPIRATION / INJECTION,3586.72,2690.04,43.04,3228.05,119
CDM,7616520501,HC REM FOREIGN BDY EXT EYE CONJUN,643.27,482.45,7.72,578.94,119
CDM,7616521002,HC REMOVE FOREIGN BODY FROM EYE UNILAT,583.94,437.96,7.01,525.55,119
CDM,7616521003,HC REMOVE FOREIGN BODY FROM EYE BILAT,583.94,437.96,7.01,525.55,119
CDM,7616522001,HC REM FOREGN BDY CORNEA W/O LAMP,643.27,482.45,7.72,578.94,119
CDM,7616522201,HC REM FOREIGN BODY CORNEA W/LAMP,643.27,482.45,7.72,578.94,119
CDM,7616702801,HC INJECTION EYE DRUG,1090.27,817.7,13.08,981.24,119
CDM,7616722901,HC TR RETINAL LES PRETERM INF,3859.52,2894.64,46.31,3473.57,238
CDM,7616770002,HC DRAINAGE OF EYELID ABSCESS UNILAT,968.79,726.59,11.63,871.91,119
CDM,7616770003,HC DRAINAGE OF EYELID ABSCESS BILAT,726.31,544.73,8.72,653.68,119
CDM,7616793002,"HC SUTURE EYELID WOUND,PARTIAL THICK UNILAT",998.8,749.1,11.99,898.92,119
CDM,7616793003,"HC SUTURE EYELID WOUND,PARTIAL THICK BILAT",998.8,749.1,11.99,898.92,119
CDM,7616793502,"HC SUTURE EYELID WOUND,FULL THICK UNILAT",125.29,93.97,1.5,112.76,119
CDM,7616793503,"HC SUTURE EYELID WOUND,FULL THICK BILAT",125.29,93.97,1.5,112.76,119
CDM,7616793802,HC REMOVE EYELID FOREIGN BODY UNILAT,643.27,482.45,7.72,578.94,119
CDM,7616793803,HC REMOVE EYELID FOREIGN BODY BILAT,643.27,482.45,7.72,578.94,119
CDM,7616802002,HC INCISE/DRAIN CONJUNCTIVA UNILAT,726.31,544.73,8.72,653.68,119
CDM,7616802003,HC INCISE/DRAIN CONJUNCTIVA BILAT,726.31,544.73,8.72,653.68,119
CDM,7616900001,"HC I&D ABSCESS EAR, EXTERNAL  SIMPLE",643.27,482.45,7.72,578.94,119
CDM,7616900501,"HC I&D ABSCESS EAR, EXTERNAL COMPLICATED",5251.0,3938.25,63.01,4725.9,119
CDM,7616902001,HC DRAN EXTRNL AUDITRY CANAL ABSC,726.31,544.73,8.72,653.68,119
CDM,7616920001,HC REM FB EXT AUDTR CANL W/O ANES,643.27,482.45,7.72,578.94,119
CDM,7616920902,HC REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL,167.44,125.58,2.01,150.7,119
CDM,7616920903,HC REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE BILATERAL,445.39,334.04,5.34,400.85,119
CDM,7616921002,HC REMOVAL IMPACTED CERUMEN REQ INSTR; UNILATERAL,128.66,96.5,1.54,115.79,119
CDM,7616921003,HC REMOVAL IMPACTED CERUMEN REQ INSTR; BILATERAL,342.73,257.05,4.11,308.46,119
CDM,7617595601,HC TAA REPAIR COVERING LT SUB,1671.1,1253.32,20.05,1503.99,119
CDM,7619103801,HC ESOPHAGEAL IMPED FUNCT TEST>1H,2231.03,1673.27,26.77,2007.93,119
CDM,7619220101,HC ROP EYE EXAM,234.31,175.73,2.81,210.88,238
CDM,7619251101,HC NASOPHARYNGOSCOPY W/ENDO,1124.76,843.57,13.5,1012.28,119
CDM,7619358301,HC PERC TRANSCATH SEPTAL REDUX INCL PMKR,45392.04,34044.03,544.7,40852.84,119
CDM,7619379901,HC CONSOLE VAD ASSIST DAILY CHECK,1439.68,1079.76,17.28,1295.71,119
CDM,7619379941,HC CONSOLE IMPELLA ASSIST DAILY CHECK,1584.59,1188.44,19.02,1426.13,119
CDM,7619379942,HC RF PEREFERATION OF PULMONARY VALVE,20705.45,15529.09,248.47,18634.91,119
CDM,7619652101,HC REFILL/MAINTAIN PORTABLE PUMP,395.02,296.26,4.74,355.52,119
CDM,7619652301,HC VENOUS ACCESS DEVICE IRRIGATION,276.55,207.41,3.32,248.9,119
CDM,7619759701,HC SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,643.97,482.98,7.73,579.57,119
CDM,7619759801,HC SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,616.095,462.07,7.07,578.94,238
CDM,7619760201,HC NON-SELECTIVE DEBRIDEMENT W/O ANESTH,377.37,283.03,4.53,339.63,119
CDM,7619760501,HC WOUND THRP W/DME <50 SQ CM,900.6,675.45,10.81,810.54,119
CDM,7619760601,HC WOUND THRP W/DME >50 SQ CM,1270.5,952.88,15.25,1143.45,119
CDM,7619760701,HC WOUND THRP W/O DME <50 SQ CM,815.75,611.81,9.79,734.18,119
CDM,7619760801,HC WOUND THRP W/O DME >50 SQ CM,969.35,727.01,11.63,872.42,119
CDM,761C972801,HC PLACE DEVICE/MARKER NON PRO,2855.2,2141.4,34.26,2569.68,119
CDM,761C975101,"HCD BRONCHOSCOPY, MICROWAVE, 3D, EBUS",12236.6,9177.45,146.84,11012.94,119
CDM,761G012701,HC TRIMMING DYSTROPHIC NAILS; ANY NUMBER,144.05,108.04,1.73,129.65,119
CDM,761G016801,HC WOUND CLOSURE UTILIZ TISSUE ADHESIVE(S) ONLY,54.15,40.61,0.65,48.74,119
CDM,761G026901,HC PLACE VENOUS/ART DEVICE,1186.26,889.7,14.24,1067.63,119
CDM,7621023697,HC WOUND VAC PUMP DAILY CHARGE ONLY CANYON DESERT REGION,130.27,97.7,1.56,117.24,119
CDM,762G037801,HC OBSERVATION/HR,173.99,130.49,2.09,156.59,119
CDM,762G037842,HC OBSERVATION/HR RADIOLOGY CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037843,HC OBSERVATION/HR GI CARVEOUT`,173.99,130.49,2.09,156.59,119
CDM,762G037844,HC OBSERVATION/HR CARDIOLOGY CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037845,HC OBSERVATION/HR RESPIRATORY CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037846,HC OBSERVATION/HR ECHO CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037847,HC OBSERVATION/HR PT OT SLP CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037848,HC OBSERVATION/HR DIALYSIS CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037849,HC OBSERVATION/HR INFUSION INJECTION CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037850,HC OBSERVATION/HR RC 361 CARVEOUT,173.99,130.49,2.09,156.59,119
CDM,762G037901,HC OBSERVATION DIRECT ADMIT,970.68,728.01,11.65,873.61,119
CDM,7711,TAMOXIFEN 10 MG TABLET,1.15,0.86,0.01,1.03,119
CDM,7719046072,HC VFC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,22.44,16.83,0.27,20.2,119
CDM,7719047101,HC IMMUNIZATION ADMIN;ONE VACCINE,35.27,26.45,0.42,31.74,119
CDM,7719047106,HC ADMIN INFLUENZA VACCINE,153.13,114.85,1.84,137.82,119
CDM,7719047107,HC ADMIN PNEUMOCOCCAL VACCINE,18.72,14.04,0.22,16.85,119
CDM,7719047108,HC ADMIN HEPATITIS B VACCINE,38.41,28.81,0.46,34.57,119
CDM,7719047109,HC VFC-ADMIN IMMUNIZATION 1 VACCINE,22.44,16.83,0.27,20.2,119
CDM,7719047201,HC IMMUNIZATION ADMIN EACH ADDL VACC,30.96,23.22,0.37,27.86,119
CDM,7719047206,HC ADMIN INFLUENZA AS SECOND VACCINE,20.27,15.2,0.24,18.24,119
CDM,7719047208,HC ADMIN HEPATITIS B AS SECOND VACCINE,20.27,15.2,0.24,18.24,119
CDM,7719047209,HC VFC-ADMIN IMMUNIZTN EA ADDL VACCINE,22.44,16.83,0.27,20.2,119
CDM,7719047301,HC ADMIN IMMUNE ORAL/NASAL 1 VACCINE,117.88,88.41,1.41,106.09,119
CDM,7719047309,HC VFC-ADMIN IMNZTN ORAL/NASAL 1 VAC,117.88,88.41,1.41,106.09,119
CDM,7719047401,HC ADMIN IMMUNIZATION ORAL/NASAL ADDL VACC,42.64,31.979999999999997,0.51,38.58,238
CDM,7719047409,HC VFC-ADMIN IMMUNZTN ORAL/NASAL ADDL VACC,42.87,32.15,0.51,38.58,119
CDM,7719048001,HC IMM ADMN SARSCOV2 VACCINE SINGLE DOSE,117.88,88.41,1.41,106.09,119
CDM,7719048072,HC VFC-ADMN SARSCOV2 VACC 1 DOSE,15.27,11.45,0.18,13.74,119
CDM,7719638001,HC ADMN RSV MONOC ANTB SEASONAL DOS IM CNSL PHY/QHP,59.57,44.68,0.71,53.61,119
CDM,7719638101,HC ADMN RSV MONOCLONAL ANTB SEASONAL DOSE IM NJX,59.57,44.68,0.71,53.61,119
CDM,7719638109,HC VFC - ADMN RSV MONOCLONAL ANTB SEASONAL DOSE IM NJX,20.72,15.54,0.25,18.65,119
CDM,77411,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,72.0,54.0,0.86,64.8,119
CDM,77412,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,63.0,47.25,0.72,59.41,238
CDM,7753,TEMAZEPAM 15 MG CAPSULE,0.56,0.42,0.01,0.5,119
CDM,77725,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,24.3,18.23,0.29,21.87,119
CDM,7784,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,60.375,45.28,0.72,54.68,238
CDM,7796,TETRACYCLINE 250 MG CAPSULE,9.99,7.49,0.12,8.99,119
CDM,780Q301401,HC TELEHEALTH FACILITY FEE,107.49,80.62,1.29,96.74,119
CDM,7821,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,448.4,336.3,5.38,403.56,119
CDM,7876,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,56.32,42.24,0.5,53.73,714
CDM,78879,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,8.5,6.37,0.1,7.65,119
CDM,7994,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,71.91,53.934999999999995,0.14,118.75,238
CDM,7995,TOBRAMYCIN 0.3 % EYE DROPS,30.0,22.5,0.36,27.0,119
CDM,8010692T01,HC ULTRAFILTRATION ONLY,2905.86,2179.4,34.87,2615.27,119
CDM,8011045497,HC CONTINUOUS RENAL REPLACMT THERAPY,3530.26,2647.7,42.36,3177.23,119
CDM,8019093501,HC HEMODIALYSIS INP,2931.63,2198.72,35.18,2638.47,119
CDM,8019099901,HC HEMO-DIALYSIS TREATMENT,1860.36,1395.27,22.32,1674.32,119
CDM,8020,TOLNAFTATE 1 % TOPICAL CREAM,13.14,9.86,0.16,11.83,119
CDM,8029094501,HC PERITONEAL DIALYSIS NON-CAPD,1346.81,1010.11,16.16,1212.13,119
CDM,8039094501,HC CAPD-CONT AMBULATORY PERITONEAL DIALYSIS,920.54,690.4,11.05,828.49,119
CDM,804,VITAMIN B COMPLEX CAPSULE,0.34,0.26,0.01,0.31,119
CDM,8049094501,HC CCPD-CONTINUOUS CYCLING PERITONEAL DIALYSIS,1292.68,969.51,15.51,1163.41,119
CDM,8084,TRAZODONE 150 MG TABLET,1.43,1.08,0.02,1.29,119
CDM,8085,TRAZODONE 50 MG TABLET,0.28,0.21,0.01,0.25,119
CDM,8112,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,42.72,32.04,0.51,38.45,119
CDM,8113,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,47.52,35.64,0.25,117.68,357
CDM,8117,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,29.61,22.21,0.36,26.65,119
CDM,8118,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,27.09,20.32,0.29,181.42,595
CDM,8121,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,300.0,225.0,3.6,270.0,119
CDM,8121024297,HC KIDNEY CADAVERIC ACQUISITION,190366.81,142775.11,2284.4,171330.13,119
CDM,8121024497,HC LIVER CADAVERIC ACQUISITION,302887.69,227165.77,3634.65,272598.92,119
CDM,8121024597,HC LIVING KIDNEY ACQUISITION,284863.57,213647.68,3418.36,256377.21,119
CDM,8121024697,HC LIVING LIVER ACQUISITION,453535.81,340151.86,5442.43,408182.23,119
CDM,8121030697,HC HEART ACQUISITION,627.05,470.29,7.52,564.34,119
CDM,8121030897,HC PANCREAS ACQUISITION,154512.43,115884.32,1854.15,139061.19,119
CDM,8123394001,HC HEART TRANSPLANT ACQUISITION,239549.33,179662.0,2874.59,215594.4,119
CDM,8132,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,1.24,0.93,0.01,1.12,119
CDM,8134,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,1.69,1.27,0.02,1.52,119
CDM,8139,TRIAZOLAM 0.25 MG TABLET,4.5,3.38,0.05,4.05,119
CDM,8161,TRIFLUOPERAZINE 1 MG TABLET,6.71,5.04,0.08,6.04,119
CDM,8166,TRIHEXYPHENIDYL 2 MG TABLET,0.9,0.68,0.01,0.81,119
CDM,8178,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,272.82,204.61,3.27,245.54,119
CDM,8182,TRIMETHOPRIM 100 MG TABLET,11.18,8.38,0.13,10.06,119
CDM,8209093501,HC NON-ROUTINE/NON-ESRD DIALYSIS OP,2931.63,2198.72,35.18,2638.47,119
CDM,82181,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,85.17,63.875,0.17,140.45,357
CDM,8219093541,HC HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,2931.63,2198.72,35.18,2638.47,119
CDM,8219099301,HC HOME DIALYSIS TRAINING HD PER TRAINING SESSION,339.29,254.47,4.07,305.36,238
CDM,8219099901,HC OP/HOME HEMO-DIALYSIS TREATMENT,1582.14,1186.6,18.99,1423.93,119
CDM,821G025701,HC OUTPT UNSCHD EMERGENT HEMODIAL,2811.94,2108.96,33.74,2530.75,119
CDM,821G049101,HC DIALYSIS ACU KIDNEY NO ESRD,2030.75,1523.06,24.37,1827.68,238
CDM,8250,TROPICAMIDE 1 % EYE DROPS,117.315,87.985,0.61,165.24,238
CDM,82640,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",0.23,0.18,0.01,0.21,119
CDM,829G025701,HC NON-ROUTINE ESRD DIALYSIS OP,2811.94,2108.96,33.74,2530.75,119
CDM,83669,BENZOCAINE 10 % MUCOSAL GEL,32.09,24.07,0.39,28.88,119
CDM,83680,LOSARTAN 50 MG TABLET,4.05,3.04,0.05,3.64,119
CDM,83686,QUETIAPINE 25 MG TABLET,1.74,1.3,0.02,1.57,119
CDM,83698,CELECOXIB 200 MG CAPSULE,6.5200000000000005,4.890000000000001,0.01,10.76,238
CDM,83701,"TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR",6.0,4.5,0.07,5.4,119
CDM,83754,PRAMIPEXOLE 1 MG TABLET,6.63,4.97,0.08,5.97,119
CDM,83774,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,231.085,173.315,0.72,362.22,238
CDM,83779,RIVASTIGMINE 1.5 MG CAPSULE,2.0,1.5,0.02,1.8,119
CDM,83781,LATANOPROST 0.005 % EYE DROPS,23.28,17.46,0.18,28.4,238
CDM,83786,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,300.83500000000004,225.625,2.38,363.3,357
CDM,83825,AMINO ACID 5 % NO.6-DEXTROSE 20 %-ELECTROLYTES NO.23 IV SOLUTION,270.0,202.5,3.24,243.0,119
CDM,83834,PIOGLITAZONE 15 MG TABLET,0.8,0.6,0.01,0.72,119
CDM,83840,ATORVASTATIN 40 MG TABLET,2.085,1.56,0.02,2.03,238
CDM,83873,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1048.52,786.39,12.58,943.67,119
CDM,83900,ALENDRONATE 10 MG TABLET,2.0,1.5,0.02,1.8,119
CDM,83903,IVERMECTIN 3 MG TABLET,24.85,18.63,0.3,22.36,119
CDM,83913,CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,12.51,9.38,0.15,11.26,119
CDM,83918,VALGANCICLOVIR 450 MG TABLET,24.405,18.305,0.29,22.5,238
CDM,83921,ANASTROZOLE 1 MG TABLET,5.44,4.08,0.07,4.9,119
CDM,83924,"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",18.22,13.66,0.22,16.4,119
CDM,83944,BICALUTAMIDE 50 MG TABLET,4.55,3.41,0.05,4.1,119
CDM,83950,FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,698.76,524.07,8.39,628.88,119
CDM,83962,ATORVASTATIN 80 MG TABLET,2.6,1.95,0.03,2.34,119
CDM,83963,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,254.36,190.77,3.05,228.92,238
CDM,83969,OXCARBAZEPINE 150 MG TABLET,1.8,1.35,0.02,1.62,119
CDM,83975,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
CDM,84008,EPINEPHRINE 1 MG/ML NASAL SOLUTION,540.0,405.0,6.48,486.0,119
CDM,84014,DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,2.4,1.8,0.03,2.16,119
CDM,84027,CARVEDILOL 6.25 MG TABLET,0.56,0.42,0.01,0.5,119
CDM,84033,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",1.4,1.05,0.02,1.26,119
CDM,84063,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,190.26,142.7,2.28,171.23,238
CDM,84102,IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,193.54,145.15,2.32,174.19,119
CDM,84121,ATORVASTATIN 20 MG TABLET,1.81,1.36,0.02,1.63,119
CDM,84133,CARVEDILOL 12.5 MG TABLET,0.58,0.44,0.01,0.52,119
CDM,84156,ROPINIROLE 1 MG TABLET,3.4,2.55,0.04,3.06,119
CDM,84160,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,13902.87,10427.15,166.83,12512.58,119
CDM,84166,DONEPEZIL 5 MG TABLET,0.81,0.61,0.01,0.73,119
CDM,84169,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,4950.35,3712.76,59.4,4455.32,119
CDM,84189,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,385.56,289.17,4.63,347.0,119
CDM,8419094501,HC PERITONEAL DIALYSIS CAPD OP/HOME,1001.54,751.16,12.02,901.39,119
CDM,8419099301,HC HOME DIALYSIS TRAINING CAPD PER TRAINING SESSION,353.48,265.11,4.24,318.13,119
CDM,84220,FLUCYTOSINE 500 MG CAPSULE,90.0,67.5,1.08,81.0,119
CDM,84226,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,119.24,89.43,1.43,107.32,238
CDM,84248,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,208.235,156.175,1.22,283.21,357
CDM,84257,FAT EMULSION 20 % INTRAVENOUS,264.0,198.0,3.17,237.6,119
CDM,8429,VALPROIC ACID 250 MG CAPSULE,2.57,1.93,0.03,2.31,119
CDM,84303,REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,521.24,390.92999999999995,6.1,480.39,357
CDM,84352,"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",1.06,0.79,0.01,0.95,119
CDM,84384,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,192.45,144.34,2.31,173.2,238
CDM,84386,LAMIVUDINE 100 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,8442,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",36.0,27.0,0.19,65.93,952
CDM,84420,CETIRIZINE 10 MG TABLET,0.7150000000000001,0.535,0.01,0.79,238
CDM,84426,ATORVASTATIN 10 MG TABLET,1.48,1.11,0.02,1.33,119
CDM,8443,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,33.485,25.11,0.22,44.07,476
CDM,84437,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,2889.77,2167.33,34.68,2600.79,119
CDM,84467,IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,268.44,201.33,3.22,241.6,119
CDM,84476,DANTROLENE 20 MG INTRAVENOUS SOLUTION,294.28,220.71,3.49,331.07,357
CDM,84489,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,200.76,150.57,2.41,180.68,119
CDM,84492,FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET,249.0,186.75,2.99,224.1,119
CDM,84494,BENZOCAINE 20 %-MENTHOL 0.5 % TOPICAL AEROSOL,33.15,24.86,0.4,29.84,119
CDM,84501,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,9.59,7.2,0.12,8.63,238
CDM,84543,CANDESARTAN 4 MG TABLET,14.38,10.78,0.17,12.94,119
CDM,84552,"ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE",7.5,5.62,0.09,6.75,119
CDM,84598,RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,0.28,0.21,0.01,0.25,119
CDM,84602,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",2.71,2.03,0.03,2.44,119
CDM,84608,LIOTHYRONINE 25 MCG TABLET,6.0,4.5,0.07,5.4,119
CDM,84610,LEVETIRACETAM 500 MG TABLET,2.18,1.63,0.03,1.96,119
CDM,84612,DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,268.65,201.49,1.66,358.99,238
CDM,84639,VALACYCLOVIR 1 GRAM TABLET,7.7,5.77,0.09,6.93,119
CDM,84649,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,1838.52,1378.89,22.06,1654.67,119
CDM,84669,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,7011.0,5258.25,84.13,6309.9,119
CDM,84674,SUMATRIPTAN 100 MG TABLET,10.63,7.97,0.13,9.57,119
CDM,84702,HYALURONIDASE 150 UNIT/ML INJECTION SOLUTION,231.57,173.68,2.78,208.41,119
CDM,84711,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,1.19,0.89,0.01,1.07,119
CDM,84718,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,134.91,101.18,1.62,121.42,238
CDM,84738,CADEXOMER IODINE 0.9 % TOPICAL GEL,513.12,384.84,6.16,461.81,119
CDM,84764,TOLTERODINE 1 MG TABLET,3.7199999999999998,2.79,0.03,4.5,238
CDM,84795,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,344.45,258.34,4.13,310.0,238
CDM,84810,"BRINZOLAMIDE 1 % EYE DROPS,SUSPENSION",1388.56,1041.42,16.66,1249.7,119
CDM,84821,DONEPEZIL 10 MG TABLET,0.7,0.53,0.01,0.63,119
CDM,84833,"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",5.5,4.12,0.07,4.95,119
CDM,84855,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,35.02,26.27,0.42,31.52,119
CDM,84857,SUMATRIPTAN 25 MG TABLET,10.63,7.97,0.13,9.57,119
CDM,84885,ELECTROLYTE-P IN DEXTROSE 5 % INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
CDM,84904,ALENDRONATE 70 MG TABLET,6.75,5.06,0.08,6.08,119
CDM,84907,DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,194.4,145.8,2.33,174.96,119
CDM,84952,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",27.02,20.27,0.07,48.6,357
CDM,84968,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",869.25,651.94,6.7,1744.2,1309
CDM,84991,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,33.0,24.75,0.29,37.8,238
CDM,850,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,13.29,9.97,0.16,11.96,119
CDM,85023,DEXTROSE 40 % ORAL GEL,4.285,3.215,0.01,6.8,357
CDM,85030,ETHACRYNIC ACID 25 MG TABLET,13.5,10.12,0.16,12.15,119
CDM,85060,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1217.25,912.94,14.61,1095.53,238
CDM,85065,QUETIAPINE 200 MG TABLET,0.73,0.54,0.01,0.66,119
CDM,85078,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,54.5,40.87,0.65,49.05,119
CDM,85087,LIDOCAINE 4 % TOPICAL CREAM,42.0,31.5,0.5,37.8,238
CDM,85091,OLANZAPINE 5 MG TABLET,1.39,1.04,0.02,1.25,119
CDM,85094,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,8025.68,6019.26,96.31,7223.11,119
CDM,85161,MICONAZOLE NITRATE 2 % TOPICAL POWDER,33.15,24.86,0.4,29.84,119
CDM,85172,DOFETILIDE 250 MCG CAPSULE,1.93,1.45,0.02,1.74,119
CDM,85181,GALANTAMINE 4 MG TABLET,3.95,2.96,0.05,3.56,119
CDM,85190,ACARBOSE 50 MG TABLET,1.98,1.48,0.02,1.78,119
CDM,8519094501,HC CCPD-CONTINUOUS CYCLING PERITONEAL DIALYSIS OP/HOME,1292.68,969.51,15.51,1163.41,119
CDM,8519099301,HC HOME DIALYSIS TRAINING CCPD PER TRAINING SESSION,339.29,254.47,4.07,305.36,119
CDM,85215,MOXIFLOXACIN 400 MG TABLET,17.65,13.23,0.21,15.88,119
CDM,85220,CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,413.8,310.35,4.97,372.42,119
CDM,85243,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,17.82,13.36,0.2,26.41,714
CDM,85250,RIFABUTIN 150 MG CAPSULE,60.0,45.0,0.72,54.0,119
CDM,8527,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CDM,85270,"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",1.67,1.25,0.02,1.5,119
CDM,85273,SUMATRIPTAN 50 MG TABLET,10.63,7.97,0.13,9.57,119
CDM,85277,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,267.66,200.74,3.21,240.89,119
CDM,8528,VERAPAMIL 120 MG TABLET,0.53,0.4,0.01,0.48,119
CDM,8529,VERAPAMIL 40 MG TABLET,0.93,0.7,0.01,0.84,119
CDM,85293,TEMOZOLOMIDE 100 MG CAPSULE,112.44,84.33,1.35,101.2,119
CDM,85299,DOFETILIDE 125 MCG CAPSULE,2.0,1.5,0.02,1.8,119
CDM,85302,TRAVOPROST 0.004 % EYE DROPS,567.3299999999999,425.5,6.75,514.94,238
CDM,85306,FELBAMATE 400 MG TABLET,8.86,6.65,0.11,7.97,119
CDM,85360,METHYLERGONOVINE 0.2 MG TABLET,74.25,55.69,0.89,66.82,119
CDM,85364,TIAGABINE 4 MG TABLET,38.09,28.57,0.46,34.28,119
CDM,85382,LEVONORGESTREL 0.15 MG-ETHINYL ESTRADIOL 0.03 MG TABLET,1.1,0.82,0.01,0.99,119
CDM,85403,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1125.64,844.23,13.51,1013.08,119
CDM,85405,OLANZAPINE 10 MG TABLET,1.22,0.91,0.01,1.1,119
CDM,85422,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,7.13,5.35,0.09,6.42,238
CDM,85441,TIAGABINE 2 MG TABLET,38.09,28.57,0.46,34.28,119
CDM,85443,TOPIRAMATE 25 MG TABLET,0.4,0.3,0.01,0.36,119
CDM,85459,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,442.31,331.73,5.31,398.08,119
CDM,85464,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,42.96,32.22,0.5,40.5,476
CDM,85491,RISPERIDONE 0.25 MG TABLET,1.0,0.75,0.01,0.9,119
CDM,85496,"ERYTHROMYCIN 250 MG TABLET,DELAYED RELEASE",29.93,22.45,0.36,26.94,119
CDM,85526,OXCARBAZEPINE 300 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,85535,PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,2.03,1.52,0.02,1.83,119
CDM,85565,PHENYTOIN 50 MG CHEWABLE TABLET,2.53,1.89,0.03,2.28,119
CDM,856,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",137.53,103.15,1.65,123.78,119
CDM,85620,LEVOFLOXACIN 250 MG TABLET,2.02,1.51,0.02,1.82,119
CDM,85630,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,1.77,1.325,0.02,2.05,238
CDM,85659,CAPECITABINE 500 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,85678,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,103.86,77.9,1.25,93.47,119
CDM,85687,"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",2.14,1.6,0.03,1.93,119
CDM,85703,PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,0.7,0.53,0.01,0.63,119
CDM,85705,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,127.44,95.58,1.53,114.7,238
CDM,85711,VALACYCLOVIR 500 MG TABLET,4.45,3.34,0.05,4.0,119
CDM,85735,OLANZAPINE 2.5 MG TABLET,1.18,0.88,0.01,1.06,119
CDM,85753,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,259.92,194.94,2.89,250.29,476
CDM,85760,LIOTHYRONINE 5 MCG TABLET,4.63,3.47,0.06,4.17,119
CDM,85774,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,755.1949999999999,566.395,8.89,692.38,238
CDM,85792,QUETIAPINE 100 MG TABLET,2.82,2.11,0.03,2.54,119
CDM,85800,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),143.1,107.32,1.72,128.79,119
CDM,85811,PRAZIQUANTEL 600 MG TABLET,275.68,206.76,3.31,248.11,119
CDM,85863,SINCALIDE 5 MCG SOLUTION FOR INJECTION,567.02,425.26,6.8,510.32,238
CDM,85887,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6171.05,4628.29,74.05,5553.95,119
CDM,85891,VANCOMYCIN 125 MG CAPSULE,15.0,11.25,0.18,13.5,238
CDM,85892,GUAR GUM ORAL PACKET,2.86,2.15,0.03,2.57,119
CDM,85900,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,1800.0,1350.0,21.6,1620.0,119
CDM,85904,CARVEDILOL 3.125 MG TABLET,0.55,0.41,0.01,0.5,119
CDM,85911,MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRANULES,10.9,8.17,0.13,9.81,119
CDM,8594,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,228.48,171.36,2.74,205.63,119
CDM,85950,FLUORESCEIN 1 MG EYE STRIPS,1.26,0.94,0.02,1.13,238
CDM,85966,LAMOTRIGINE 25 MG TABLET,0.68,0.51,0.01,0.92,238
CDM,8597,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,41.665,31.25,0.3,52.32,238
CDM,85981,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,33.12,24.84,0.4,29.81,119
CDM,85983,DISULFIRAM 250 MG TABLET,58.0,43.5,0.7,52.2,119
CDM,85997,PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,36.36,27.27,0.44,32.72,119
CDM,860,BACLOFEN 10 MG TABLET,2.59,1.94,0.03,2.5,238
CDM,86007,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,396.03,297.02,4.75,356.43,238
CDM,86021,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,12.94,9.7,0.16,11.65,119
CDM,86023,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,8572.56,6429.42,102.87,7715.3,119
CDM,86035,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,18260.83,13695.62,219.13,16434.75,119
CDM,86041,"PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE",1.48,1.11,0.02,1.33,119
CDM,86049,PHENOXYBENZAMINE 10 MG CAPSULE,123.75,92.81,1.48,111.38,119
CDM,86051,"PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION",721.8,541.35,8.66,649.62,119
CDM,86054,KETOROLAC 0.5 % EYE DROPS,180.18,135.135,2.02,173.12,238
CDM,86069,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.6,4.95,0.08,5.94,119
CDM,86083,PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,34.69,26.02,0.42,31.22,119
CDM,861,BACLOFEN 20 MG TABLET,1.61,1.21,0.02,1.45,119
CDM,86102,PRAMIPEXOLE 0.5 MG TABLET,5.0,3.75,0.06,4.5,119
CDM,86119,DRONABINOL 2.5 MG CAPSULE,26.82,20.11,0.13,38.21,357
CDM,86146,RISPERIDONE 2 MG TABLET,1.3,0.98,0.02,1.17,119
CDM,86175,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,704.67,528.5,8.46,634.2,119
CDM,86189,BISACODYL 10 MG/30 ML ENEMA,14.43,10.82,0.17,12.99,119
CDM,86195,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,136.66,102.5,1.64,122.99,238
CDM,86200,ALENDRONATE 35 MG TABLET,7.79,5.84,0.09,7.01,119
CDM,86212,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,300.0,225.0,3.6,270.0,119
CDM,86266,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,7589.54,5692.155,60.27,9140.85,238
CDM,86267,CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,5753.68,4315.26,69.04,5178.31,119
CDM,86278,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,599.67,449.76,4.48,623.33,357
CDM,86288,ENTACAPONE 200 MG TABLET,3.6,2.7,0.04,3.24,119
CDM,86294,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,8.32,6.234999999999999,0.09,8.23,357
CDM,86301,OFLOXACIN 0.3 % EAR DROPS,90.0,67.5,1.08,81.0,119
CDM,86329,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,49.5,37.12,0.59,44.55,238
CDM,86341,ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,1757.4,1318.05,21.09,1581.66,119
CDM,86354,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,284.4,213.3,3.41,255.96,119
CDM,86374,ZIPRASIDONE 20 MG CAPSULE,16.69,12.51,0.2,15.02,119
CDM,8639,"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",0.25,0.19,0.01,0.22,119
CDM,8641,"VITAMIN A 2,400 MCG CAPSULE",0.2,0.15,0.01,0.18,119
CDM,86428,SIROLIMUS 1 MG/ML ORAL SOLUTION,3570.12,2677.59,42.84,3213.11,119
CDM,86460,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,82.08,61.56,0.98,73.87,119
CDM,86476,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,11.7,8.77,0.14,10.53,119
CDM,86484,PYRETHRINS 0.33 %-PIPERONYL BUTOXIDE 4 % SHAMPOO,49.56,37.17,0.59,44.6,119
CDM,86505,EXEMESTANE 25 MG TABLET,10.0,7.5,0.12,9.0,119
CDM,86510,FAMCICLOVIR 500 MG TABLET,19.38,14.54,0.23,17.44,119
CDM,86511,TRIENTINE 250 MG CAPSULE,42.0,31.5,0.5,37.8,119
CDM,86524,SIROLIMUS 1 MG TABLET,45.01,33.75,0.54,40.51,119
CDM,86597,TAMSULOSIN 0.4 MG CAPSULE,2.38,1.78,0.03,2.14,119
CDM,86605,LINEZOLID 600 MG TABLET,21.0,15.75,0.25,18.9,119
CDM,86610,LEVETIRACETAM 250 MG TABLET,1.61,1.21,0.02,1.45,119
CDM,86655,ROPINIROLE 0.25 MG TABLET,0.72,0.54,0.01,0.65,119
CDM,86714,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,222.0,166.5,2.66,199.8,119
CDM,86752,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,38.99,29.24,0.47,35.09,119
CDM,86757,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.25,29.7,833
CDM,86760,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,349.03499999999997,261.78,4.16,316.41,238
CDM,86761,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,6389.64,4792.23,76.68,5750.68,119
CDM,86789,"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",7.81,5.86,0.09,7.03,119
CDM,86791,COLESEVELAM 625 MG TABLET,2.5,1.88,0.03,2.25,119
CDM,86801,DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLUTION,258.0,193.5,2.22,298.08,238
CDM,86804,IOPAMIDOL 200 MG IODINE/ML (41 %) INJECTION SOLUTION,131.4,98.55,1.58,118.26,119
CDM,86822,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,311.73,233.8,3.49,299.66,357
CDM,86828,RIZATRIPTAN 10 MG DISINTEGRATING TABLET,12.24,9.18,0.15,11.02,119
CDM,86866,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,260.1,195.08,0.61,244.62,714
CDM,86880,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,562.5,421.88,6.75,506.25,238
CDM,86889,MIFEPRISTONE 200 MG TABLET,193.5,145.12,2.32,174.15,119
CDM,86898,IOHEXOL 240 MG IODINE/ML INTRAVENOUS SOLUTION,248.22,186.16500000000002,2.82,235.12,238
CDM,86905,ROPINIROLE 2 MG TABLET,2.76,2.07,0.03,2.48,119
CDM,86909,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,36.33,27.244999999999997,0.4,35.1,595
CDM,86923,IOPAMIDOL 250 MG IODINE/ML (51 %) INTRAVENOUS SOLUTION,187.65,140.74,1.62,216.0,238
CDM,86924,"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",1.8,1.35,0.02,1.62,119
CDM,86946,ACYCLOVIR 5 % TOPICAL OINTMENT,180.0,135.0,2.16,162.0,119
CDM,86964,OSELTAMIVIR 75 MG CAPSULE,15.0,11.25,0.18,13.5,119
CDM,87019,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,16567.24,12425.43,198.81,14910.52,119
CDM,87023,DICLOFENAC 0.1 % EYE DROPS,84.0,63.0,1.01,75.6,119
CDM,87027,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,163.75,122.81,1.96,147.38,119
CDM,87036,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION,18.49,13.86,0.22,16.64,119
CDM,87048,MEROPENEM 500 MG INTRAVENOUS SOLUTION,22.68,17.01,0.22,32.4,595
CDM,87066,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,85.2,63.9,0.72,99.36,357
CDM,87070,ROPINIROLE 0.5 MG TABLET,0.72,0.54,0.01,0.65,119
CDM,87071,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,2714.88,2036.16,0.25,7456.32,833
CDM,87080,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,955.2,716.4000000000001,11.01,893.38,238
CDM,87096,HYDROCORTISONE 1 %-PRAMOXINE 1 % RECTAL FOAM,833.04,624.78,10.0,749.74,119
CDM,87101,CEVIMELINE 30 MG CAPSULE,12.72,9.54,0.15,11.45,119
CDM,87129,"DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",310.5,232.88,3.73,279.45,119
CDM,87165,METHYLCELLULOSE (LAXATIVE) 500 MG TABLET,0.89,0.67,0.01,0.8,119
CDM,87169,CYCLOPENTOLATE 2 % EYE DROPS,198.72,149.04,2.38,178.85,119
CDM,87181,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,39.03,29.27,0.42,38.39,476
CDM,87187,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,278.43,208.82,3.21,260.28,238
CDM,87189,ALBENDAZOLE 200 MG TABLET,180.0,135.0,2.16,162.0,119
CDM,87194,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,2280.8,1710.605,16.22,2888.78,238
CDM,87199,"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",0.58,0.43,0.01,0.52,119
CDM,87219,"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",3.37,2.52,0.04,3.03,119
CDM,87222,LIDOCAINE 5 % TOPICAL PATCH,17.97,13.48,0.22,16.17,238
CDM,87239,POVIDONE-IODINE 5 % EYE SOLUTION,52.915,39.69,0.04,92.18,238
CDM,87242,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,4662.49,3496.87,55.95,4196.24,119
CDM,87251,"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",62.1,46.58,0.75,55.89,119
CDM,87264,CARBACHOL 0.01 % INTRAOCULAR SOLUTION,201.06,150.8,2.41,180.95,119
CDM,87288,CANDESARTAN 16 MG TABLET,14.38,10.78,0.17,12.94,119
CDM,87297,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,37.35,28.009999999999998,0.38,38.88,357
CDM,87305,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,212.5,159.38,2.55,191.25,238
CDM,87313,FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,636.0,477.0,7.63,572.4,119
CDM,87316,FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,918.72,689.04,11.02,826.85,119
CDM,87332,URSODIOL 250 MG TABLET,4.5,3.38,0.05,4.05,119
CDM,87334,CONJUGATED ESTROGENS 0.625 MG TABLET,42.43,31.82,0.51,38.19,119
CDM,87335,HYDROCORTISONE ACETATE 30 MG RECTAL SUPPOSITORY,35.5,26.62,0.43,31.95,119
CDM,87336,LOSARTAN 25 MG TABLET,0.84,0.63,0.01,0.76,119
CDM,87356,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,17649.27,13236.95,211.79,15884.34,119
CDM,87360,"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",4.47,3.35,0.05,4.02,119
CDM,87426,INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,267.66,200.74,3.21,240.89,119
CDM,8748,WARFARIN 10 MG TABLET,1.995,1.495,0.02,1.96,238
CDM,8749,WARFARIN 2 MG TABLET,1.825,1.37,0.02,2.05,238
CDM,87499,OLANZAPINE 10 MG DISINTEGRATING TABLET,15.25,11.43,0.18,13.72,119
CDM,8750,WARFARIN 2.5 MG TABLET,2.59,1.945,0.02,3.39,238
CDM,87503,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",2012.08,1509.06,24.14,1810.87,119
CDM,8751,WARFARIN 5 MG TABLET,1.43,1.07,0.02,1.29,119
CDM,8752,WARFARIN 7.5 MG TABLET,2.43,1.825,0.02,3.12,238
CDM,87529,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,359.8,269.85,4.32,323.82,119
CDM,87546,NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL,841.78,631.34,10.1,757.6,119
CDM,87567,SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,6.38,4.79,0.08,5.74,119
CDM,87584,PRAMIPEXOLE 0.125 MG TABLET,0.67,0.5,0.01,0.6,119
CDM,87599,ZAFIRLUKAST 20 MG TABLET,10.81,8.11,0.13,9.73,119
CDM,87628,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.62,31.96,0.17,54.28,595
CDM,87631,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,720.3,540.225,7.26,751.68,238
CDM,87641,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,450.0,337.5,5.4,405.0,119
CDM,87646,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,22089.72,16567.29,265.08,19880.75,119
CDM,87654,RILUZOLE 50 MG TABLET,3.99,2.99,0.05,3.59,119
CDM,87679,ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,397.91,298.43,4.77,358.12,119
CDM,87680,KETAMINE 10 MG/ML INJECTION SOLUTION,115.8,86.85,1.39,104.22,238
CDM,87697,PRAMIPEXOLE 0.25 MG TABLET,0.67,0.5,0.01,0.6,119
CDM,87729,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,195.78,146.835,1.71,224.1,238
CDM,87731,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,47.44,35.58,0.57,42.7,119
CDM,87735,TOBRAMYCIN 0.3 % EYE OINTMENT,1057.33,793.0,12.69,951.6,119
CDM,87743,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,23.445,17.585,0.12,33.29,238
CDM,87748,BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET,0.46,0.34,0.01,0.41,119
CDM,87780,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,55.82,41.87,0.67,50.24,238
CDM,87799,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,229.33499999999998,172.0,1.9,270.0,238
CDM,87834,RALOXIFENE 60 MG TABLET,9.3,6.98,0.11,8.37,119
CDM,87868,BENZTROPINE 1 MG/ML INJECTION SOLUTION,270.0,202.5,3.24,243.0,238
CDM,87942,"VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE",29.26,21.95,0.35,26.33,119
CDM,87952,NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,14.53,10.9,0.17,13.08,119
CDM,87953,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,2.03,1.53,0.02,1.83,119
CDM,87977,CIPROFLOXACIN 0.3 % EYE OINTMENT,1128.17,846.13,13.54,1015.35,119
CDM,87981,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,210.0,157.5,2.52,189.0,119
CDM,87989,"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",5.6,4.2,0.05,6.3,238
CDM,87990,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,62.82,47.12,0.75,56.54,238
CDM,88007,MONTELUKAST 10 MG TABLET,0.39,0.29,0.01,0.35,119
CDM,88041,LAMIVUDINE 10 MG/ML ORAL SOLUTION,498.24,373.68,0.36,613.01,595
CDM,88057,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,0.41,0.31,0.01,0.37,119
CDM,88089,FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,1244.05,933.04,14.93,1119.64,119
CDM,8809098901,HC OP DIALYSIS TRAINING COMPLETE,5289.61,3967.21,63.48,4760.65,119
CDM,8809099301,HC OP DIALYSIS TRAINING RE-EVALUATION,326.39,244.79,3.92,293.75,119
CDM,8810692T01,HC ULTRAFILTRATION OP ONLY,1734.38,1300.79,20.81,1560.94,119
CDM,88111,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,139.41,104.56,1.67,125.47,119
CDM,88121,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,13.51,10.13,0.16,12.16,119
CDM,88123,LEVETIRACETAM 750 MG TABLET,2.67,2.0,0.03,2.4,119
CDM,88174,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,1423.0,1067.25,17.08,1280.7,119
CDM,88190,ZIPRASIDONE 40 MG CAPSULE,5.11,3.83,0.06,4.6,119
CDM,88213,BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,12285.16,9213.87,147.42,11056.64,119
CDM,88265,ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,238
CDM,88271,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,24.85,18.63,0.3,22.36,238
CDM,88278,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,180.0,135.0,2.16,162.0,119
CDM,88285,COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,1800.0,1350.0,21.6,1620.0,119
CDM,88286,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,422.1,316.58,1.84,1371.6,1071
CDM,88313,DOXYLAMINE SUCCINATE 25 MG TABLET,1.4,1.05,0.02,1.26,119
CDM,88324,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,89.44,67.08,1.07,80.5,238
CDM,88351,"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",5.92,4.44,0.07,5.33,119
CDM,88353,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,289.2,216.9,1.8,529.58,476
CDM,88365,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",622.5,466.88,7.47,560.25,238
CDM,88373,FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,562.32,421.74,6.75,506.09,238
CDM,88401,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,72.54,54.4,0.87,65.29,119
CDM,88433,LEVOFLOXACIN 500 MG TABLET,2.32,1.74,0.03,2.09,119
CDM,88443,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,18.95,14.22,0.23,17.06,119
CDM,88444,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,431.97,323.98,5.18,388.77,119
CDM,88466,LEVOFLOXACIN 750 MG TABLET,4.33,3.25,0.05,3.9,119
CDM,88467,LETROZOLE 2.5 MG TABLET,1.8,1.35,0.02,1.62,119
CDM,88481,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,741.01,555.76,0.68,1282.52,238
CDM,88507,HYDROCODONE 10 MG-CHLORPHENIRAMINE 8 MG/5 ML ORAL SUSP EXTEND.REL 12HR,338.79,254.09,0.18,1231.13,357
CDM,88510,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,176.1,132.075,1.64,194.29,238
CDM,88517,SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,131.25,98.44,1.58,118.12,119
CDM,88518,TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,72.92,54.69,0.88,65.63,119
CDM,88543,ALOE VERA TOPICAL GEL,26.52,19.89,0.32,23.87,119
CDM,88560,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,220.94,165.71,2.65,198.85,238
CDM,88565,ELECTROLYTE-R INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
CDM,88572,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,2300.5150000000003,1725.385,27.33,2090.97,238
CDM,88587,RIZATRIPTAN 5 MG DISINTEGRATING TABLET,12.24,9.18,0.15,11.02,119
CDM,88592,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,0.8,0.6,0.01,0.72,119
CDM,88596,CELECOXIB 100 MG CAPSULE,8.7,6.52,0.1,7.83,119
CDM,88600,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,13.2,9.9,0.16,11.88,119
CDM,88652,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,3076.86,2307.65,36.92,2769.17,119
CDM,88676,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,725.02,543.76,8.7,652.52,238
CDM,88739,TOPIRAMATE 100 MG TABLET,0.7,0.53,0.01,0.63,119
CDM,8874,ZINC OXIDE 20 % TOPICAL OINTMENT,18.0,13.5,0.22,16.2,119
CDM,88750,"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",31.11,23.33,0.37,28.0,119
CDM,88754,TEMOZOLOMIDE 20 MG CAPSULE,36.78,27.58,0.44,33.1,119
CDM,8878,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,184.2,138.15,1.21,412.29,476
CDM,88828,"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",5.03,3.77,0.06,4.53,119
CDM,88848,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,599.61,449.71,7.2,539.65,238
CDM,88852,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",8589.565,6442.17,34.36,12884.35,238
CDM,88853,RISPERIDONE 1 MG TABLET,1.2,0.9,0.01,1.08,119
CDM,88862,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,830.0,622.5,9.96,747.0,238
CDM,88864,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,768.46,576.34,9.22,691.61,119
CDM,88873,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.74,0.555,0.01,1.26,238
CDM,88881,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",6.2,4.654999999999999,0.07,6.21,238
CDM,88886,DOFETILIDE 500 MCG CAPSULE,1.96,1.47,0.02,1.76,119
CDM,88888,INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,512.46,384.34,6.15,461.21,119
CDM,88908,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,96.26,72.19500000000001,0.04,170.42,238
CDM,88962,PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE,8.71,6.53,0.1,7.84,119
CDM,88963,LAMOTRIGINE 100 MG TABLET,0.83,0.63,0.01,0.75,119
CDM,88983,RAMIPRIL 1.25 MG CAPSULE,1.86,1.4,0.02,1.67,119
CDM,88994,RAMIPRIL 5 MG CAPSULE,1.25,0.94,0.02,1.12,119
CDM,88999,BRIMONIDINE 0.15 % EYE DROPS,690.03,517.52,8.28,621.03,119
CDM,89006,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET,0.16,0.12,0.01,0.14,119
CDM,89034,RIVASTIGMINE 3 MG CAPSULE,2.0,1.5,0.02,1.8,119
CDM,89045,ELECTROLYTE-A INTRAVENOUS SOLUTION,102.0,76.5,1.22,91.8,119
CDM,89105,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,217.5,163.12,1.37,387.23,357
CDM,89130,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,124.1,93.07,1.49,111.69,238
CDM,89147,FINASTERIDE 1 MG TABLET,0.5,0.37,0.01,0.45,119
CDM,89158,PROGESTERONE MICRONIZED 100 MG CAPSULE,3.02,2.27,0.04,2.72,119
CDM,89177,HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL CREAM,727.92,545.94,8.74,655.13,119
CDM,89178,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,14.87,11.15,0.18,13.38,119
CDM,89207,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1447.22,1085.42,17.37,1302.5,119
CDM,89210,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,476
CDM,89212,DORZOLAMIDE 2 % EYE DROPS,203.94,152.95,2.45,183.55,119
CDM,89217,CONJUGATED ESTROGENS 0.3 MG TABLET,42.43,31.82,0.51,38.19,119
CDM,89220,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,17.36,13.02,0.21,15.62,238
CDM,89225,ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,178.5,133.88,2.14,160.65,119
CDM,89240,ARTIFICIAL TEARS (HYPROMELLOSE) 0.5 % EYE DROPS,167.76,125.82,2.01,150.98,119
CDM,89241,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",4.535,3.4,0.03,5.67,238
CDM,89242,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,38.01,28.51,0.46,34.21,238
CDM,89246,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1224.92,918.69,14.7,1102.43,119
CDM,89272,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,168.8,126.6,2.03,151.92,119
CDM,89283,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",170.68,128.01,2.05,153.61,238
CDM,89290,OLANZAPINE 5 MG DISINTEGRATING TABLET,5.14,3.85,0.06,4.63,119
CDM,89291,MODAFINIL 100 MG TABLET,2.4,1.8,0.03,2.16,119
CDM,89300,VALSARTAN 160 MG TABLET,2.38,1.78,0.03,2.14,119
CDM,89312,ABACAVIR 300 MG TABLET,40.09,30.07,0.48,36.08,119
CDM,89314,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",269.82,202.365,2.12,326.59,238
CDM,89330,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,11555.42,8666.565,138.64,10401.71,238
CDM,89337,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15438.0,11578.5,185.26,13894.2,119
CDM,89357,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,180.0,135.0,1.08,224.1,357
CDM,8958,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,9.76,7.32,0.12,8.78,238
CDM,8970,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,251.105,188.33,0.27,431.66,238
CDM,8971,ACYCLOVIR 400 MG TABLET,0.76,0.57,0.01,0.68,119
CDM,8975,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,238
CDM,89759,SODIUM HYPOCHLORITE 0.25 % SOLUTION,42.57,31.93,0.51,38.31,119
CDM,89799,"PAROXETINE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",12.6,9.45,0.15,11.34,119
CDM,89800,"PAROXETINE ER 12.5 MG TABLET,EXTENDED RELEASE 24 HR",12.0,9.0,0.14,10.8,119
CDM,8981,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",810.0,607.5,6.48,972.0,357
CDM,8982,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",540.0,405.0,2.36,972.0,476
CDM,9001,ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,669.31,501.98,8.03,602.38,119
CDM,905S948001,HC INTENSIVE OUTPATIENT PSYCHIA,554.28,415.71,6.65,498.85,119
CDM,9065,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,17.5,13.12,0.14,20.69,476
CDM,9066,AMIODARONE 200 MG TABLET,2.2300000000000004,1.67,0.03,2.02,238
CDM,9069,AMLODIPINE 10 MG TABLET,0.26,0.2,0.01,0.23,119
CDM,906H001501,HC ADULT GROUP CDIOP,275.86,206.9,3.31,248.27,119
CDM,9070,AMLODIPINE 2.5 MG TABLET,0.195,0.14500000000000002,0.01,45.75,952
CDM,9071,AMLODIPINE 5 MG TABLET,0.47,0.36,0.01,0.42,119
CDM,9071020097,HC PHP DAY PROGRAM,0.01,0.01,0.01,0.01,119
CDM,91073,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,532.19,399.14,6.39,478.97,119
CDM,91131,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,5020.09,3765.07,57.07,4755.85,357
CDM,91132,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,12550.18,9412.64,150.6,11295.16,119
CDM,91133,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,23225.4,17419.05,278.7,20902.86,119
CDM,91134,TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,46450.71,34838.04,557.41,41805.64,119
CDM,91137,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,16.060000000000002,12.04,0.19,14.96,357
CDM,91138,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,32.22,24.16,0.39,29.0,119
CDM,91139,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,44.4,33.3,0.53,39.96,238
CDM,91140,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,55.92,41.94,0.67,50.33,238
CDM,91141,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,22.08,16.56,0.26,19.87,238
CDM,91222,"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",2.91,2.18,0.03,2.62,119
CDM,91227,"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",7.0,5.25,0.08,6.3,119
CDM,91332,VORICONAZOLE 50 MG TABLET,51.19,38.39,0.61,46.07,119
CDM,91333,VORICONAZOLE 200 MG TABLET,47.05,35.29,0.56,42.34,119
CDM,91334,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,176.05,132.035,1.24,224.1,238
CDM,9149083201,HC PSYTX PT&/FAMILY 30 MINUTES,158.59,118.94,1.9,142.73,119
CDM,9149083401,"HC PSYTX, 45 MIN WITH PATIENT",394.31,295.73,4.73,354.88,119
CDM,9149615601,HC HLTH BHV ASSMT/REASSESSMENT,248.03,186.02,2.98,223.23,119
CDM,9149615801,HC HLTH BHV INVTJ INDIV 1ST 30 MINS,169.55,127.16,2.03,152.6,119
CDM,9149615901,HC HLTH BHV INVTJ INDIV EACH ADDL 15 MINS,60.26,45.2,0.72,54.23,119
CDM,9149896601,HC NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN,38.08,28.56,0.46,34.27,119
CDM,9149896701,HC NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN,70.7,53.02,0.85,63.63,119
CDM,9149896801,HC NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN,105.09,78.82,1.26,94.58,119
CDM,91560,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,155.4,116.55,1.86,139.86,119
CDM,9159085301,HC GROUP THERAPY,138.68,104.01,1.66,124.81,119
CDM,9169084601,HC FAMILY PSYTX W/O PT 50 MIN,208.45,156.34,2.5,187.6,119
CDM,91806,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,44.62,33.47,0.54,40.16,119
CDM,9183,AZATHIOPRINE 50 MG TABLET,4.06,3.04,0.05,3.65,119
CDM,91833,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1668.9,1251.68,20.03,1502.01,119
CDM,9189611601,HC NEUROBEHAVIORAL EXAM,366.15,274.61,4.39,329.54,119
CDM,9209255801,HC EVOKED AUDITORY TST COMPLETE COM CONN,215.09,161.32,2.58,193.58,119
CDM,9209478001,HC CAR SEAT/BD AIRWAY TESTING W/INTERP 60 MIN INFT-12 MO,191.7,143.78,2.3,172.53,119
CDM,9209478101,HC CAR SEAT/BD AIRWAY TESTING W/INTERP EA ADDTL 30 MIN INFT-12 MO,191.7,143.78,2.3,172.53,119
CDM,9209586501,HC NEEDLE ELECTROMYOGRAPHY; LARYNX,293.33,220.0,3.52,264.0,119
CDM,9209592501,HC SOMATOSENSORY EVOK POT UP EXTR,1853.79,1390.34,22.25,1668.41,119
CDM,9209593001,HC VIS EVOKED POTENTIAL PER TEST,1239.37,929.53,14.87,1115.43,119
CDM,9209593301,HC BLINK REFLEX TEST,519.44,389.58,6.23,467.5,119
CDM,9209597201,HC NEUROSTIM ANAL COMPLEX W/PRORAM,644.92,483.69,7.74,580.43,119
CDM,9209612701,HC BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,162.45,121.84,1.95,146.2,119
CDM,9219388001,HC US DUPLEX SCAN CAROTID BILATERAL S&I,1298.32,973.74,15.58,1168.49,119
CDM,9219388201,HC US DUPLEX SCAN CAROTID UNILATERAL,697.03,522.77,8.36,627.33,119
CDM,9219388601,HC US TRANSCRANIAL DOPPLER COMPLT,1442.69,1082.02,17.31,1298.42,119
CDM,9219388801,HC US TRANSCRANIAL DOPPLER LIMITED,932.42,699.32,11.19,839.18,119
CDM,9219389201,HC US INTRACRANIAL DOPPLER EMBOLI,957.97,718.48,11.5,862.17,119
CDM,9219389301,HC TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,1074.23,805.67,12.89,966.81,119
CDM,9219392201,HC UPR/L EXTREMITY ART 1-2 LEVELS BILATERAL,1390.07,1042.55,16.68,1251.06,119
CDM,9219392204,HC UPR/L EXTREMITY ART 1-2 LEVELS UNILATERAL,695.04,521.28,8.34,625.54,119
CDM,9219392301,HC UPR/LXTR ART STDY 3+LVLS BILATERAL,1662.25,1246.69,19.95,1496.02,119
CDM,9219392304,HC UPR/LXTR ART STDY 3+ LVLS UNILATERAL,831.13,623.35,9.97,748.02,119
CDM,9219392401,HC NIVA LOWER EXTREMITY W/STRESS,881.84,661.38,10.58,793.66,119
CDM,9219392501,HC DOPPLER LOWER EXTREMTIY BILATERAL,1111.55,833.66,13.34,1000.4,119
CDM,9219392601,HC DOPPLER LOWER EXTREM UNILATERAL OR LIMITED,1000.39,750.29,12.0,900.35,119
CDM,9219393001,HC US DOPPLER EXTREM UPPER BILATERAL,1290.31,967.73,15.48,1161.28,119
CDM,9219393101,HC DOPPLER EXTREM UPPER UNILATERAL,1030.59,772.94,12.37,927.53,119
CDM,9219397001,HC DOPPLER EXTREM COMPLETE BILATERAL,1687.75,1265.81,20.25,1518.98,119
CDM,9219397101,HC DOPPLER EXTREMITY VEINS UNILATERAL,1142.46,856.84,13.71,1028.21,119
CDM,9219397501,HC US DUPLEX VASCULAR SCAN COMPLETE,1579.75,1184.81,18.96,1421.78,119
CDM,9219397601,HC DUPLEX VASCULAR SCAN LIMITED,946.36,709.77,11.36,851.72,119
CDM,9219397801,"HC DUPLEX A,IVC, IL/BPG; COMPL",1492.12,1119.09,17.91,1342.91,119
CDM,9219397901,HC US DUPLX AORT IVC ILAC GRF LIMITED,654.07,490.55,7.85,588.66,119
CDM,9219398101,HC US DUPLEX SCAN PENILE LIMITED,1392.24,1044.18,16.71,1253.02,119
CDM,9219398601,HC US DUP-SCAN HEMO COMPL UNILATERAL STD,1098.69,824.02,13.18,988.82,119
CDM,9219399001,HC DUPLEX HEMODIALYSIS ACCESS,1195.71,896.78,14.35,1076.14,119
CDM,9219399801,HC UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,622.61,466.96,7.47,560.35,119
CDM,9219399841,HC TCOM ONLY EXTREMITY STUDY,622.61,466.96,7.47,560.35,119
CDM,92277,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,234.16,175.62,2.81,210.74,119
CDM,9229586001,HC EMG 1 EXTREMITY,577.29,432.97,6.93,519.56,119
CDM,9229586101,HC EMG 2 EXTREMITIES,878.87,659.15,10.55,790.98,119
CDM,9229586801,HC EMG CRANIAL NERVE BILATERAL,846.1,634.58,10.15,761.49,119
CDM,9229586901,HC EMG THORACIC PARASPINAL MUSCLE,265.31,198.98,3.18,238.78,119
CDM,9229587201,HC EMG SINGLE FIBER,712.01,534.01,8.54,640.81,119
CDM,9229587401,HC GUIDE NERV DESTR NEEDLE EMG,337.78,253.34,4.05,304.0,119
CDM,9229588501,HC MUSC TST DONE W/NERV TST LIMITED,531.78,398.84,6.38,478.6,119
CDM,9229588601,HC MUSC TEST DONE W/N TEST COMPLETE,447.16,335.37,5.37,402.44,119
CDM,9229588701,HC MUSC TST DONE W/N TST NONEXT,435.0,326.25,5.22,391.5,119
CDM,9229590701,HC NRV CNDJ TST 1-2 STUDIES,367.97,275.98,4.42,331.17,119
CDM,9229590801,HC NRV CNDJ TST 3-4 STUDIES,541.74,406.3,6.5,487.57,119
CDM,9229590901,HC NRV CNDJ TST 5-6 STUDIES,880.2,660.15,10.56,792.18,119
CDM,9229591001,HC NRV CNDJ TEST 7-8 STUDIES,1165.88,874.41,13.99,1049.29,119
CDM,9229591101,HC NRV CNDJ TEST 9-10 STUDIES,1484.29,1113.22,17.81,1335.86,119
CDM,9229591201,HC NRV CNDJ TEST 11-12 STUDIES,1743.28,1307.46,20.92,1568.95,119
CDM,9229591301,HC NRV CNDJ TEST 13/> STUDIES,2982.12,2236.59,35.79,2683.91,119
CDM,9229593701,HC EMG NEUROMUSCULA JUNCTION TEST,1005.13,753.85,12.06,904.62,119
CDM,9229602001,HC FUNCTIONAL BRAIN MAPPING,956.39,717.29,11.48,860.75,119
CDM,92301,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,107.39,80.54,1.29,96.65,238
CDM,92340,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,28.5,21.38,0.34,25.65,238
CDM,92351,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,37.5,28.12,0.38,43.2,357
CDM,92353,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,113.4,85.05,1.36,102.06,119
CDM,923G012301,HC THIN PREP PAP SCREEN CRYOPATH,395.23,296.42,4.74,355.71,119
CDM,92436,DIAZEPAM 5 MG/ML INJECTION SYRINGE,131.66,98.745,1.34,136.33,476
CDM,9249507001,HC INHALATION OF METHACHOLINE,68.23,51.17,0.82,61.41,119
CDM,92503,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,118.2,88.65,1.42,106.38,119
CDM,92544,MORPHINE 2 MG/ML PF INJECTION SYRINGE,17.22,12.92,0.21,15.5,238
CDM,92575,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.91,37.43,0.6,44.92,238
CDM,92577,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1392.28,1044.21,16.71,1253.05,238
CDM,92751,ESCITALOPRAM 10 MG TABLET,0.92,0.69,0.01,0.83,119
CDM,92752,ESCITALOPRAM 20 MG TABLET,0.9,0.68,0.01,0.81,119
CDM,92757,VALSARTAN 40 MG TABLET,1.5950000000000002,1.1949999999999998,0.02,1.44,238
CDM,92762,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4024.44,3018.33,48.29,3622.0,119
CDM,92864,EPLERENONE 25 MG TABLET,8.39,6.3,0.1,7.55,119
CDM,92880,METAXALONE 800 MG TABLET,3.6,2.7,0.04,3.24,119
CDM,9289,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,124.00999999999999,93.005,1.01,147.38,238
CDM,92947,EZETIMIBE 10 MG TABLET,1.91,1.44,0.02,1.72,119
CDM,92961,DUTASTERIDE 0.5 MG CAPSULE,1.97,1.48,0.02,1.77,119
CDM,9297,BROMOCRIPTINE 2.5 MG TABLET,18.02,13.52,0.22,16.22,119
CDM,92987,KIT FOR YTTRIUM-90-IBRITUMOMAB 3.2 MG/2 ML INTRAVENOUS,190068.69,142551.52,1003.68,208709.06,357
CDM,92999,BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,196.31,147.23,2.36,176.68,119
CDM,93025,ARIPIPRAZOLE 10 MG TABLET,3.73,2.8,0.04,3.36,119
CDM,93034,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",2.32,1.74,0.03,2.12,238
CDM,93040,ATOMOXETINE 10 MG CAPSULE,9.77,7.33,0.11,21.19,357
CDM,93041,ATOMOXETINE 18 MG CAPSULE,16.25,12.190000000000001,0.12,20.46,238
CDM,93044,ATOMOXETINE 60 MG CAPSULE,10.62,7.96,0.13,9.56,119
CDM,9308,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,17.28,12.96,0.16,22.95,714
CDM,9310,BUMETANIDE 1 MG TABLET,6.0,4.5,0.07,5.4,119
CDM,9311,BUMETANIDE 2 MG TABLET,10.29,7.72,0.12,9.26,119
CDM,9316,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,17.1,12.82,0.21,15.39,238
CDM,9321,BUPROPION HCL 100 MG TABLET,2.22,1.66,0.03,2.0,119
CDM,9322,BUPROPION HCL 75 MG TABLET,7.25,5.44,0.09,6.52,119
CDM,9323,BUSPIRONE 10 MG TABLET,0.83,0.62,0.01,0.75,119
CDM,9324,BUSPIRONE 5 MG TABLET,0.61,0.45,0.01,0.55,119
CDM,93432,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,3.89,2.92,0.05,3.5,119
CDM,93433,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,5.6,4.2,0.07,5.04,119
CDM,93438,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,14.04,10.53,0.17,12.64,119
CDM,93439,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,4.8,3.6,0.06,4.32,119
CDM,93499,INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,434.04,325.53,5.21,390.64,119
CDM,9350,CALCITRIOL 0.25 MCG CAPSULE,1.63,1.22,0.02,1.47,119
CDM,9351,CALCITRIOL 0.5 MCG CAPSULE,2.54,1.91,0.03,2.29,119
CDM,93540,CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE,41.5,31.125,0.28,54.0,238
CDM,93702,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,245.62,184.22,2.95,221.06,119
CDM,93736,"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
CDM,93746,MOXIFLOXACIN 0.5 % EYE DROPS,229.64,172.23,1.44,400.95,357
CDM,93747,ACYCLOVIR 5 % TOPICAL CREAM,3027.3,2270.48,36.33,2724.57,119
CDM,93754,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,20140.08,15105.06,241.68,18126.07,119
CDM,93776,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,131.0,98.25,1.38,123.8,357
CDM,93794,PEG 400-PROPYLENE GLYCOL 0.4 %-0.3 % EYE DROPS,52.2,39.15,0.63,46.98,119
CDM,93815,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,34.8,26.1,0.15,32.94,357
CDM,93816,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,37.8,28.35,0.26,70.47,357
CDM,93817,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,42.0,31.5,0.5,37.8,119
CDM,93824,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",58.86,44.14,0.71,52.97,238
CDM,93826,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",54.989999999999995,41.24,0.48,62.69,476
CDM,93827,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,13.89,10.415,0.16,12.64,238
CDM,93828,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,15.629999999999999,11.725,0.18,28.3,476
CDM,9385,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.34,0.25,0.01,0.31,119
CDM,93876,IMATINIB 400 MG TABLET,26.0,19.5,0.31,23.4,119
CDM,93893,PHENYLEPHRINE 0.5 % NASAL SPRAY,20.79,15.59,0.25,18.71,119
CDM,9399,CAPSAICIN 0.075 % TOPICAL CREAM,28.04,21.03,0.34,25.24,119
CDM,9401,CAPTOPRIL 12.5 MG TABLET,4.8,3.6,0.06,4.32,119
CDM,9406,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.33,1.0,0.02,1.2,119
CDM,9407,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.13,0.85,0.01,1.02,119
CDM,9408,CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,0.7,0.53,0.01,0.63,119
CDM,9409919501,HC PHLEBOTOMY THERAPEUTIC,378.48,283.86,4.54,340.63,119
CDM,9409919519,HC PHLEBOTOMY THERAPEUTIC,350.1,262.58,4.2,315.09,119
CDM,94116,"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",37.9,28.42,0.45,34.11,119
CDM,9420403T06,HC MT. MCAID DPP DAILY CLASS (MIN 60 MINS PER SESSION),87.0,65.25,1.04,78.3,238
CDM,94224,ASCORBIC ACID (VITAMIN C) 500 MG/5 ML ORAL SYRUP,35.515,26.635,0.01,63.86,238
CDM,9429604101,HC GENETIC COUNSELING SVC EA 30,340.2,255.15,4.08,306.18,119
CDM,9429755101,HC CAREGIVER TRAING EA ADDL 15,119.97,89.98,1.44,107.97,119
CDM,9429755201,HC GROUP CAREGIVER TRAINING,50.1,37.58,0.6,45.09,119
CDM,9429780201,HC MED NUTRITION INDIV 1ST EA 15MIN,56.44,42.33,0.68,50.8,119
CDM,9429780241,HC VIDEO VISIT MEDICAL NUTRITION ASSMT INDIV EACH 15 MIN,63.27,47.45,0.76,56.94,119
CDM,9429780301,HC MED NUTRTION INDIV RE-ASMT EA 15MIN,53.79,40.34,0.65,48.41,119
CDM,9429780401,HC MED NUTRITION GRP EA 30 MIN,40.02,30.02,0.48,36.02,119
CDM,9429896001,HC SELF-MGMT EDUC & TRAIN 1 PT,126.29,94.72,1.52,113.66,119
CDM,9429940601,HC SMOKING CESSATION ASYMPTOMATIC >3 & UP TO 10 MIN,74.79,56.09,0.9,67.31,119
CDM,9429940701,HC SMOKING CESSATION ASYMP >10MIN,82.78,62.08,0.99,74.5,119
CDM,942G010801,HC DIABETES INITIAL/FOLLOWUP INDIVIDUAL 30 MIN,146.35,109.76,1.76,131.72,119
CDM,942G987301,HC FIRST MDPP SESSION,26.0,19.5,0.31,23.4,238
CDM,942G987401,HC MDPP 4 CORE SESSION 1-6M,52.0,39.0,0.62,46.8,238
CDM,942G987501,HC MDPP 9 CORE SESSION 1-6M,94.0,70.5,1.13,84.6,238
CDM,942G987601,HC MDPP SESSION 2CM 7-9M 5% WL NOT ACH,15.0,11.25,0.18,13.5,238
CDM,942G987701,HC MDPP SESSION 2CM 10-12 NO WL,15.0,11.25,0.18,13.5,238
CDM,942G987801,HC MDPP SESSION 2CM 7-9M 5% WL ACH,63.0,47.25,0.76,56.7,238
CDM,942G987901,HC MDPP SESSION 2CM 10-12M 5% WL ACH,66.15,49.61,0.79,59.54,119
CDM,942G988001,HC MDPP SESSION 5% LOSS 1-12M,168.0,126.0,2.02,151.2,238
CDM,942G988101,HC MDPP SESSION 5% LOSS 1-24M,26.0,19.5,0.31,23.4,238
CDM,942S944101,HC ASTHMA EDUCATION,59.03,44.27,0.71,53.13,119
CDM,942S944181,HC COM CON ASTHMA EDUCATION,82.78,62.08,0.99,74.5,119
CDM,942S944301,HC LACTATION EDUCATION; NON PHYSICIAN PROVIDER PER SESSION,290.1,217.58,3.48,261.09,238
CDM,942S944901,HC RDN WTH FULL PROGRAM S9449,800.0,600.0,9.6,720.0,119
CDM,942S944941,HC RDN WTH PARTIAL PROGRAM S9449,917.45,688.09,11.01,825.7,119
CDM,942S947001,HC DIETITIAN MEDICAID CONSULT 30 MIN,92.53,69.39500000000001,1.03,89.24,238
CDM,9431024197,HC CARDIAC PHASE I,219.58,164.68,2.63,197.62,119
CDM,94328,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,13.8,10.35,0.14,126.9,714
CDM,94342,ARIPIPRAZOLE 5 MG TABLET,1.4,1.05,0.02,1.26,119
CDM,9439379701,HC CARDIAC PHASE II ROUTINE WO ECG,293.21,219.91,3.52,263.89,119
CDM,9439379801,HC CARDIAC PHASE II ROUTINE W/ECG,305.21,228.91,3.66,274.69,119
CDM,94396,"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",675.0,506.25,8.1,607.5,119
CDM,94440,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,138.125,103.595,0.76,191.25,238
CDM,94441,ROSUVASTATIN 5 MG TABLET,1.23,0.92,0.01,1.11,119
CDM,94442,ROSUVASTATIN 10 MG TABLET,1.21,0.9,0.01,1.09,119
CDM,94443,ROSUVASTATIN 20 MG TABLET,8.4,6.3,0.1,7.56,119
CDM,94478,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,109.08,81.81,1.31,98.17,119
CDM,94479,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.2,52.65,0.84,63.18,238
CDM,94553,"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",11.12,8.34,0.13,10.01,119
CDM,94566,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,3.03,2.27,0.04,2.73,119
CDM,9461,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,59.7,44.78,0.72,53.73,119
CDM,9463,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
CDM,9473394701,HC ECMO INITIATION VENO-ARTERIAL,4656.11,3492.08,55.87,4190.5,119
CDM,9473394801,HC ECMO DAILY MGMT  VENOUS,5102.2,3826.65,61.23,4591.98,119
CDM,9473394901,HC ECMO DAILY MGMT ARTERY,5102.2,3826.65,61.23,4591.98,119
CDM,9474,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,19.12,14.34,0.23,17.21,119
CDM,9476,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
CDM,94818,WHITE PETROLATUM 41 % TOPICAL OINTMENT,42.84,32.13,0.35,70.57,357
CDM,9489,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,4.57,3.43,0.05,4.11,119
CDM,9489462501,HC PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,480.64,360.48,5.77,432.58,119
CDM,9489462601,HC PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,480.64,360.48,5.77,432.58,119
CDM,9490,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,5.79,4.34,0.07,5.21,357
CDM,9495,CEFUROXIME AXETIL 250 MG TABLET,22.69,17.02,0.27,20.42,119
CDM,9496,CEFUROXIME AXETIL 500 MG TABLET,18.93,14.2,0.23,17.04,119
CDM,94981,"ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR",1.67,1.25,0.02,1.5,119
CDM,9499,CEPHALEXIN 250 MG CAPSULE,1.94,1.46,0.02,1.75,119
CDM,9500,CEPHALEXIN 500 MG CAPSULE,1.73,1.3,0.02,1.56,119
CDM,9502,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,246.0,184.5,2.95,221.4,119
CDM,95154,"METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE",13.45,10.09,0.16,12.1,119
CDM,9516,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH (REPACKAGING),11.43,8.57,0.01,28.1,476
CDM,95216,VIT E-GLYCERIN-DIMETHICONE LOTION,65.27,48.96,0.78,58.74,119
CDM,95223,PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,17.03,12.77,0.2,15.33,119
CDM,95441,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,238
CDM,95542,TADALAFIL 5 MG TABLET,6.44,4.83,0.08,5.8,119
CDM,95544,TADALAFIL 20 MG TABLET,10.64,7.98,0.13,9.58,119
CDM,95564,MEMANTINE 10 MG TABLET,4.0,3.0,0.05,3.6,119
CDM,95567,MEMANTINE 5 MG TABLET,2.59,1.94,0.03,2.33,119
CDM,95745,"PROPAFENONE ER 225 MG CAPSULE,EXTENDED RELEASE 12 HR",4.9,3.68,0.06,4.41,119
CDM,95764,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,25.064999999999998,18.795,0.27,25.19,238
CDM,95769,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,457.12,342.84,5.49,411.41,119
CDM,95772,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",9.71,7.28,0.12,8.74,119
CDM,95777,AMIODARONE 150 MG/3 ML INTRAVENOUS SYRINGE,77.99,58.5,0.94,70.19,119
CDM,95827,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,6071.6900000000005,4553.765,29.14,8743.23,238
CDM,95830,TOPIRAMATE 50 MG TABLET,0.55,0.41,0.01,0.5,119
CDM,95840,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",22.35,16.76,0.27,20.12,119
CDM,95841,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",45.65,34.24,0.55,41.08,119
CDM,95852,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",706.12,529.59,8.47,635.51,119
CDM,9588,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,6.0,4.5,0.07,5.4,238
CDM,9610,CIPROFLOXACIN 0.3 % EYE DROPS,63.0,47.25,0.76,56.7,119
CDM,9612,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,128.35,96.265,1.05,157.59,476
CDM,9617,CLARITHROMYCIN 500 MG TABLET,5.6,4.2,0.07,5.04,119
CDM,9624,CLINDAMYCIN 2 % VAGINAL CREAM,625.68,469.26,7.51,563.11,119
CDM,9626,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,44.1,33.075,0.29,57.78,357
CDM,9627,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,54.15,40.61,0.36,70.47,238
CDM,9630,CLOBETASOL 0.05 % TOPICAL CREAM,27.0,20.25,0.32,24.3,119
CDM,9631,CLOBETASOL 0.05 % TOPICAL OINTMENT,119.88,89.91,0.36,1124.93,595
CDM,9635,CLOMIPRAMINE 25 MG CAPSULE,2.0,1.5,0.02,1.8,119
CDM,9637,CLONAZEPAM 0.5 MG TABLET,0.16,0.12,0.01,0.14,119
CDM,9638,CLONAZEPAM 1 MG TABLET,1.69,1.27,0.01,2.82,238
CDM,9644,CLOTRIMAZOLE 10 MG TROCHE,7.72,5.79,0.09,6.95,119
CDM,9647,CLOZAPINE 100 MG TABLET,9.9,7.43,0.12,8.91,119
CDM,9648,CLOZAPINE 25 MG TABLET,3.9,2.92,0.05,3.51,119
CDM,9681,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,126.0,94.5,1.51,113.4,119
CDM,9718,DANTROLENE 25 MG CAPSULE,7.175000000000001,5.38,0.06,8.54,238
CDM,9722,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,179.965,134.97500000000002,2.09,166.86,238
CDM,9723,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,238
CDM,9748,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,1958.21,1468.6599999999999,17.36,2223.07,238
CDM,9751,DESONIDE 0.05 % TOPICAL OINTMENT,180.495,135.37,1.45,216.11,238
CDM,97860,CLOBETASOL 0.05 % SHAMPOO,609.59,457.195,5.4,692.0,238
CDM,97874,CINACALCET 30 MG TABLET,3.0,2.25,0.04,2.7,119
CDM,97879,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,4500.0,3375.0,54.0,4050.0,119
CDM,9788,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
CDM,97932,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,90.0,67.5,1.08,81.0,119
CDM,98034,CETIRIZINE 5 MG CHEWABLE TABLET,25.75,19.31,0.31,23.18,119
CDM,98125,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,599.94,449.96,7.2,539.95,119
CDM,98180,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,3072.88,2304.66,36.87,2765.59,119
CDM,98521,AZACITIDINE 100 MG SOLUTION FOR INJECTION,147.38,110.53,1.77,132.64,119
CDM,9859,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,323.7,242.77,3.88,291.33,119
CDM,98680,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,12.0,9.0,0.14,10.8,238
CDM,98681,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,6.75,5.0649999999999995,0.04,9.45,357
CDM,9869,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,24.65,18.49,0.11,34.8,476
CDM,988,BENZONATATE 100 MG CAPSULE,0.9,0.68,0.01,0.81,119
CDM,98821,RIFAXIMIN 200 MG TABLET,60.0,45.0,0.72,54.0,119
CDM,98861,ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSPENSION,131.76,98.82,1.58,118.58,119
CDM,98862,ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,113.76,85.32,1.37,102.38,119
CDM,98902,CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,1.5,1.12,0.02,1.35,119
CDM,98930,NITAZOXANIDE 500 MG TABLET,539.88,404.91,6.48,485.89,119
CDM,9894,DOXAZOSIN 1 MG TABLET,5.09,3.82,0.06,4.58,119
CDM,98945,LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,32.15,24.12,0.39,28.94,238
CDM,98953,EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,6.37,4.77,0.08,5.73,119
CDM,98955,TROSPIUM 20 MG TABLET,4.76,3.57,0.06,4.28,119
CDM,98956,"ACAMPROSATE 333 MG TABLET,DELAYED RELEASE",13.56,10.17,0.16,12.2,119
CDM,98957,"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",9.62,7.22,0.12,8.66,119
CDM,98958,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",8.62,6.46,0.1,7.76,119
CDM,98959,"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",8.62,6.46,0.1,7.76,119
CDM,9896,DOXAZOSIN 4 MG TABLET,0.95,0.71,0.01,0.86,119
CDM,98960,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,20.0,15.0,0.24,18.0,119
CDM,9915,ECONAZOLE NITRATE 1 % TOPICAL CREAM,150.21,112.66,1.8,135.19,119
CDM,99153,MENTHOL 5.8 MG LOZENGES,0.24,0.18,0.01,0.22,119
CDM,99233,"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",809.985,607.49,1.73,1328.13,238
CDM,9927,ENALAPRIL MALEATE 5 MG TABLET,1.26,0.94,0.02,1.13,119
CDM,9929,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,31.85,23.89,0.38,28.67,238
CDM,99339,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,225.43,169.07,2.71,202.89,119
CDM,99340,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,241.12,180.84,2.89,217.01,119
CDM,99342,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,241.735,181.305,2.89,218.49,238
CDM,99357,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,24298.34,18223.75,291.58,21868.51,119
CDM,99371,LANTHANUM 500 MG CHEWABLE TABLET,33.34,25.0,0.4,30.01,119
CDM,99456,OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,1.25,0.94,0.02,1.12,119
CDM,99462,ESZOPICLONE 1 MG TABLET,3.47,2.61,0.04,3.12,119
CDM,99493,"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",9.82,7.37,0.12,8.84,119
CDM,99494,"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",9.82,7.37,0.12,8.84,119
CDM,99530,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,78.0,58.5,0.79,81.0,238
CDM,9957,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,119
CDM,99585,ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,1293.3,969.97,15.52,1163.97,119
CDM,99594,"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",60.0,45.0,0.72,54.0,119
CDM,99603,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,4504.71,3378.53,54.06,4054.24,119
CDM,9967,ESTRADIOL 1 MG TABLET,1.84,1.38,0.02,1.66,119
CDM,998,BENZTROPINE 0.5 MG TABLET,0.83,0.63,0.01,0.75,119
CDM,99819,LEVALBUTEROL HFA 45 MCG/ACTUATION AEROSOL INHALER,353.79,265.34,4.25,318.41,119
CDM,99822,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,108.0,81.0,1.3,97.2,238
CDM,9983,ETHAMBUTOL 400 MG TABLET,7.6,5.7,0.09,6.84,119
CDM,99866,ENTECAVIR 0.5 MG TABLET,32.595,24.445,0.1,51.47,238
CDM,9989,ETHOSUXIMIDE 250 MG CAPSULE,2.52,1.89,0.03,2.27,119
CDM,999,BENZTROPINE 1 MG TABLET,0.97,0.72,0.01,0.87,119
CPT,0001U,Rbc dna hea 35 ag 11 bld grp,,,641.52,2184.84,66
CPT,0002M,Liver dis 10 assays w/ash,,,503.4,1527.57,62
CPT,0002U,Onc clrct 3 ur metab alg plp,,,25.0,75.86,65
CPT,0003M,Liver dis 10 assays w/nash,,,503.4,1527.57,62
CPT,0003U,Onc ovar 5 prtn ser alg scor,,,950.0,2882.78,65
CPT,0004M,Scoliosis dna alys,,,79.0,239.73,62
CPT,0005U,Onco prst8 3 gene ur alg,,,760.0,2306.22,65
CPT,0006M,Onc hep gene risk classifier,,,150.0,455.18,62
CPT,0007M,Onc gastro 51 gene nomogram,,,375.0,1137.94,62
CPT,0007U,Rx test prsmv ur w/def conf,,,114.43,347.24,65
CPT,0008U,Hpylori detcj abx rstnc dna,,,597.91,1814.36,65
CPT,0009U,Onc brst ca erbb2 amp/nonamp,,,107.0,324.69,65
CPT,00100,Anes px salivary gland w/bx,,,20.69,20.69,18
CPT,00102,Anes px plstc rpr cleft lip,,,20.69,20.69,18
CPT,00103,Anes rcnstv px eyelid,,,20.69,20.69,18
CPT,00104,Anes electroconvulsive ther,,,20.69,20.69,18
CPT,0010U,Nfct ds strn typ whl gen seq,,,427.26,1296.52,65
CPT,0011M,Onc prst8 ca mrna 12 gen alg,,,760.0,2306.22,65
CPT,0011U,Rx mntr lc-ms/ms oral fluid,,,101.96,347.24,66
CPT,00120,Anes px ear w/bx nos,,,20.69,20.69,18
CPT,00124,Anes px ear otoscopy,,,20.69,20.69,18
CPT,00126,Anes px ear tympanotomy,,,20.69,20.69,18
CPT,0012M,Onc mrna 5 gen rsk urthl ca,,,760.0,2306.22,65
CPT,0012U,Germln do gene reargmt detcj,,,6397.67,7633.58,8
CPT,0013M,Onc mrna 5 gen recr urthl ca,,,760.0,2306.22,65
CPT,0013U,Onc sld org neo gene reargmt,,,6397.67,7633.58,8
CPT,00140,Anes procedures on eye nos,,,20.69,20.69,18
CPT,00142,Anes px on eye lens surgery,,,20.69,20.69,18
CPT,00144,Anes px eye corneal trnspl,,,20.69,20.69,18
CPT,00145,Anes px eye vitreortnl surg,,,20.69,20.69,18
CPT,00147,Anes px on eye iridectomy,,,20.69,20.69,18
CPT,00148,Anes px eye ophthalmoscopy,,,20.69,20.69,18
CPT,0014M,Liver ds alys 3 bmrk srm alg,,,176.19,534.65,44
CPT,0014U,Hem hmtlmf neo gene reargmt,,,6397.67,7633.58,8
CPT,0015M,Adrnl cortcl tum bchm asy 25,,,1305.37,3961.15,65
CPT,00160,Anes px nose&sinus nos,,,20.69,20.69,18
CPT,00162,Anes px nose&sinus rad surg,,,20.69,20.69,18
CPT,00164,Anes px nose&sins bx sft tis,,,20.69,20.69,18
CPT,0016M,Onc bladder mrna 219 gen alg,,,3489.63,10589.28,65
CPT,0016U,Onc hmtlmf neo rna bcr/abl1,,,163.96,497.53,65
CPT,00170,Anes intraoral px nos,,,20.69,20.69,18
CPT,00172,Anes ntroral px rpr clft pal,,,20.69,20.69,18
CPT,00174,Anes ntrorl exc rtrphrng tum,,,20.69,20.69,18
CPT,00176,Anes intraoral px rad surg,,,20.69,15039.8,36
CPT,0017M,Onc dlbcl mrna 20 genes alg,,,2236.6,7617.24,66
CPT,0017U,Onc hmtlmf neo jak2 mut dna,,,91.66,278.15,65
CPT,0018M,Trnsplj rnl meas cd154+cll,,,640.73,1944.3,65
CPT,0018U,Onc thyr 10 microrna seq alg,,,3002.09,9109.84,65
CPT,00190,Anes px facial b1/skull nos,,,20.69,20.69,18
CPT,00192,Anes px fcl b1/skl rad surg,,,20.69,15039.8,28
CPT,0019M,Cv ds plasma alys prtn bmrk,,,712.4,2161.78,29
CPT,0019U,Onc rna tiss predict alg,,,3675.0,11151.79,65
CPT,0020M,Onc cns alys 30000 dna loci,,,0.5,2500.0,12
CPT,00210,Anes intracranial px nos,,,20.69,20.69,18
CPT,00211,Anes icr px crnec/crnot hmtm,,,20.69,15039.8,37
CPT,00212,Anes icr px subdural taps,,,20.69,20.69,18
CPT,00214,Anes icr px burr holes,,,20.69,15039.8,36
CPT,00215,Anes icr px crnop/elvtn fx,,,20.69,15039.8,36
CPT,00216,Anes icr px vascular px,,,20.69,20.69,18
CPT,00218,Anes icr px in sitting pos,,,20.69,20.69,18
CPT,0021U,Onc prst8 detcj 8 autoantb,,,760.0,2306.22,65
CPT,00220,Anes icr px csf shunting px,,,20.69,20.69,18
CPT,00222,Anes icr px ecoag icr nrv,,,20.69,20.69,18
CPT,0022U,Tgsap nsm lung neo dna&rna23,,,1737.45,5917.28,30
CPT,0023U,Onc aml dna detcj/nondetcj,,,221.42,754.1,66
CPT,0024U,Glyca nuc mr spectrsc quan,,,34.19,103.75,65
CPT,0025U,Tenofovir liq chrom ur quan,,,85.77,347.24,65
CPT,0026U,Onc thyr dna&mrna 112 genes,,,3600.0,10924.2,65
CPT,0027U,Jak2 gene trgt seq alys,,,121.91,369.94,65
CPT,0029U,Rx metab advrs trgt seq alys,,,742.27,2252.42,65
CPT,00300,Anes all px integ h/n/ptrunk,,,20.69,20.69,18
CPT,0030U,Rx metab warf trgt seq alys,,,134.13,407.02,65
CPT,0031U,Cyp1a2 gene,,,174.81,530.46,65
CPT,00320,Anes all px neck nos 1yr/>,,,20.69,20.69,18
CPT,00322,Anes all px nck ndl bx thyr,,,20.69,20.69,18
CPT,00326,Anes all px larynx&trach<1yr,,,20.69,20.69,18
CPT,0032U,Comt gene,,,174.81,530.46,65
CPT,0033U,Htr2a htr2c genes,,,349.62,1060.92,56
CPT,0034U,Tpmt nudt15 genes,,,466.17,1414.59,65
CPT,00350,Anes px major vsl neck nos,,,20.69,20.69,18
CPT,00352,Anes px maj vsl nck smpl lig,,,20.69,20.69,18
CPT,0035U,HC NEURO CSF PRION PRTN QUAL,1464.74,1098.56,17.58,1318.27,119
CPT,0035U,Neuro csf prion prtn qual,,,540.99,1641.63,65
CPT,0036U,Xome tum & nml spec seq alys,,,4780.0,14504.91,65
CPT,0037U,Trgt gen seq dna 324 genes,,,3118.5,10620.75,66
CPT,0038U,Vitamin d srm microsamp quan,,,26.37,89.82,66
CPT,0039U,Dna antb 2strand hi avidity,,,13.74,41.7,65
CPT,00400,Anes integumentary sys nos,,,20.69,500.0,19
CPT,00402,Anes integ sys rcnstv breast,,,20.69,20.69,18
CPT,00404,Anes integ sys rad/modf brst,,,20.69,20.69,18
CPT,00406,Anes integ sys rad brst dsj,,,20.69,20.69,18
CPT,0040U,Bcr/abl1 gene major bp quan,,,365.22,1243.84,66
CPT,00410,Anes integ sys conv arrhyt,,,20.69,20.69,18
CPT,0041U,B brgdrferi antb 5 prtn igm,,,17.21,52.23,65
CPT,00420,ANESTH-SKIN SURGERY-BACK,,,20.69,20.69,18
CPT,0042T,Ct perfusion w/contrast cbf,,,157.5,187.93,8
CPT,0042T,HCD CT PERFUSION W/CONTRAST CBF,871.9,653.92,10.46,784.71,119
CPT,0042U,B brgdrferi antb 12 prtn igg,,,17.21,52.23,65
CPT,0043U,Tbrf b grp antb 4 prtn igm,,,14.86,45.1,65
CPT,0044U,Tbrf b grp antb 4 prtn igg,,,14.86,45.1,65
CPT,00450,Anes px clav&scapula nos,,,20.69,20.69,18
CPT,00454,Anes px clav&scapula bx clav,,,20.69,20.69,18
CPT,0045U,Onc brst dux carc is 12 gene,,,3873.0,11752.62,65
CPT,0046U,Flt3 gene itd variants quan,,,407.43,1236.34,65
CPT,00470,Anes partial rib rescj nos,,,20.69,20.69,18
CPT,00472,Anes prtl rib rescj thoracop,,,20.69,20.69,18
CPT,00474,Anes prtl rib rescj rad px,,,20.69,15039.8,28
CPT,0047U,Onc prst8 mrna 17 gene alg,,,3873.0,11752.62,65
CPT,0048U,Onc sld org neo dna 468 gene,,,2601.36,8859.52,66
CPT,0049U,Npm1 gene analysis quan,,,407.43,1236.34,65
CPT,00500,Anes all px on esophagus,,,20.69,20.69,18
CPT,0050U,Trgt gen seq dna 194 genes,,,2916.6,8850.42,65
CPT,0051U,Rx mntr lc-ms/ms ur/bld 31,,,193.71,749.28,65
CPT,00520,Anes closed chest px nos,,,20.69,20.69,18
CPT,00522,Anes clsd ch px ndl bx pleur,,,20.69,20.69,18
CPT,00524,Anes clsd ch px pneumocents,,,20.69,15039.8,36
CPT,00528,Anes clsd ch mediast&thrc wo,,,20.69,20.69,18
CPT,00529,Anes clsd ch mediast&thrc w/,,,20.69,20.69,18
CPT,0052U,Lpoprtn bld w/5 maj classes,,,33.86,102.75,65
CPT,00530,Anes perm transvns pm insj,,,20.69,20.69,18
CPT,00532,Anes access ctr venous crcj,,,20.69,20.69,18
CPT,00534,Anes insertion/rplcmt cvdfb,,,20.69,20.69,18
CPT,00537,Anes cardiac ep procedures,,,20.69,20.69,18
CPT,00539,Anes tracheobronchial rcnstj,,,20.69,20.69,18
CPT,0053A,N/A,,,101.73,121.38,8
CPT,0053U,Onc prst8 ca fish alys 4 gen,,,2030.0,6160.04,44
CPT,00540,Anes thoracotomy px nos,,,20.69,15039.8,36
CPT,00541,Anes thrcm px 1 lung vntj,,,20.69,20.69,18
CPT,00542,Anes thrcm px decortication,,,20.69,15039.8,36
CPT,00544,ANESTH-CHEST LINING REMOVAL,,,20.69,20.69,18
CPT,00546,Anes thrcm px pulm rescj,,,20.69,15039.8,36
CPT,00548,Anes thrcm px trach&bronchi,,,20.69,20.69,18
CPT,0054T,Bone srgry cmptr fluor image,,,393.39,469.38,8
CPT,0054U,Rx mntr 14+ drugs & sbsts,,,148.96,603.08,65
CPT,00550,Anes for sternal debridement,,,20.69,20.69,18
CPT,0055T,Bone srgry cmptr ct/mri imag,,,568.13,677.88,8
CPT,0055U,Card hrt trnspl 96 dna seq,,,3240.0,9831.78,65
CPT,00560,Anes px heart w/o pump oxtj,,,20.69,15039.8,36
CPT,00561,Anes px heart w/pump<1 yr,,,20.69,15039.8,36
CPT,00562,Anes px hrt w/pump age 1yr+,,,20.69,15039.8,36
CPT,00563,Anes px heart w/pmp crc arst,,,20.69,20.69,18
CPT,00566,Anes direct cabg w/o pump,,,20.69,20.69,18
CPT,00567,Anes direct cabg w/pump,,,20.69,15039.8,37
CPT,0056U,Hem aml dna gene reargmt,,,6397.67,7633.58,8
CPT,00580,Anes heart/lung transplant,,,20.69,15039.8,36
CPT,0058U,Onc merkel cll carc srm quan,,,322.96,980.02,65
CPT,0059U,Onc merkel cll carc srm +/-,,,322.96,980.02,65
CPT,00600,Anes px crv spine&cord nos,,,20.69,20.69,18
CPT,00604,Anes px crv spn&cord sitting,,,20.69,15039.8,28
CPT,0060U,Twn zyg gen seq alys chrms2,,,759.05,2303.33,65
CPT,0061U,Tc meas 5 bmrk sfdi m-s alys,,,25.1,76.17,65
CPT,00620,Anes px thrc spine&cord nos,,,20.69,20.69,18
CPT,00625,Anes thrc spine wo 1lng vent,,,20.69,20.69,18
CPT,00626,Anes thrc spine w/1 lng vent,,,20.69,20.69,18
CPT,0062U,Ai sle igg&igm alys 80 bmrk,,,380.72,1155.29,65
CPT,00630,Anes px lumbar region nos,,,20.69,20.69,18
CPT,00632,Anes px lumbar sympathectomy,,,20.69,15039.8,36
CPT,00635,Anes dx/ther lumbar pnxr,,,20.69,20.69,18
CPT,0063U,Neuro autism 32 amines alg,,,750.0,2275.88,65
CPT,00640,Anes spine manipulation,,,20.69,20.69,18
CPT,0064U,Antb tp total&rpr ia qual,,,27.92,95.07,66
CPT,0064U,HC ANTIBODY TREPONEMA PALLIDUM TOTAL & RPR IA QUAL,68.94,51.7,0.83,62.05,119
CPT,0065U,HC SYPHILIS TST NON-TREPONEMAL ANTIBODY IA QUAL RPR,39.81,29.86,0.48,35.83,119
CPT,0065U,Syfls tst nontreponemal antb,,,16.12,54.89,66
CPT,0066U,Pamg-1 ia cervico-vag fluid,,,15.29,46.4,44
CPT,00670,Anes xtnsv sp&spi cord px,,,20.69,20.69,18
CPT,0067U,Onc brst imhchem prfl 4 bmrk,,,1897.0,5756.45,65
CPT,0068U,Candida species pnl amp prb,,,127.08,432.81,66
CPT,0069U,Onc clrct microrna mir-31-3p,,,380.0,1153.11,65
CPT,00700,Anes px upr ant abd wall nos,,,20.69,20.69,18
CPT,00702,Anes upr ant abd wall lvr bx,,,20.69,20.69,18
CPT,0070U,Cyp2d6 gen com&slct rar vrnt,,,676.37,2052.45,65
CPT,0071T,Us leiomyomata ablate <200,,,3048.08,3538.83,18
CPT,0071U,Cyp2d6 full gene sequence,,,600.0,1820.7,65
CPT,0072T,Fcsd us abltj leiomyom>200,,,3048.08,3538.83,18
CPT,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,450.91,1368.29,65
CPT,00730,Anes px upper pst abdl wall,,,20.69,20.69,18
CPT,00731,Anes upr gi ndsc px nos,,,20.69,20.69,18
CPT,00732,Anes upr gi ndsc px ercp,,,20.69,20.69,18
CPT,0073A,N/A,,,101.73,121.38,8
CPT,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,450.91,1368.29,65
CPT,0074A,N/A,,,101.73,121.38,8
CPT,0074U,Cyp2d6 nonduplicated gene,,,450.91,1368.29,65
CPT,00750,Anes hrna rpr upr abd nos,,,20.69,20.69,18
CPT,00752,Anes hrna rpr lmbr&vnt&/dehs,,,20.69,20.69,18
CPT,00754,Anes hrna rpr omphalocele,,,20.69,20.69,18
CPT,00756,Anes hrna rpr diphrg hrna,,,20.69,20.69,18
CPT,0075T,HC PLACE CAROTID ARTERY STENT INIT,19922.93,14942.2,239.08,17930.64,119
CPT,0075T,Perq stent/chest vert art,,,12954.18,15039.8,19
CPT,0075U,Cyp2d6 5 gene dup/mlt,,,450.91,1368.29,65
CPT,0076T,S&i stent/chest vert art,,,12954.18,15039.8,19
CPT,0076U,Cyp2d6 3 gene dup/mlt,,,450.91,1368.29,65
CPT,00770,Anes px maj abd blood vessel,,,20.69,20.69,18
CPT,0077U,Ig paraprotein qual bld/ur,,,38.7,131.79,66
CPT,0078U,Pain mgt opi use gnotyp pnl,,,450.91,1368.29,44
CPT,00790,Anes iper upr abd nos,,,20.69,20.69,18
CPT,00792,Anes iper upr abd prtl hptc,,,20.69,15039.8,36
CPT,00794,Anes iper upr abd pncrtect,,,20.69,15039.8,36
CPT,00796,Anes iper upr abd lvr trnspl,,,20.69,15039.8,36
CPT,00797,Anes iper upr abd gstr px mo,,,20.69,20.69,18
CPT,00798,ANESTH-GASTRIC RESTRICTIVE PROCEDURES FOR MORBID OBESITY,,,20.69,20.69,18
CPT,0079U,Cmprtv dna alys mlt snps,,,0.5,0.5,3
CPT,00800,Anes px lwr ant abdl wal nos,,,20.69,20.69,18
CPT,00802,Anes px lwr abdl wal pannic,,,20.69,20.69,18
CPT,0080U,Onc lng 5 clin rsk factr alg,,,3520.0,10681.44,65
CPT,00811,Anes lwr intst ndsc nos,,,20.69,20.69,18
CPT,00812,Anes lwr intst scr colsc,,,20.69,20.69,18
CPT,00813,Anes upr lwr gi ndsc px,,,20.69,20.69,18
CPT,0081A,N/A,,,101.73,121.38,8
CPT,00820,Anes px lwr post abdl wall,,,20.69,20.69,18
CPT,0082A,N/A,,,101.73,121.38,8
CPT,0082U,Rx test def 90+ rx/sbsts ur,,,246.92,749.28,65
CPT,00830,Anes hernia rpr lwr abd nos,,,20.69,20.69,18
CPT,00832,Anes hernia repair vnt&incal,,,20.69,20.69,18
CPT,00834,Anes hernia repair<1 yr age,,,20.69,20.69,18
CPT,00836,Anes hrna rpr<37wk brth<50,,,20.69,20.69,18
CPT,0083A,N/A,,,101.73,121.38,8
CPT,0083U,Onc rspse chemo cntrst tomog,,,167.35,507.82,65
CPT,00840,Anes iper px lower abd nos,,,20.69,20.69,18
CPT,00842,Anes iper px amniocentesis,,,20.69,20.69,18
CPT,00844,Anes iper px abdmnprnl rescj,,,20.69,15039.8,36
CPT,00846,Anes iper px rad hystrectomy,,,20.69,15039.8,36
CPT,00848,Anes iper px pel exentration,,,20.69,15039.8,36
CPT,0084U,Rbc dna gnotyp 10 bld groups,,,641.52,2184.84,66
CPT,00850,ANESTH-CESAREAN SECTION,,,20.69,20.69,18
CPT,00851,Anes iper px tubal ligation,,,20.69,20.69,18
CPT,00855,ANESTH-HYSTERECTOMY,,,20.69,20.69,18
CPT,00857,ANALGESIA-LABOR & C-SECTION,,,20.69,20.69,18
CPT,00860,Anes xtrprtl px lwr abd nos,,,20.69,20.69,18
CPT,00862,Anes xtrprtl lwr abd rnl px,,,20.69,20.69,18
CPT,00864,Anes xtrprt lwr abd tot cstc,,,20.69,15039.8,36
CPT,00865,Anes xtrprt lwr abd prst8ect,,,20.69,20.69,18
CPT,00866,Anes xtrprt lw abd adrnlctmy,,,20.69,15039.8,36
CPT,00868,Anes xtrprtl px rnl transpl,,,20.69,15039.8,36
CPT,0086U,Nfct ds bact&fng org id 6+,,,178.2,606.9,66
CPT,00870,Anes xtrprtl cystolithotomy,,,20.69,20.69,18
CPT,00872,Anes lithotrp esw water bath,,,20.69,20.69,18
CPT,00873,Anes lithotrp esw wo wtr bth,,,20.69,20.69,18
CPT,0087U,Crd hrt trnspl mrna 1283 gen,,,3159.42,9587.26,65
CPT,00880,Anes maj lwr abd vessel nos,,,20.69,20.69,18
CPT,00882,Anes maj lwr adb vsl ivc lig,,,20.69,15039.8,36
CPT,00884,ANESTH-MAJOR VEIN REVISION,,,20.69,20.69,18
CPT,0088U,Trnsplj kdn algrft rej 1494,,,3159.42,9587.26,65
CPT,0089U,Onc mlnma prame & linc00518,,,760.0,2306.22,65
CPT,00900,ANESTH-PERINEAL PROCEDURE,,,20.69,20.69,18
CPT,00902,Anes anorectal px,,,20.69,20.69,18
CPT,00904,Anes radical perineal px,,,20.69,15039.8,28
CPT,00906,Anes vulvectomy,,,20.69,20.69,18
CPT,00908,Anes perineal prostatectomy,,,20.69,15039.8,36
CPT,0090U,Onc cutan mlnma mrna 23 gene,,,1755.0,5917.28,65
CPT,00910,Anes transurethral px nos,,,20.69,20.69,18
CPT,00912,Anes trurl px rescj bldr tum,,,20.69,20.69,18
CPT,00914,Anes trurl px rescj prst8,,,20.69,20.69,18
CPT,00916,Anes trurl px rescj bleeding,,,20.69,20.69,18
CPT,00918,Anes trurl px urtrl cal rmvl,,,20.69,20.69,18
CPT,0091A,N/A,,,101.73,121.38,8
CPT,0091U,Onc clrct scr whl bld alg,,,0.5,0.5,3
CPT,00920,Anes px male genitalia nos,,,20.69,20.69,18
CPT,00921,Anes px male genitalia vasec,,,20.69,20.69,18
CPT,00922,Anes px male gent sem ves,,,20.69,20.69,18
CPT,00924,Anes male gent undscnd tstis,,,20.69,20.69,18
CPT,00926,Anes male gent rad orch ing,,,20.69,20.69,18
CPT,00928,Anes male gent rad orch abd,,,20.69,20.69,18
CPT,0092A,N/A,,,101.73,121.38,8
CPT,0092U,Onc lng 3 prtn bmrk plsm alg,,,2488.0,7549.84,65
CPT,00930,Anes px male gent orchiopexy,,,20.69,20.69,18
CPT,00932,Anes male gent compl amp pns,,,20.69,15039.8,36
CPT,00934,Anes rad amp penis ingun lym,,,20.69,15039.8,36
CPT,00936,Anes rad amp pns ingun&ilac,,,20.69,15039.8,36
CPT,00938,Anes insj penile prosthesis,,,20.69,20.69,18
CPT,0093A,N/A,,,101.73,121.38,8
CPT,0093U,Rx mntr 65 com drugs urine,,,62.14,188.56,65
CPT,00940,Anes vaginal px nos,,,20.69,20.69,18
CPT,00942,Anes vag px clptmy vgnc clpr,,,20.69,20.69,18
CPT,00944,Anes vag px vag hysterectomy,,,20.69,20.69,18
CPT,00946,ANESTH-VAGINAL DELIVERY,,,20.69,20.69,18
CPT,00948,Anes vag px crv cerclage,,,20.69,20.69,18
CPT,0094A,N/A,,,101.73,121.38,8
CPT,0094U,Genome rapid sequence alys,,,7582.2,23008.19,65
CPT,00950,Anes vag px culdoscopy,,,20.69,20.69,18
CPT,00952,Anes vag px hystsc&/hsg,,,20.69,20.69,18
CPT,00955,ANALGESIA-VAGINAL DELIVERY,,,20.69,20.69,18
CPT,0095T,Rmvl artific disc addl crvcl,,,12954.18,15039.8,10
CPT,0095U,Ee 2 prtn bmrk elisa est,,,771.98,2342.57,65
CPT,0096U,Hpv hi risk types male urine,,,35.09,106.48,65
CPT,0097U,Gi pathogen 22 targets,,,923.29,1101.65,8
CPT,0098T,Rev artific disc addl,,,12954.18,15039.8,9
CPT,01000,ANESTH-SKIN SURGERY-PELVIS,,,20.69,20.69,18
CPT,0101T,Esw muscskel sys nos,,,35.66,266.99,27
CPT,0101T,HC OT SHOCKWAVE THERAPY 0101T,109.3,81.98,1.31,98.37,119
CPT,0101U,Hered colon ca do 15 genes,,,1743.95,5292.02,65
CPT,0102T,Esw phy anes lat hmrl epcndl,,,3110.48,3611.26,18
CPT,0102U,Hered brst ca rltd do 17 gen,,,1303.95,3956.84,65
CPT,0103U,Hered ova ca pnl 24 genes,,,1676.96,5292.02,65
CPT,0105U,Neph ckd mult eclia tum nec,,,950.0,2882.78,65
CPT,0106T,Touch quant sensory test,,,37.63,43.69,18
CPT,0106U,Gstr emptg 7 timed brth spec,,,779.17,2653.64,66
CPT,0107T,Vibrate quant sensory test,,,37.63,43.69,18
CPT,0107U,C diff tox ag detcj ia stool,,,16.0,48.55,65
CPT,0108T,Cool quant sensory test,,,56.94,66.11,18
CPT,0108U,Gi barrett esoph 9 prtn bmrk,,,3769.88,15020.78,65
CPT,0109T,Heat quant sensory test,,,37.63,43.69,18
CPT,0109U,Id aspergillus dna 4 species,,,142.63,432.81,65
CPT,0110T,Nos quant sensory test,,,123.57,143.47,18
CPT,0110U,Rx mntr 1+oral onc rx&sbsts,,,27.11,82.27,65
CPT,01110,ANESTH-SKIN SURGERY-PELVIS,,,20.69,20.69,18
CPT,01112,Anes bone marrow aspir&/bx,,,20.69,20.69,18
CPT,0111A,N/A,,,101.73,121.38,8
CPT,0111U,Onc colon ca kras&nras alys,,,607.92,2070.41,66
CPT,01120,Anes px on bony pelvis,,,20.69,20.69,18
CPT,0112A,N/A,,,101.73,121.38,8
CPT,0112U,Iadi 16s&18s rrna genes,,,356.13,1080.68,65
CPT,01130,Anes body cast appl/revj,,,20.69,20.69,18
CPT,0113A,N/A,,,101.73,121.38,8
CPT,0113U,Onc prst8 pca3&tmprss2-erg,,,760.0,2306.22,65
CPT,01140,Anes ntrplvabdmnl amputation,,,20.69,15039.8,28
CPT,0114U,Gi barretts esoph vim&ccna1,,,1938.01,5880.89,65
CPT,01150,Anes rad px tumor of pelvis,,,20.69,15039.8,28
CPT,0115U,Respir iadna 18 viral&2 bact,,,275.35,835.55,65
CPT,01160,Anes clsd px symph pub/si jt,,,20.69,20.69,18
CPT,0116U,Rx mntr nzm ia 35+oral flu,,,246.92,749.28,65
CPT,01170,Anes opn px symph pub/si jt,,,20.69,20.69,18
CPT,01173,Anes opn rpr fx disrpj plvs,,,20.69,20.69,18
CPT,01175,ANESTH-OPEN REPAIR OF PELVIC ACETABULAR FRACTURES,,,20.69,20.69,18
CPT,0117U,Pain mgmt 11 endogenous anal,,,840.65,2550.95,65
CPT,0118U,Trnsplj don-drv cll-fr dna,,,2753.25,8354.73,65
CPT,0119U,Crd ceramides liq chrom plsm,,,83.76,254.17,65
CPT,01200,Anes all closed px hip joint,,,20.69,20.69,18
CPT,01202,Anes arthroscopic px hip jt,,,20.69,20.69,18
CPT,0120U,Onc b cll lymphm mrna 58 gen,,,2510.21,7617.24,65
CPT,01210,Anes open px hip joint nos,,,20.69,20.69,18
CPT,01212,Anes open px hip jt disrtcj,,,20.69,15039.8,28
CPT,01214,Anes open px tot hip arthrp,,,20.69,20.69,18
CPT,01215,Anes opn revj tot hip arthrp,,,20.69,20.69,18
CPT,0121U,Sc dis vcam-1 whole blood,,,509.2,1545.17,65
CPT,01220,Anes clsd px upper 2/3 femur,,,20.69,20.69,18
CPT,0122U,Sc dis p-selectin whl blood,,,526.23,1596.84,65
CPT,01230,Anes opn upper 2/3 femur nos,,,20.69,20.69,18
CPT,01232,Anes opn px upr 2/3 fem amp,,,20.69,15039.8,28
CPT,01234,Anes opn upr 2/3 fem rad res,,,20.69,15039.8,28
CPT,0123U,Mchnl fragility rbc prflg,,,357.63,1085.23,65
CPT,01240,ANESTH-UPPER LEG SKIN SURG,,,20.69,20.69,18
CPT,0124A,N/A,,,95.65,114.12,8
CPT,01250,Anes all px nrv musc upr leg,,,20.69,20.69,18
CPT,01260,Anes all px veins upper leg,,,20.69,20.69,18
CPT,01270,Anes px arteries upr leg nos,,,20.69,20.69,18
CPT,01272,Anes px art femoral art lig,,,20.69,15039.8,36
CPT,01274,Anes px art fem art emblc,,,20.69,15039.8,28
CPT,0129U,Hered brst ca rltd do panel,,,1303.95,3956.84,65
CPT,01300,ANESTH-SKIN SURGERY-KNEE,,,20.69,20.69,18
CPT,0130U,Hered colon ca do mrna pnl,,,584.9,1774.88,65
CPT,0131U,Hered brst ca rltd do pnl 13,,,710.0,2154.5,56
CPT,01320,Anes all px nrv msc kne&/pop,,,20.69,20.69,18
CPT,0132U,Hered ova ca rltd do pnl 17,,,741.64,2250.51,56
CPT,0133U,Hered prst8 ca rltd do 11,,,690.29,2094.69,65
CPT,01340,Anes clsd px lower 1/3 femur,,,20.69,20.69,18
CPT,0134A,N/A,,,95.65,114.12,8
CPT,0134U,Hered pan ca mrna pnl 18 gen,,,748.39,2270.99,65
CPT,0135U,Hered gyn ca mrna pnl 12 gen,,,700.56,2125.85,56
CPT,01360,Anes open px lower 1/3 femur,,,20.69,20.69,18
CPT,0136U,Atm mrna seq alys,,,407.43,1236.34,65
CPT,0137U,Palb2 mrna seq alys,,,282.88,858.4,65
CPT,01380,Anes all clsd px knee joint,,,20.69,20.69,18
CPT,01382,Anes dx arthrs px knee jt,,,20.69,20.69,18
CPT,0138U,Brca1 brca2 mrna seq alys,,,468.33,1421.14,65
CPT,01390,Anes cls px upr tib fib&/pat,,,20.69,20.69,18
CPT,01392,Anes opn px upr tib fib&/pat,,,20.69,20.69,18
CPT,0139U,Neuro austm meas 6 c metablt,,,1907.4,2275.88,8
CPT,01400,Anes opn/arthrs knee jt nos,,,20.69,20.69,18
CPT,01402,Anes opn/arth tot kne arthrp,,,20.69,20.69,18
CPT,01404,Anes opn/arthrs disrtcj knee,,,20.69,15039.8,28
CPT,0140U,HC BLOOD CULTURE ID FUNGAL BY MOLECULAR ASSAY,1704.63,1278.47,20.46,1534.17,119
CPT,0140U,HC NFCT DS FUNGAL PATHOGEN ID DNA 15 FUNGAL TARGETS,1704.63,1278.47,20.46,1534.17,119
CPT,0140U,Nfct ds fungi dna 15 trgt,,,139.66,475.66,66
CPT,0141U,HC BLOOD CULTURE ID GRAM POSITIVE BY MOLECULAR ASSAY,1704.8,1278.6,20.46,1534.32,119
CPT,0141U,HC NFCT DS BACT&FNG GRAM POS ORG ID & RX RESIST DNA,1704.8,1278.6,20.46,1534.32,119
CPT,0141U,Nfct ds bact&fng gram pos,,,139.66,475.66,66
CPT,01420,Anes cst appl rmv/rpr kne jt,,,20.69,20.69,18
CPT,0142U,HC BLOOD CULTURE ID GRAM NEGATIVE BY MOLECULAR ASSAY,1704.8,1278.6,20.46,1534.32,119
CPT,0142U,HC NFCT DS BACT&FNG GRAM NEG ORG ID & RX RESIST DNA,1704.8,1278.6,20.46,1534.32,119
CPT,0142U,Nfct ds bact&fng gram neg,,,139.66,475.66,66
CPT,01430,Anes px veins knee&pop nos,,,20.69,20.69,18
CPT,01432,Anes px vn knee&pop av fstl,,,20.69,20.69,18
CPT,0143U,Drug assay 120+ rx/metablt,,,114.43,347.24,44
CPT,01440,Anes px art knee&pop nos,,,20.69,20.69,18
CPT,01442,Anes px art knee&pop teaec,,,20.69,15039.8,36
CPT,01444,Anes px art knee&pop exc&grf,,,20.69,15039.8,36
CPT,0144A,N/A,,,95.65,114.12,8
CPT,0144U,Drug assay 160+ rx/metablt,,,114.43,347.24,44
CPT,0145U,Drug assay 65+ rx/metablt,,,114.43,347.24,44
CPT,01460,ANESTH-LOWER LEG SKIN SURG,,,20.69,20.69,18
CPT,01462,Anes clsd px lower l/a/f,,,20.69,20.69,18
CPT,01464,Anes arthrs px ankle&/foot,,,20.69,20.69,18
CPT,0146U,Drug assay 80+ rx/metablt,,,114.43,347.24,44
CPT,01470,Anes px nrv msc lw l/a/f nos,,,20.69,20.69,18
CPT,01472,Anes rpr rpt achilles tendon,,,20.69,20.69,18
CPT,01474,Anes gastrocnemius recession,,,20.69,20.69,18
CPT,0147U,Drug assay 85+ rx/metablt,,,114.43,347.24,44
CPT,01480,Anes open px lower l/a/f nos,,,20.69,20.69,18
CPT,01482,Anes opn lwr l/a/f rad rescj,,,20.69,20.69,18
CPT,01484,Anes opn lw l/a/f oste/ostpl,,,20.69,20.69,18
CPT,01486,Anes open total ankle rplcmt,,,20.69,20.69,18
CPT,0148U,Drug assay 100+ rx/metablt,,,114.43,347.24,44
CPT,01490,Anes lwr leg cst app rmv/rpr,,,20.69,20.69,18
CPT,0149U,Drug assay 60+ rx/metablt,,,114.43,347.24,44
CPT,01500,Anes px art lower leg nos,,,20.69,20.69,18
CPT,01502,Anes px art lower leg emblc,,,20.69,15039.8,36
CPT,0150U,Drug assay 120+ rx/metablt,,,114.43,347.24,44
CPT,0151U,Nfct bct/vir resp nfctj 33,,,486.01,579.89,8
CPT,01520,Anes px veins lower leg nos,,,20.69,20.69,18
CPT,01522,Anes px vn lwr leg ven thrmb,,,20.69,20.69,18
CPT,0152U,Nfct ds dna untrgt ngnrj seq,,,2126.2,6451.96,65
CPT,0153U,Onc breast mrna 101 genes,,,3159.42,9587.26,65
CPT,0154A,N/A,,,95.65,114.12,8
CPT,0154U,Onc urthl ca rna fgfr3 gene,,,429.59,1463.05,66
CPT,0155U,Onc brst ca dna pik3ca gene,,,244.87,833.97,66
CPT,0156U,Copy number sequence alys,,,1740.0,5280.03,65
CPT,0157U,Apc mrna seq alys,,,282.88,858.4,65
CPT,0158U,Mlh1 mrna seq alys,,,282.88,858.4,65
CPT,0159U,Msh2 mrna seq alys,,,282.88,858.4,65
CPT,01600,ANESTH-SHOULDER SKIN SURG,,,20.69,20.69,18
CPT,0160U,Msh6 mrna seq alys,,,282.88,858.4,65
CPT,01610,Anes all px nrv musc sho&ax,,,20.69,20.69,18
CPT,0161U,Pms2 mrna seq alys,,,282.88,858.4,65
CPT,01620,Anes clsd px shoulder joint,,,20.69,20.69,18
CPT,01622,Anes dx arthr px shoulder jt,,,20.69,20.69,18
CPT,0162U,Hered colon ca trgt mrna pnl,,,486.54,1476.41,65
CPT,01630,Anes opn/arthr px sho jt nos,,,20.69,20.69,18
CPT,01632,Anesth - surgery of shoulder,,,20.69,20.69,18
CPT,01634,Anes open/arthrs sho disrtcj,,,20.69,15039.8,28
CPT,01636,Anes open/arthr ntrthrc amp,,,20.69,15039.8,28
CPT,01638,Anes opn/arthr tot sho rplcm,,,20.69,20.69,18
CPT,0163U,Onc clrct scr 3 prtn alg,,,390.75,1185.73,47
CPT,0164T,Remove lumb artif disc addl,,,12954.18,15039.8,10
CPT,0164U,Gi ibs ia anti-cdtb&vinculin,,,112.02,339.93,65
CPT,01650,Anes art sho&ax nos,,,20.69,20.69,18
CPT,01652,Anes art sho&ax ax-brch arsm,,,20.69,15039.8,36
CPT,01654,Anes art sho&ax bypass grf,,,20.69,15039.8,36
CPT,01656,Anes art sho&ax ax-fem bpg,,,20.69,15039.8,36
CPT,0165T,Revise lumb artif disc addl,,,12954.18,15039.8,9
CPT,0165U,Peanut allg asmt epi,,,463.76,1407.28,65
CPT,0166U,Liver ds 10 biochem asy srm,,,503.4,1527.57,65
CPT,01670,Anes all px vn shoulder&ax,,,20.69,20.69,18
CPT,0167U,Chornc gonadotropin hcg ia,,,7.52,22.82,44
CPT,01680,Anes sho cast appl rmvl/rpr,,,20.69,20.69,18
CPT,0168U,Ftl aneuploidy dna seq alys,,,1930.41,2303.33,8
CPT,0169U,Nudt15&tpmt gene com vrnt,,,466.17,1414.59,65
CPT,01700,ANESTH-ELBOW AREA SKIN SURG,,,20.69,20.69,18
CPT,0170U,Neuro asd rna next gen seq,,,1755.0,5917.28,65
CPT,01710,Anes px nrv musc upr a&e nos,,,20.69,20.69,18
CPT,01712,Anes px nrv msc upr a&e tnot,,,20.69,20.69,18
CPT,01714,Anes nrv msc upr a&e tnplsty,,,20.69,20.69,18
CPT,01716,Anes nrv msc upr a&e tndsis,,,20.69,20.69,18
CPT,0171U,Trgt gen seq alys pnl dna 23,,,1519.06,4609.58,65
CPT,0172U,Onc sld tum alys brca1 brca2,,,2699.73,9194.54,66
CPT,01730,Anes clsd px humerus&elbow,,,20.69,20.69,18
CPT,01732,Anes dx arthrs px elbow jt,,,20.69,20.69,18
CPT,0173U,Psyc gen alys panel 14 genes,,,466.17,1414.59,65
CPT,01740,Anes opn/arthrs px elbw nos,,,20.69,20.69,18
CPT,01742,Anes opn/arthrs elbw osteot,,,20.69,20.69,18
CPT,01744,Anes opn/arthrs elbw rpr hum,,,20.69,20.69,18
CPT,0174U,Onc solid tumor 30 prtn trgt,,,1305.37,3961.15,65
CPT,01756,Anes opn/arthrs elbw rad px,,,20.69,15039.8,28
CPT,01758,Anes opn/arthrs elbw exc cst,,,20.69,20.69,18
CPT,0175U,Psyc gen alys panel 15 genes,,,1336.09,4054.37,65
CPT,01760,Anes opn/arthr elb tot rplct,,,20.69,20.69,18
CPT,0176U,Cdtb&vinculin igg antb ia,,,64.19,194.79,65
CPT,01770,Anes px art upr arm&elbw nos,,,20.69,20.69,18
CPT,01772,Anes art upr arm&elbw emblc,,,20.69,20.69,18
CPT,0177U,Onc brst ca dna pik3ca 11,,,244.87,833.97,66
CPT,01780,Anes px vn upr arm&elbw nos,,,20.69,20.69,18
CPT,01782,Anes vn upr arm&elbw phlbrpy,,,20.69,20.69,18
CPT,01784,ANESTH-AV FISTULA REPAIR,,,20.69,20.69,18
CPT,0178U,Peanut allg asmt epi clin rx,,,459.86,1395.45,65
CPT,0179U,Onc nonsm cll lng ca alys 23,,,1943.21,5896.67,65
CPT,01800,ANESTH-LOWER ARM SKIN SURG,,,20.69,20.69,18
CPT,0180U,Abo gnotyp abo 7 exons,,,274.83,833.97,65
CPT,01810,Anes px nrv musc f/arm wrst,,,20.69,20.69,18
CPT,0181U,Co gnotyp aqp1 exon 1,,,185.2,561.99,65
CPT,01820,Anes clsd px rds u/w/h bones,,,20.69,20.69,18
CPT,01829,Anes dx arthroscopic px wrst,,,20.69,20.69,18
CPT,0182U,Crom gnotyp cd55 exons 1-10,,,301.35,914.45,65
CPT,01830,Anes arthr/ndsc wrst/hnd nos,,,20.69,20.69,18
CPT,01832,Anes arthr/ndsc tot wrst rpl,,,20.69,20.69,18
CPT,0183U,Di gnotyp slc4a1 exon 19,,,185.2,561.99,65
CPT,01840,Anes art f/arm wrst&hnd nos,,,20.69,20.69,18
CPT,01842,Anes art farm wrst&hnd emblc,,,20.69,20.69,18
CPT,01844,Anes vasc shunt/shunt revj,,,20.69,20.69,18
CPT,0184T,Exc rectal tumor endoscopic,,,2045.34,6625.5,27
CPT,0184U,Do gnotyp art4 exon 2,,,185.2,561.99,65
CPT,01850,Anes vein f/arm wrst&hnd nos,,,20.69,20.69,18
CPT,01852,Anes px vn f/arm phlbrrhaphy,,,20.69,20.69,18
CPT,0185U,Fut1 gnotyp fut1 exon 4,,,185.2,561.99,65
CPT,01860,Anes forearm wrist/hand cast,,,20.69,20.69,18
CPT,0186U,Fut2 gnotyp fut2 exon 2,,,185.2,561.99,65
CPT,0187U,Fy gnotyp ackr1 exons 1-2,,,274.83,833.97,65
CPT,0188U,Ge gnotyp gypc exons 1-4,,,274.83,833.97,65
CPT,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,274.83,833.97,65
CPT,01900,N/A,,,20.69,20.69,18
CPT,01902,ANESTH-BURR HOLES-SKULL,,,20.69,20.69,18
CPT,01904,ANESTH-SKULL X-RAY INJECT,,,20.69,20.69,18
CPT,01905,N/A,,,20.69,20.69,18
CPT,01906,ANESTH-LUMBAR MYELOGRAPHY,,,20.69,20.69,18
CPT,01908,ANESTH-CERVICAL MYELOGRAPHY,,,20.69,20.69,18
CPT,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,274.83,833.97,65
CPT,01910,ANESTH-SKULL MYELOGRAPHY,,,20.69,20.69,18
CPT,01912,ANESTH-LUMBAR DISCOGRAPHY,,,20.69,20.69,18
CPT,01914,ANESTH-CERVICAL DISCOGRAPHY,,,20.69,20.69,18
CPT,01916,Anes dx arteriography/vngrph,,,20.69,20.69,18
CPT,01918,ANESTH-LIMB ARTERIOGRAM,,,20.69,20.69,18
CPT,0191U,In gnotyp cd44 exons 2 3 6,,,274.83,833.97,65
CPT,01920,Anes cardiac catheterization,,,20.69,20.69,18
CPT,01921,ANESTH-VESSEL SURGERY,,,20.69,20.69,18
CPT,01922,Anes n-invas img/radj ther,,,20.69,20.69,18
CPT,01924,Anes ther ivntl rad artl nos,,,20.69,20.69,18
CPT,01925,Anes ivntl rad artl crtd/c,,,20.69,20.69,18
CPT,01926,Anes ivntl rad icr icar/aort,,,20.69,20.69,18
CPT,0192U,Jk gnotyp slc14a1 exon 9,,,274.83,833.97,65
CPT,01930,Anes ther ivntl rad ven nos,,,20.69,20.69,18
CPT,01931,Anes ivnt rad ntrhpt/prt crc,,,20.69,20.69,18
CPT,01932,Anes th ivnt rad ntrthrc/jug,,,20.69,20.69,18
CPT,01933,Anes ther ivntl rad px icr,,,20.69,20.69,18
CPT,01935,Anesth perc img dx sp proc,,,20.69,20.69,18
CPT,01936,Anesth perc img tx sp proc,,,20.69,20.69,18
CPT,0193U,Jr gnotyp abcg2 exons 2-26,,,282.88,858.4,65
CPT,01941,Anes neuromd/ntrvrt crv/thrc,,,20.69,20.69,18
CPT,01942,Anes neuromd/ntrvrt lmbr/sac,,,20.69,20.69,18
CPT,01943,ANESTH-INTERVENTIONAL RADIOLOGIC FOR INTRATHORACIC OR JUGULAR,,,20.69,20.69,18
CPT,01944,ANESTH-INTERVENTIONAL RADIOLOGIC FOR INTRACRANIAL,,,20.69,20.69,18
CPT,0194U,Kel gnotyp kel exon 8,,,185.2,561.99,65
CPT,01951,Anes 2&3 burn less 4 % tbsa,,,20.69,20.69,18
CPT,01952,Anes 2&3 burn 4-9% tbsa,,,20.69,20.69,18
CPT,01953,Anes 2&3 burn ea add 9% tbsa,,,20.69,20.69,18
CPT,01958,Anes xtrnl cephalic version,,,20.69,20.69,18
CPT,0195U,Klf1 targeted sequencing,,,375.25,1138.69,65
CPT,01960,Anes vaginal delivery only,,,20.69,20.69,18
CPT,01961,Anes cesarean delivery only,,,20.69,20.69,18
CPT,01962,Anes urgent hysterectomy,,,20.69,20.69,18
CPT,01963,Anes cesarean hysterectomy,,,20.69,20.69,18
CPT,01965,Anes incompl/missed ab px,,,20.69,20.69,18
CPT,01966,Anes induced abortion px,,,20.69,20.69,18
CPT,01967,Neuraxl lbr anes vag dlvr,,,20.69,20.69,18
CPT,01968,Anes/analg cs dlvr neuraxial,,,20.69,20.69,18
CPT,01969,Anes c hyst flwg neuraxial,,,20.69,20.69,18
CPT,0196U,Lu gnotyp bcam exon 3,,,185.2,561.99,65
CPT,0197U,Lw gnotyp icam4 exon 1,,,185.2,561.99,65
CPT,01980,ACUTE NORMOVOLEMIC HEMODILUTION,,,20.69,20.69,18
CPT,0198T,Ocular blood flow measure,,,123.57,143.47,18
CPT,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,282.88,858.4,65
CPT,01990,Physiol support hrvg organs,,,20.69,15039.8,36
CPT,01991,Anes dx/ther nrv blk&inj oth,,,20.69,20.69,18
CPT,01992,Anes dx/ther nrv blk&inj prn,,,20.69,20.69,18
CPT,01995,Regional anesthesia limb,,,20.69,20.69,18
CPT,01996,Dly hosp mgmt edrl rx admin,,,20.69,20.69,18
CPT,01997,DAILY HOSPITAL MANAGEMENT OF INTRAVENOUS PATIENT,,,20.69,20.69,18
CPT,01998,DAILY HOSPITAL MANAGEMENT OF CONTINUOUS PLEXUS OR MAJOR NERVE DRUG ADMINISTRATION,,,20.69,20.69,18
CPT,01999,Unlisted anes procedure,,,20.69,20.69,18
CPT,0199U,Sc gnotyp ermap exons 4 12,,,274.83,833.97,65
CPT,0200T,HC PERC SACROPLAST UNILATERAL INCL IMAGE AND BIOPSY,3850.77,2888.08,46.21,3465.69,119
CPT,0200T,Perq sacral augmt unilat inj,,,6848.41,7951.0,18
CPT,0200U,Xk gnotyp xk exons 1-3,,,274.83,833.97,65
CPT,0201T,HC PERC SACROPLAST BILATERAL INCL IMAGE AND BIOPSY,9516.38,7137.28,114.2,8564.74,119
CPT,0201T,Perq sacral augmt bilat inj,,,3508.88,7951.0,26
CPT,0201U,Yt gnotyp ache exon 2,,,185.2,561.99,65
CPT,0202T,Post vert arthrplst 1 lumbar,,,12954.18,15039.8,18
CPT,0202U,HC  BCT/VIR RESPIR DNA/RNA 22 TRGT SARSCOV2,599.96,449.97,7.2,539.96,119
CPT,0202U,Nfct ds 22 trgt sars-cov-2,,,371.35,1382.87,66
CPT,0203U,Ai ibd mrna xprsn prfl 17,,,760.0,2306.22,65
CPT,0204U,Onc thyr mrna xprsn alys 593,,,2919.6,8859.52,44
CPT,0205U,Oph amd alys 3 gene variants,,,47.0,142.62,65
CPT,0206U,Neuro alzheimer cell aggregj,,,2215.4,6722.64,65
CPT,0207T,Clear eyelid gland w/heat,,,123.57,190.75,26
CPT,0207U,Neuro alzheimer quan imaging,,,511.2,1551.24,47
CPT,0208T,Audiometry air only,,,37.63,43.69,18
CPT,0209T,Audiometry air & bone,,,37.63,43.69,18
CPT,0209U,Cytog const alys interrog,,,787.15,2388.6,65
CPT,0210T,Speech audiometry threshold,,,37.63,43.69,18
CPT,0210U,Syphilis tst antb ia quan,,,16.6,56.53,66
CPT,0211T,Speech audiom thresh & recog,,,37.63,43.69,18
CPT,0211U,Onc pan-tum dna&rna gnrj seq,,,8455.0,25656.7,65
CPT,0212T,Compre audiometry evaluation,,,130.29,174.14,18
CPT,0212U,Rare ds gen dna alys proband,,,5475.2,16614.5,65
CPT,0213T,Njx paravert w/us cer/thor,,,489.77,990.9,26
CPT,0213U,Rare ds gen dna alys ea comp,,,2709.95,8223.35,65
CPT,0214T,Njx paravert w/us cer/thor,,,247.02,294.75,8
CPT,0214U,Rare ds xom dna alys proband,,,5224.6,15854.04,65
CPT,0215T,Njx paravert w/us cer/thor,,,249.89,298.17,8
CPT,0215U,Rare ds xom dna alys ea comp,,,2574.65,7812.78,65
CPT,0216T,Njx paravert w/us lumb/sac,,,435.63,990.9,26
CPT,0216U,Neuro inh ataxia dna 12 com,,,1537.02,4664.09,65
CPT,0217T,Njx paravert w/us lumb/sac,,,224.21,267.52,8
CPT,0217U,Neuro inh ataxia dna 51 gene,,,2198.35,6670.89,65
CPT,0218T,Njx paravert w/us lumb/sac,,,227.08,270.95,8
CPT,0218U,Neuro musc dys dmd seq alys,,,2279.0,6915.63,65
CPT,0219T,Plmt post facet implt cerv,,,12954.18,15039.8,18
CPT,0219U,Nfct agt hiv gnrj seq alys,,,645.97,2200.01,66
CPT,0220T,Plmt post facet implt thor,,,12954.18,15039.8,18
CPT,0220U,Onc brst ca ai assmt 12 feat,,,706.25,2143.11,65
CPT,0221T,Plmt post facet implt lumb,,,6848.41,7951.0,18
CPT,0221U,Abo gnotyp next gnrj seq abo,,,274.83,833.97,65
CPT,0222U,Rhd&rhce gntyp next gnrj seq,,,282.88,858.4,65
CPT,0223U,Nfct ds 22 trgt sars-cov-2,,,371.35,1264.71,66
CPT,0224U,Antibody sars-cov-2 titer(s),,,45.82,156.06,66
CPT,0225U,Nfct ds dna&rna 21 sarscov2,,,371.35,1264.71,66
CPT,0226U,Svnt sarscov2 elisa plsm srm,,,37.67,128.3,66
CPT,0227U,Rx asy prsmv 30+rx/metablt,,,62.14,188.56,65
CPT,0228U,Onc prst8 ma molec prfl alg,,,173.03,525.06,65
CPT,0229U,Bcat1&ikzf1 prmtr mthyln aly,,,288.0,1165.25,65
CPT,0230U,Ar full sequence analysis,,,301.35,914.45,65
CPT,0231U,Cacna1a full gene analysis,,,846.27,2568.01,65
CPT,0232T,HC NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,583.22,437.42,7.0,524.9,119
CPT,0232T,Njx platelet plasma,,,355.74,452.32,27
CPT,0232U,Cstb full gene analysis,,,274.83,833.97,65
CPT,0233U,Fxn gene analysis,,,274.83,833.97,65
CPT,0234T,Trluml perip athrc renal art,,,10871.75,12622.1,18
CPT,0234U,Mecp2 full gene analysis,,,527.87,1601.82,65
CPT,0235T,Trluml perip athrc visceral,,,12954.18,15039.8,18
CPT,0235U,Pten full gene analysis,,,600.0,1820.7,65
CPT,0236T,Trluml perip athrc abd aorta,,,10871.75,12622.1,18
CPT,0236U,Smn1&smn2 full gene analysis,,,602.7,1828.89,65
CPT,0237T,HC TRLUML PERIP ATHREC BRCHIOCPH,22109.54,16582.16,265.31,19898.59,119
CPT,0237T,Trluml perip athrc brchiocph,,,10871.75,30373.04,26
CPT,0237U,Car ion chnlpthy gen seq pnl,,,584.9,1774.88,65
CPT,0238T,Trluml perip athrc iliac art,,,17214.39,33890.33,26
CPT,0238U,Onc lnch syn gen dna seq aly,,,584.9,1774.88,65
CPT,0239U,Trgt gen seq alys pnl 311+,,,3118.5,10620.75,66
CPT,0240U,Nfct ds vir resp rna 3 trgt,,,127.08,432.81,45
CPT,0241U,Nfct ds vir resp rna 4 trgt,,,14.19,142.63,45
CPT,0242U,Trgt gen seq alys pnl 55-74,,,4455.0,15172.5,66
CPT,0243U,Ob pe biochem assay pgf alg,,,64.41,195.45,65
CPT,0244U,Onc solid orgn dna 257 genes,,,3500.0,10620.75,65
CPT,0245U,Onc thyr mut alys 10 gen&37,,,1266.07,3841.89,65
CPT,0246U,Rbc dna gnotyp 16 bld groups,,,720.0,2184.84,65
CPT,0247U,Ob prtrm brth ibp4 shbg meas,,,750.0,2275.88,65
CPT,0248U,Onc sphrd cell cul 12 rx pnl,,,3033.86,9206.25,65
CPT,0249U,Onc brst alys 32 phsprtn alg,,,2219.13,6733.95,65
CPT,0250U,Onc sld org neo dna 505 gene,,,2601.36,8859.52,66
CPT,0251U,Hepcidin-25 elisa serum/plsm,,,17.27,52.41,65
CPT,0252U,Ftl aneuploidy str alys dna,,,759.05,2303.33,65
CPT,0253T,Insert aqueous drain device,,,3856.55,4477.46,19
CPT,0253U,Rprdtve med rna gen prfl 238,,,3159.42,9587.26,65
CPT,0254U,Reprdtve med alys 24 chrmsm,,,759.05,2303.33,65
CPT,0255U,Andrology infertility assmt,,,31.6,95.89,65
CPT,0256U,Tma/tmao prfl lcms/ms ur alg,,,159.95,485.37,65
CPT,0257U,Vlcad leuk nzm actv whl bld,,,712.47,2161.99,65
CPT,0258U,Ai psor mrna 50-100 gen alg,,,3675.0,11151.79,65
CPT,0259U,Neph ckd nuc mrs meas gfr,,,52.71,159.95,65
CPT,0260U,Rare ds id opt genome mapg,,,1263.53,3834.18,65
CPT,0261U,Onc clrct ca img alys w/ai,,,2513.25,7626.45,65
CPT,0262U,Onc sld tum rt-pcr 7 gen,,,3200.0,9710.4,65
CPT,0263T,Im b1 mrw cel ther cmpl,,,4410.06,5214.62,18
CPT,0263U,Neuro asd meas 16 c metblt,,,750.0,2275.88,65
CPT,0264T,Im b1 mrw cel ther xcl hrvst,,,4410.06,5214.62,18
CPT,0264U,Rare ds id opt genome mapg,,,1263.53,3834.18,65
CPT,0265T,Im b1 mrw cel ther hrvst onl,,,4410.06,5214.62,18
CPT,0265U,Rar do whl gn&mtcdrl dna als,,,5475.8,16616.31,65
CPT,0266T,Implt/rpl crtd sns dev total,,,670.44,50085.75,17
CPT,0266U,Unxpl cnst hrtbl do gn xprsn,,,3200.0,9710.4,65
CPT,0267T,Implt/rpl crtd sns dev lead,,,402.0,3827.63,17
CPT,0267U,Rare do id opt gen mapg&seq,,,6739.33,20450.49,65
CPT,0268T,Implt/rpl crtd sns dev gen,,,399.97,33917.23,17
CPT,0268U,Hem ahus gen seq alys 15 gen,,,608.17,1845.49,65
CPT,0269T,Rev/remvl crtd sns dev total,,,6139.33,7127.76,9
CPT,0269U,Hem aut dm cgen trmbctpna 22,,,608.17,1845.49,65
CPT,0270T,Rev/remvl crtd sns dev lead,,,3296.84,3827.63,9
CPT,0270U,Hem cgen coagj do 20 genes,,,608.17,1845.49,65
CPT,0271T,Rev/remvl crtd sns dev gen,,,3296.84,3827.63,9
CPT,0271U,Hem cgen neutropenia 24 gen,,,608.17,1845.49,65
CPT,0272T,Interrogate crtd sns dev,,,75.03,174.14,17
CPT,0272U,Hem genetic bld do 60 genes,,,608.17,1845.49,65
CPT,0273T,Interrogate crtd sns w/pgrmg,,,149.99,202.98,17
CPT,0273U,Hem gen hyprfibrnlysis 8 gen,,,608.17,1845.49,65
CPT,0274T,Prq lamot/lam dcmpr crv/thrc,,,6848.41,7951.0,18
CPT,0274U,Hem gen pltlt do 62 genes,,,608.17,1845.49,65
CPT,0275T,Perq lamot/lam lumbar,,,6848.41,7951.0,9
CPT,0275U,Hem heprn nduc trmbctpna srm,,,18.37,55.74,65
CPT,0276U,Hem inh thrombocytopenia 42,,,2448.56,7430.16,65
CPT,0277U,Hem gen pltlt funcj do 40,,,608.17,1845.49,65
CPT,0278T,Tempr,,,130.29,174.14,18
CPT,0278U,Hem gen thrombosis 14 genes,,,608.17,1845.49,65
CPT,0279U,Hem vw factor&clgn iii bndg,,,11.53,34.99,65
CPT,0280U,Hem vw factor&clgn iv bndg,,,17.27,52.41,65
CPT,0281U,Hem vwd propeptide ag lvl,,,17.27,52.41,65
CPT,0282U,Rbc dna gntyp 12 bld grp gen,,,720.0,2184.84,65
CPT,0283U,Vw factor type 2b eval plsm,,,18.4,55.84,65
CPT,0284U,Vw factor type 2n eval plsm,,,17.27,52.41,65
CPT,0285U,Onc ds prog&rspse mntr radj,,,443.31,1470.9,29
CPT,0286U,Cep72 nudt15&tpmt gene alys,,,134.13,407.02,65
CPT,0287U,Onc thyr dna&mrna 112 genes,,,3600.0,10924.2,65
CPT,0288U,Onc lung mrna quan pcr 11&3,,,3873.0,11752.62,65
CPT,0289U,Neuro alzheimer mrna 24 gen,,,760.0,2306.22,65
CPT,0290U,Pain mgmt mrna gen xprsn 36,,,760.0,2306.22,65
CPT,0291U,Psyc mood do mrna 144 genes,,,1755.0,5823.09,29
CPT,0292U,Psyc strs do mrna 72 genes,,,1755.0,5823.09,29
CPT,0293U,Psyc suicidal idea mrna 54,,,760.0,2306.22,65
CPT,0294U,Lngvty&mrtlty rsk mrna 18gen,,,760.0,2306.22,47
CPT,0295U,Onc brst dux carc 7 proteins,,,1897.0,16492.51,65
CPT,0296U,Onc orl&/orop ca 20 mlc feat,,,1755.0,5917.28,65
CPT,0297U,Onc pan tum whl gen seq dna,,,2919.6,9687.24,29
CPT,0298U,Onc pan tum whl trns seq rna,,,2919.6,8859.52,65
CPT,0299U,Onc pan tum whl gen opt mapg,,,1863.22,6182.17,29
CPT,0300U,Onc pan tum whl gen seq&opt,,,4183.13,13879.62,29
CPT,0301U,Iadna bartonella ddpcr,,,262.72,871.71,29
CPT,0302U,Iadna brtnla ddpcr flwg liq,,,361.37,1199.03,29
CPT,0303U,Hem rbc ads whl bld hypoxic,,,2201.62,7304.98,29
CPT,0304U,Hem rbc ads whl bld normoxic,,,2075.8,6887.51,29
CPT,0305U,Hem rbc fnclty&dfrm shr strs,,,662.58,2198.44,29
CPT,0306U,Onc mrd nxt-gnrj alys 1st,,,3878.45,12868.7,29
CPT,0307U,Onc mrd nxt-gnrj alys sbsq,,,794.49,2636.12,29
CPT,0308T,Insj ocular telescope prosth,,,15737.79,18271.57,19
CPT,0308U,Crd cad alys 3 prtn 3 param,,,390.75,1185.73,65
CPT,0309U,Crd cv ds aly 4 prtn plm alg,,,390.75,1185.73,65
CPT,0310U,Ped vsclts kd alys 3 bmrks,,,390.75,1185.73,65
CPT,0311U,Nfct ds bct quan antmcrb sc,,,7.2,24.52,66
CPT,0312U,Ai ds sle alys 8 igg autoant,,,840.65,2550.95,65
CPT,0313U,Onc pncrs dna&mrna seq 74,,,3600.0,10924.2,65
CPT,0314U,Onc cutan mlnma mrna 35 gene,,,1950.0,6470.1,29
CPT,0315U,Onc cutan sq cll ca mrna 40,,,8500.0,28203.0,29
CPT,0316U,B brgdrferi lyme ds ospa evl,,,18.66,56.63,65
CPT,0317U,Onc lung ca 4-prb fish assay,,,2030.0,6160.04,65
CPT,0318U,Ped whl gen mthyltn alys 50+,,,1770.48,5874.46,29
CPT,0319U,Neph rna pretrnspl perph bld,,,2650.0,8792.7,29
CPT,0320U,Neph rna psttrnspl perph bld,,,2650.0,8792.7,29
CPT,0321U,Iadna gu pthgn 20bct&fng org,,,634.84,1926.42,65
CPT,0322U,Neuro asd meas 14 acyl carn,,,750.0,2275.88,65
CPT,0323U,Iadna cns pthgn next gen seq,,,2126.2,6451.96,65
CPT,0324U,Onc ovar sphrd cell 4 rx pnl,,,1112.14,1112.14,36
CPT,0325U,Onc ovar sphrd cell parp,,,1112.14,1112.14,36
CPT,0326U,Trgt gen seq alys pnl 83+,,,4455.0,16590.0,30
CPT,0327U,Ftl aneuploidy trsmy dna seq,,,795.0,2412.43,65
CPT,0328U,Drug assay 120+ rx&metablt,,,114.43,347.24,65
CPT,0329U,Onc neo xome&trns seq alys,,,3437.98,11407.22,29
CPT,0330T,Tear film img uni/bi w/i&r,,,37.63,125.33,26
CPT,0330U,Iadna vag pthgn panel 27 org,,,416.78,1264.71,65
CPT,0331T,Heart symp image plnr,,,1251.51,1453.0,18
CPT,0331U,Onc hl neo opt gen mapping,,,1863.22,6182.17,29
CPT,0332T,Heart symp image plnr spect,,,1251.51,1453.0,18
CPT,0332U,Onc pan tum gen prflg 8 dna,,,1142.06,3789.36,29
CPT,0333U,Onc lvr surveilanc hcc cfdna,,,662.32,2197.58,29
CPT,0334U,Onc sld orgn tgsa dna 84/+,,,2919.6,10620.75,65
CPT,0335T,Insj sinus tarsi implant,,,6848.41,7951.0,18
CPT,0335U,Rare ds whl gen seq feta,,,5224.6,15854.04,65
CPT,0336U,Rare ds whl gen seq bld/slv,,,2574.65,7812.78,65
CPT,0337U,Onc plsm cell do&myeloma id,,,2435.0,8079.33,29
CPT,0338T,HC TRNSCTH RENAL SYMP DENRV UNL,16652.58,12489.44,199.83,14987.32,119
CPT,0338T,Trnscth renal symp denrv unl,,,5465.82,6345.82,18
CPT,0338U,Onc sld tum crcg tum cl slct,,,2169.58,8079.33,30
CPT,0339T,HC TRNSCTH RENAL SYMP DENRV BIL,24176.42,18132.31,290.12,21758.78,119
CPT,0339T,Trnscth renal symp denrv bil,,,5465.82,6345.82,18
CPT,0339U,Onc prst8 mrna hoxc6 & dlx1,,,760.0,2306.22,65
CPT,0340U,Onc pan ca alys mrd plasma,,,3590.0,11895.24,65
CPT,0341U,Ftl aneup dna seq cmpr alys,,,1900.2,6304.86,29
CPT,0342T,Thxp apheresis w/hdl delip,,,4410.06,5214.62,18
CPT,0342U,Onc pncrtc ca mult ia eclia,,,897.0,2721.95,47
CPT,0343U,Onc prst8 xom aly 442 sncrna,,,677.16,2306.22,66
CPT,0344U,Hep nafld semiq evl 28 lipid,,,792.17,2628.42,29
CPT,0345T,HC TMVR PERQ VIA CORONARY SINUS,19042.84,14282.13,228.51,17138.56,119
CPT,0345T,Transcath mtral vlve repair,,,12954.18,15039.8,18
CPT,0345U,Psyc genom alys pnl 15 gen,,,1336.09,4054.37,65
CPT,0347T,Ins bone device for rsa,,,56.94,66.11,18
CPT,0347U,Rx metab/pcx dna 16 gen alys,,,1336.09,4054.37,65
CPT,0348T,Rsa spine exam,,,101.95,118.36,18
CPT,0348U,Rx metab/pcx dna 25 gen alys,,,742.27,2252.42,65
CPT,0349T,Rsa upper extr exam,,,101.95,118.36,18
CPT,0349U,Rx metab/pcx dna 27gen rx ia,,,742.27,2252.42,65
CPT,0350T,Rsa lower extr exam,,,84.41,98.0,18
CPT,0350U,Rx metab/pcx dna 27 gen alys,,,1336.09,4054.37,65
CPT,0351U,Nfct ds bct/viral trail ip10,,,232.11,790.49,66
CPT,0352U,HCD NFCT DS BCT VAGINOSIS&VAGINITIS MULT AMP PROBE,689.22,516.92,8.27,620.3,119
CPT,0352U,Nfct ds bv&vaginitis amp prb,,,142.63,432.81,44
CPT,0353U,Iadna chlmyd&gonorr amp prb,,,70.18,212.96,44
CPT,0354U,Hpv hi rsk qual mrna e6/e7,,,35.09,106.48,44
CPT,0355U,Apol1 risk variants,,,137.0,454.57,29
CPT,0356U,Onc orop/anal 17 dna ddpcr,,,1800.0,5972.4,29
CPT,0358T,Bia whole body,,,22.0,29.28,27
CPT,0358U,Neuro alys b-amyl 1-42&1-40,,,260.5,864.34,29
CPT,0359U,Onc prst8 ca alys all psa,,,760.0,2521.68,29
CPT,0360U,Onc lung elisa 7 autoant alg,,,782.93,2597.76,29
CPT,0361U,Neurflmnt lt chn dig ia quan,,,116.23,174.35,12
CPT,0362T,Bhv id suprt assmt ea 15 min,,,28.56,37.93,18
CPT,0362U,Onc pap thyr ca rna 82&10,,,3600.0,11944.8,29
CPT,0363U,Onc urthl mrna 5 gen alg,,,760.0,2521.68,29
CPT,0364U,Onc hl neo gen seq alys alg,,,2007.25,6660.06,29
CPT,0365U,Onc bldr 10 ur hrbr urthl ca,,,897.0,2976.25,29
CPT,0366U,Onc bldr 10 prb recr bldr ca,,,897.0,2976.25,29
CPT,0367U,Onc bldr 10 flwg trurl rescj,,,902.18,2993.43,29
CPT,0368U,Onc clrct ca mut&mthyltn mrk,,,625.17,1382.87,11
CPT,0369U,Iadna gi pthgn 31 org&21 arg,,,1158.98,1382.87,8
CPT,0370U,Iadna surg wnd pthgn 34&21,,,1158.98,1382.87,8
CPT,0371U,Iadna gu pthgn semiq dna16&1,,,416.78,1382.87,29
CPT,0372U,Nfct ds gu pthgn arg detcj,,,416.78,1382.87,29
CPT,0373T,Adapt bhv tx ea 15 min,,,28.56,37.93,18
CPT,0373U,Iadna rsp tr nfct 17 8 13&16,,,1158.98,1382.87,8
CPT,0374U,Iadna gu pthgn 21 org&21arg,,,1158.98,1382.87,8
CPT,0375U,Onc ovrn bchm asy 7 prtn alg,,,799.23,2976.25,30
CPT,0376U,Onc prst8 ca img alys 128,,,706.25,2343.34,29
CPT,0377U,Cv ds quan advsrm/plsm lprtn,,,42.39,71.37,22
CPT,0378U,Rfc1 repeat xpnsj vrnt alys,,,137.0,454.57,29
CPT,0379T,Vis field assmnt tech suppt,,,37.63,43.69,19
CPT,0379U,Tgsap sl or neo dna523&rna55,,,3288.51,10911.27,29
CPT,0380U,Rx metb advrs trgt sq aly 20,,,1158.98,1382.87,8
CPT,0381U,Maple syrup ur ds mntr quan,,,44.12,146.39,29
CPT,0382U,Hyprphenylalninmia mntr quan,,,51.64,77.46,21
CPT,0383U,Tyrosinemia typ i mntr quan,,,52.05,78.08,21
CPT,0384U,Neph ckd rsk hi stg kdn ds,,,750.0,2488.5,29
CPT,0385U,Neph ckd alg rsk dbtc kdn ds,,,390.75,1296.51,29
CPT,0387U,Onc mlnma ambra1&amlo,,,948.5,3147.12,29
CPT,0388U,Onc nonsm cll lng ca 37 gen,,,3500.0,11613.0,29
CPT,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,70.2,232.92,29
CPT,0390U,Ob pe kdr eng&rbp4 ia alg,,,64.41,96.62,21
CPT,0391U,Onc sld tum dna&rna 437 gen,,,3600.0,11944.8,29
CPT,0392U,Rx metab genrx ia 16 genes,,,1336.09,4433.14,29
CPT,0393U,Neu prksn msfl a-syncln prtn,,,482.02,1795.01,30
CPT,0394T,Hdr elctrnc skn surf brchytx,,,252.11,507.1,17
CPT,0394U,Pfas 16 pfas compnd lc ms/ms,,,198.74,659.42,29
CPT,0395T,Hdr elctr ntrst/ntrcv brchtx,,,665.12,1820.01,26
CPT,0395U,Onc lng multiomics plsm alg,,,797.45,2419.86,29
CPT,0398T,Mrgfus strtctc les abltj,,,1038.51,1239.14,8
CPT,0398U,Gi baret esph dna mthyln aly,,,1755.0,5325.55,29
CPT,0399U,Neuro cere folate defncy srm,,,300.0,910.35,29
CPT,0400U,Ob xpnd car scr 145 genes,,,2185.32,4420.9,11
CPT,0401U,Crd c hrt ds 9 gen 12 vrnts,,,489.68,1485.94,29
CPT,0402T,Colgn crs-link crn&pachymtry,,,1302.07,2596.59,27
CPT,0402U,Nfct agt sti mult amp prb tq,,,127.08,213.95,22
CPT,0403T,HC MT. MCAID DPP DAILY CLASS (MIN 60 MINS PER SESSION),87.0,65.25,1.04,78.3,238
CPT,0403U,Onc prst8 mrna 18 gen 1st ur,,,760.0,2521.68,29
CPT,0404U,Onc brst semiq meas thym kn,,,287.76,1071.58,30
CPT,0405U,Onc pncrtc 59 mthltn blk mrk,,,1770.48,5874.46,29
CPT,0406U,Onc lung flow cytmtry 5 mrk,,,760.0,2521.68,29
CPT,0407U,Neph dbtc ckd mult eclia alg,,,677.16,3152.1,30
CPT,0408T,Insj/rplc cardiac modulj sys,,,2531.78,35684.67,26
CPT,0408U,Iaad blk ac wv bsnsr sarscv2,,,14.13,21.2,21
CPT,0409T,Insj/rplc car modulj pls gn,,,21518.27,24982.71,18
CPT,0409U,Onc sld tum dna 80 & rna 36,,,2919.6,9687.24,29
CPT,0410T,Insj/rplc car modulj atr elt,,,7933.85,9211.2,18
CPT,0410U,Onc pncrtc dna whl gn seq 5-,,,1160.0,3848.88,29
CPT,0411T,Insj/rplc car modulj vnt elt,,,7933.85,9211.2,18
CPT,0411U,Psyc genom alys pnl 15 gen,,,1336.09,4433.14,29
CPT,0412T,Rmvl cardiac modulj pls gen,,,664.57,4050.56,26
CPT,0412U,Beta amyloid ab42/40 imprcip,,,750.0,2488.5,29
CPT,0413T,Rmvl car modulj tranvns elt,,,3488.85,4050.56,18
CPT,0413U,Onc hl neo opt gen mapg dna,,,1263.53,4192.39,29
CPT,0414T,Rmvl & rpl car modulj pls gn,,,21518.27,24982.71,18
CPT,0414U,Onc lng aug alg aly whl sld8,,,706.25,2343.34,29
CPT,0415T,Repos car modulj tranvns elt,,,592.7,688.13,18
CPT,0415U,Cv ds acs bld alg 5 yr score,,,390.75,1296.51,29
CPT,0416T,Reloc skin pocket pls gen,,,844.72,2089.12,26
CPT,0417T,Prgrmg eval cardiac modulj,,,35.75,41.5,18
CPT,0417U,Rare ds alys 335 nuc genes,,,2842.53,9431.51,29
CPT,0418T,Interro eval cardiac modulj,,,35.75,170.24,26
CPT,0418U,Onc brst aug alg aly whl sl8,,,706.25,2343.34,29
CPT,0419T,Dstrj neurofibroma xtnsv,,,586.82,748.33,18
CPT,0419U,Nrpsyc gen seq vrnt aly 13,,,1336.09,4433.14,29
CPT,0420T,Dstrj neurofibroma xtnsv,,,586.82,748.33,18
CPT,0420U,Onc urthl mrna xprsn 6 snp,,,0.5,1328.32,12
CPT,0421T,Waterjet prostate abltj cmpl,,,1808.07,10292.11,18
CPT,0421U,Onc clrct scr sgl amp 8 rna,,,763.31,1688.43,11
CPT,0422T,Tactile breast img uni/bi,,,84.41,98.0,18
CPT,0422U,Onc pan solid tum alys dna,,,0.5,1943.21,12
CPT,0423U,Psyc genomic alys pnl 26 gen,,,416.78,1382.87,29
CPT,0424T,Insj/rplc nstim apnea compl,,,910.36,1086.23,8
CPT,0424U,Onc prst8 xom alys 53 sncrna,,,760.0,2521.68,29
CPT,0425U,Genom rpd seq alys ea cmprtr,,,0.5,4094.39,12
CPT,0426T,Insj/rplc nstim apnea stm ld,,,483.69,577.13,8
CPT,0426U,Genome ultra-rapid seq alys,,,0.5,7582.2,12
CPT,0427T,Insj/rplc nstim apnea pls gn,,,522.3,623.2,8
CPT,0427U,Monocyte dstrbj wdth whl bld,,,4.48,6.72,21
CPT,0429U,Hpv orop swab 14 hi-risk typ,,,35.09,52.64,21
CPT,0430U,Gi malabs aat calpro pncrtc,,,61.54,92.31,21
CPT,0431U,Gly rcptr alpha1 igg srm/csf,,,36.57,121.34,29
CPT,0432T,Repos nstim apnea stimj ld,,,1431.14,1707.6,8
CPT,0432U,Klhl11 antb sr/csf asy qual,,,36.57,121.34,29
CPT,0433U,Onc prst8 5 dna reg mrk pcr,,,760.0,2521.68,29
CPT,0434T,Interro eval npgs apnea,,,47.35,56.5,8
CPT,0434U,Rx metab advrs vrnt alys 25,,,416.78,1382.87,29
CPT,0435T,Prgrmg eval npgs apnea 1 ses,,,143.39,171.09,8
CPT,0435U,Onc chemo rx cytox csc 14 rx,,,3033.86,10066.35,29
CPT,0436T,Prgrmg eval npgs apnea study,,,130.16,155.31,8
CPT,0436U,Onc lng plsm alys 388 prtn,,,0.5,1504.24,12
CPT,0437U,Psyc anxiety do mrna 15 bmrk,,,760.0,2521.68,29
CPT,0438U,Rx metab advrs vrnt alys 33,,,416.78,1382.87,29
CPT,0439U,Crd chd dna alys 5 snp 3 dna,,,0.5,854.0,12
CPT,0440T,Abltj perc uxtr/perph nrv,,,1872.05,2173.45,19
CPT,0440U,Crd chd dna alys 10 snp 6dna,,,0.5,854.0,12
CPT,0441T,Abltj perc lxtr/perph nrv,,,1872.05,2173.45,19
CPT,0441U,Nfct ds bct fngl/viral semiq,,,0.5,444.08,12
CPT,0442T,Abltj perc plex/trncl nrv,,,612.96,8885.77,26
CPT,0442T,HC ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,14689.73,11017.3,176.28,13220.76,119
CPT,0442U,Nfct ds respir nfctj mxa&crp,,,41.38,62.07,21
CPT,0443U,Neurflmnt lt chn ultrsens ia,,,0.5,116.23,12
CPT,0444U,Onc sld orgn neo tgsap 361,,,2919.6,9687.24,29
CPT,0445U,Abeta42 & ptau181 eclia csf,,,260.5,864.34,29
CPT,0446T,Insj impltbl glucose sensor,,,54.8,16560.39,63
CPT,0446U,Ai ds sle alys 10 cytokine,,,840.65,2789.27,29
CPT,0447T,Rmvl impltbl glucose sensor,,,64.39,278.96,63
CPT,0447U,Ai ds sle alys 11 cytokine,,,840.65,2789.27,29
CPT,0448T,Remvl insj impltbl gluc sens,,,91.8,15564.47,63
CPT,0449T,Insj aqueous drain dev 1st,,,1977.36,5742.78,27
CPT,0449U,Car scr sev inh cond 5 genes,,,2737.32,6054.95,11
CPT,0450U,Onc mm lc-ms/ms monoc p-prtn,,,65.15,144.1,11
CPT,0451U,Onc mm lc-ms/ms pep ion quan,,,65.15,144.1,11
CPT,0452U,Onc bldr mthyl penk lte-qmsp,,,192.0,637.06,29
CPT,0453U,Onc clrct ca cfdna qpcr asy,,,192.0,637.06,29
CPT,0454U,Rare ds id opt genome mapg,,,1263.53,4192.39,29
CPT,0455U,Nfct agt sti mult amp prb ur,,,142.63,213.95,21
CPT,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,198.74,659.42,29
CPT,0458U,Onc brst ca s100 a8&a9 elisa,,,260.5,864.34,29
CPT,0459U,Abeta42 & ttau eclia csf,,,260.5,864.34,29
CPT,0460U,Onc whl bld/bucc rtpcr 24gen,,,0.5,917.08,12
CPT,0461U,Onc rxgenom alys rtpcr 24gen,,,0.5,917.08,12
CPT,0462U,Melatonin lvl tst slp std7/9,,,17.27,25.91,21
CPT,0463U,Onc crvx mrna genxprsn 14bmk,,,0.5,760.0,12
CPT,0464T,Visual ep test for glaucoma,,,130.29,174.14,18
CPT,0464U,Onc clrct scr qrtsa dna mrk,,,591.92,1963.99,29
CPT,0465T,Supchrdl njx rx w/o supply,,,276.01,329.33,8
CPT,0465U,Onc urthl carc dna qmsp 2gen,,,1938.01,6430.32,29
CPT,0466U,Crd cad dna gwas 564856 snp,,,0.5,345.43,12
CPT,0467U,Onc bldr dna ngs 60gen&aneup,,,1519.06,5040.24,29
CPT,0468U,Hep nash mir34a5p a2m ykl40,,,251.7,835.14,29
CPT,0469U,Rare ds whl gen seq ftl samp,,,1197.94,3974.76,29
CPT,0470U,Onc orop detcj mrd 8 dna hpv,,,0.5,597.91,12
CPT,0471U,Onc clrc ca 35 vrn kras&nras,,,760.0,2521.68,29
CPT,0472T,Prgrmg io rta eltrd ra,,,287.51,333.8,19
CPT,0472U,Ca vi psp&sp1 antb sjogren,,,0.5,27.9,12
CPT,0473T,Reprgrmg io rta eltrd ra,,,88.0,102.16,19
CPT,0473U,Onc sld tum bld/slv 648 gene,,,4500.0,14931.0,29
CPT,0474T,Insj aqueous drg dev io rsvr,,,636.61,759.59,8
CPT,0474U,Hered pan ca gsap 88gene ngs,,,1303.95,4326.5,29
CPT,0475U,Hered prst8 ca gsap 23 genes,,,1303.95,4326.5,29
CPT,0476U,Rx metab psyc 14gen&cyp2d6,,,416.78,1382.87,29
CPT,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,416.78,1382.87,29
CPT,0478U,Onc nsclc dna&rna dpcr 9gens,,,0.5,552.99,12
CPT,0479T,Fxjl abl lsr 1st 100 sq cm,,,586.82,1091.63,27
CPT,0479U,Tau phosphorylated ptau217,,,17.27,25.91,21
CPT,0480T,Fxjl abl lsr ea addl 100sqcm,,,194.96,232.63,8
CPT,0480U,Nfct ds csf metag ngs alys,,,2126.2,7054.73,29
CPT,0481T,Njx autol wbc concentrate,,,382.54,452.32,18
CPT,0481U,Idh1 idh2&tert promoter ngs,,,674.24,2237.13,29
CPT,0482U,Ob pe biochem asy sflt1&plgf,,,128.82,193.23,21
CPT,0483T,HC TMVI W PROSTHETIC VALVE PERCUTANEOUS APPROACH,60060.61,45045.46,720.73,54054.55,238
CPT,0483T,Tmvi percutaneous approach,,,3792.45,15039.8,26
CPT,0483U,Nfct ds ng gyra s91f pt mut,,,0.5,35.09,12
CPT,0484T,HC TMVI TRANSTHORACIC EXPOSURE,72049.81,54037.36,864.6,64844.83,119
CPT,0484T,Tmvi transthoracic exposure,,,4981.78,15039.8,26
CPT,0484U,Nfct ds mgen 23s rrna pt mut,,,0.5,35.09,12
CPT,0485T,Oct mid ear i&r unilateral,,,37.63,43.69,18
CPT,0485U,Onc sol tum cfdna&rna ngs gm,,,0.5,3649.48,12
CPT,0486T,Oct mid ear i&r bilateral,,,37.63,43.69,18
CPT,0486U,Onc pan sol tum ngs cfctdna,,,0.5,1644.25,12
CPT,0487U,Onc sol tum cfcdna tgsap 84,,,2919.6,9687.24,29
CPT,0488U,Ob fetal ag nipt cfdna alys,,,1138.58,2518.53,11
CPT,0489U,Ob sgnipt cfdna seq alys 1+,,,0.5,0.5,3
CPT,0490U,Onc cutan/uveal mlnma cd146,,,2435.0,8079.33,29
CPT,0491U,Onc sol tum ctc slct er prtn,,,2435.0,8079.33,29
CPT,0492U,Onc sol tum ctc slctn pd-l1,,,2435.0,8079.33,29
CPT,0493U,Trnspl med quan dd-cfdna ngs,,,2753.25,9135.28,29
CPT,0494T,Prep & cannulj cdvr don lung,,,12954.18,15039.8,18
CPT,0494U,Rbc ag ftl rhd gene alys ngs,,,759.05,2518.53,29
CPT,0495T,Mntr cdvr don lng 1st 2 hrs,,,12954.18,15039.8,18
CPT,0495U,Onc prst8 alys crcg plsm prt,,,760.0,2521.68,29
CPT,0496T,Mntr cdvr don lng ea addl hr,,,12954.18,15039.8,18
CPT,0496U,Onc clrct cfdna 8/7 genes,,,0.5,485.86,12
CPT,0497U,Onc prst8 mrna rt-pcr 6genes,,,3873.0,12850.61,29
CPT,0498U,Onc clrct ngs mut detc 43gen,,,0.5,1345.31,12
CPT,0499U,Onc clrct&lng dna ngs 8genes,,,597.91,1983.87,29
CPT,0500U,Autoinflam ds vexas synd dna,,,175.4,581.97,29
CPT,0501T,Cor ffr derived cor cta data,,,2419.38,2886.75,8
CPT,0501U,Onc clrc bld quan meas cfdna,,,0.5,0.5,3
CPT,0502T,Cor ffr data prep & transmis,,,147.36,175.82,8
CPT,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,35.09,52.64,21
CPT,0503T,Cor ffr alys gnrj ffr mdl,,,834.05,2530.92,44
CPT,0503U,Neuro alz ds bamyl&tau prtn,,,750.0,2488.5,29
CPT,0504T,Cor ffr data review i&r,,,179.85,214.6,8
CPT,0504U,Nfct ds uti id 17 path orgs,,,416.78,1382.87,29
CPT,0505T,Ev fempop artl revsc,,,2348.26,12622.1,26
CPT,0505U,Nfct ds vag infctj id 32orgs,,,679.77,2255.47,29
CPT,0506T,Mac pgmt opt dns meas hfp,,,56.94,66.11,18
CPT,0506U,Gi barretts esophgl cell 89,,,1938.01,6430.32,29
CPT,0507T,Near ifr 2img mibmn glnd i&r,,,52.87,66.11,26
CPT,0507U,Onc ovr dna whole gen w/5hmc,,,1160.0,3848.88,29
CPT,0508U,Trnsplj med dd-cfdna 40 snps,,,0.5,0.5,3
CPT,0509T,Pattern erg w/i&r,,,20.44,346.59,98
CPT,0509U,Trnsplj med dd-cfdna<12 snps,,,0.5,0.5,3
CPT,0510T,Rmvl sinus tarsi implant,,,3110.48,3611.26,18
CPT,0510U,Onc pncrtc ca alg alys 16gen,,,0.5,473.91,12
CPT,0511T,Rmvl&rinsj sinus tarsi implt,,,6848.41,7951.0,18
CPT,0511U,Onc sol tum 3dmicroenvir 36+,,,3033.86,10066.35,29
CPT,0512T,Esw integ wnd hlg 1st wnd,,,55.9,221.16,26
CPT,0512U,Onc prst8 alys dgtz img msi,,,706.25,2343.34,29
CPT,0513T,Esw integ wnd hlg ea addl,,,28.89,34.47,8
CPT,0513U,Onc prst8 alg alys msi&hrd,,,706.25,2343.34,29
CPT,0514U,Gi ibd ia quan deter adl lvl,,,38.57,57.86,21
CPT,0515T,Insj wcs lv compl sys,,,21518.27,24982.71,19
CPT,0515U,Gi ibd ia quan deter ifx lvl,,,38.57,57.86,21
CPT,0516T,Insj wcs lv eltrd only,,,10032.69,11647.96,19
CPT,0516U,Rx metab rxgenomic gnotyp 40,,,416.78,1382.87,29
CPT,0517T,Insj wcs lv both compnt pg,,,10032.69,11647.96,19
CPT,0517U,Ther rx mntr 80+ psyactiv rx,,,246.92,819.28,29
CPT,0518T,HC REMOVAL OF GENERATOR COMPONENT,7842.28,5881.71,94.11,7058.05,119
CPT,0518T,Rmvl pg wcs lv battery only,,,3488.85,4050.56,19
CPT,0518U,Ther rx mntr 90+ pn&mtl hlth,,,246.92,819.28,29
CPT,0519T,HC REMOVAL/REPLACEMENT OF WIRELESS CARDIAC STIMULATOR,62715.63,47036.72,752.59,56444.07,119
CPT,0519T,Rmv&rplcmt pg wcs lv both,,,10032.69,11647.96,19
CPT,0519U,Ther rx mntr meds p/d/a 110+,,,246.92,819.28,29
CPT,0520T,Rmv&rplcmt pg wcs lv battery,,,10032.69,11647.96,19
CPT,0520U,Ther rx mntr 200+ rx/sbsts,,,246.92,819.28,29
CPT,0521T,Interrog dev eval wcs ip,,,23.48,21518.27,19
CPT,0521U,Rf iga&igm ccp antb sr-a ia,,,0.5,51.8,12
CPT,0522T,Prgrmg dev eval wcs ip,,,35.75,41.5,19
CPT,0522U,Ca vi psp&sp1 antb cl semiql,,,0.5,260.5,12
CPT,0523U,Onc soltum dna ngs snv 22gen,,,0.5,1352.09,12
CPT,0524T,Ev cath dir chem abltj w/img,,,3017.38,3503.18,18
CPT,0524U,Ob pe sflt-1/plgf ia srm/pls,,,0.5,128.82,12
CPT,0525T,Insj/rplcmt compl iims,,,1108.12,21226.29,26
CPT,0525U,Onc sphrd cell cul 11-rx pnl,,,0.5,3033.86,12
CPT,0526T,Insj/rplcmt iims eltrd only,,,7933.85,9211.2,18
CPT,0526U,Nefro rnl trnspl quan cxcl10,,,0.5,0.5,3
CPT,0527T,Insj/rplcmt iims implt mntr,,,882.34,9211.2,26
CPT,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,0.5,142.63,12
CPT,0528T,Prgrmg dev eval iims ip,,,35.75,108.94,26
CPT,0528U,Lrt iad 18bct/8vir&7arg rna,,,0.5,634.84,12
CPT,0529T,Interrog dev eval iims ip,,,35.75,41.5,18
CPT,0529U,Hem vte snp f2&f5 gen leiden,,,0.5,0.5,3
CPT,0530T,Removal complete iims,,,3488.85,4050.56,18
CPT,0530U,Onc pan-sol tum ctdna 77 gen,,,0.5,2919.6,12
CPT,0531T,Removal iims electrode only,,,3488.85,4050.56,18
CPT,0531U,Nfct ds afb&inv fng 673orgs,,,0.5,0.5,3
CPT,0532T,Removal iims implt mntr only,,,3488.85,4050.56,18
CPT,0532U,Rare ds whlgen&mitochdrl dna,,,0.5,5031.2,12
CPT,0533U,Rx metab advrs gnotyp 16gens,,,0.5,416.78,12
CPT,0534U,Onc prst8 mirna snp 32 vrnt,,,0.5,0.5,3
CPT,0535U,Pfas lc-ms/ms plsm/srm quan,,,0.5,62.14,12
CPT,0536U,Rbcag ftl rhd pcr alys exon4,,,0.5,192.0,12
CPT,0537U,Onc clrct ca cfdna >2500 dmr,,,1495.0,4960.41,29
CPT,0538U,Onc sol tum ngts ffpe 600gen,,,0.5,2989.55,12
CPT,0539U,Onc sol tumor cfctdna 152gen,,,0.5,3288.51,12
CPT,0540T,Car-t cll admn autologous,,,417.54,498.2,8
CPT,0540U,Trnsplj med quan dd-cfdna,,,0.5,2753.25,12
CPT,0541T,Myocardial imaging mcg,,,377.83,590.56,19
CPT,0541U,Cv ds hdl rct cec lc-ms/ms 5,,,0.5,0.5,3
CPT,0542U,Nefro renal trnspl ur nmr 84,,,0.5,0.5,3
CPT,0543T,HC TA MV RPR W/ARTIF CHORD TEND,1811.88,1358.91,21.74,1630.69,119
CPT,0543T,Ta mv rpr w/artif chord tend,,,12954.18,15039.8,18
CPT,0543U,Onc sol tum ngs dna 517 gens,,,0.5,2989.55,12
CPT,0544T,HC TCAT MV ANNULUS RCNSTJ,11368.52,8526.39,136.42,10231.67,119
CPT,0544T,Tcat mv annulus rcnstj,,,12954.18,15039.8,18
CPT,0544U,Nefro trnsp mntr 48vrnt dpcr,,,0.5,0.5,3
CPT,0545T,Tcat tv annulus rcnstj,,,5967.85,15039.8,26
CPT,0545U,Achr antb id imfluor livecll,,,0.5,37.73,12
CPT,0546U,Ldns lrp4 antb imflr livecll,,,0.5,37.73,12
CPT,0547U,Neurflmnt lt chn cleia plsm,,,0.5,116.23,12
CPT,0548U,Gfap cleia plasma,,,0.5,116.23,12
CPT,0549U,Onc urthl dna mthyltd rt pcr,,,0.5,760.0,12
CPT,0550U,Onc prst8 elisa tot&free psa,,,0.5,0.5,3
CPT,0551U,Tp ptau217 ult dgt prtn detj,,,0.5,0.5,3
CPT,0552T,Low-level laser therapy,,,16.28,19.43,8
CPT,0552U,Repr med pga gdo te bx locus,,,0.5,0.5,3
CPT,0553U,Repr med pga embry te strux,,,0.5,759.05,12
CPT,0554U,Repr med pga 24chrm te bx qc,,,0.5,759.05,12
CPT,0555T,B1 str&fx rsk transmis data,,,23.48,29.28,18
CPT,0555U,Repr med pga embryonic te qc,,,0.5,759.05,12
CPT,0556T,B1 str & fx rsk assessment,,,231.73,269.03,18
CPT,0556U,Nfct ds p-s dna&rna 12 trgts,,,0.5,142.63,12
CPT,0557U,Nfct ds bv dna mrk vag fluid,,,0.5,262.99,12
CPT,0558T,Ct scan f/biomchn ct alys,,,84.41,98.0,18
CPT,0558U,Onc clrct elisa bf7 ag serum,,,0.5,20.81,12
CPT,0559T,Antmc mdl 3d print 1st cmpnt,,,56.94,134.72,18
CPT,0559U,Onc brs quan elisa bf9ag srm,,,0.5,20.81,12
CPT,0560U,Onc mrd gsa cfdna baseline,,,0.5,3878.45,12
CPT,0561T,Antmc guide 3d print 1st gd,,,56.94,134.72,18
CPT,0561U,Onc mrd gsa cfdna subsequent,,,0.5,794.49,12
CPT,0562U,Onc sol tum tgsa 33gens snvs,,,0.5,597.91,12
CPT,0563T,Evac meibomian glnd heat bi,,,38.17,66.11,26
CPT,0563U,Nfct ds pthgn-sna 11vir&4bct,,,0.5,416.78,12
CPT,0564U,Nfct ds pthgn-sna 10vir&4bct,,,0.5,416.78,12
CPT,0565U,Onc hcc ngs detc 6626epigalt,,,0.5,1160.0,12
CPT,0566U,Onc lng qpcr-bsd alys 13dmrs,,,0.5,416.78,12
CPT,0567U,Rare ds whl gen seq srs&lrs,,,0.5,5031.2,12
CPT,0568U,Neurol dementia bamyl ptau,,,0.5,897.0,12
CPT,0569T,HC TRANSCATH TRICUSPID VALVE REPAIR;INITIAL PROSTHESIS,19556.15,14667.11,234.67,17600.54,119
CPT,0569T,Ttvr perq appr 1st prosth,,,2350.4,15039.8,26
CPT,0569U,Onc sol tum ngs tmm>20000dmr,,,0.5,0.5,3
CPT,0570T,HC TRANSCATH TRICUSPID VALVE REPAIR;ADDTL PROSTHESIS,9720.13,7290.1,116.64,8748.12,119
CPT,0570T,Ttvr perq ea addl prosth,,,1175.64,15039.8,26
CPT,0570U,Neurol tbi alys gfap&uch-l1,,,0.5,260.5,12
CPT,0571T,HC INSERT/REPLMNT ICDS W/SUBSTERNAL ELECTRODE,46037.7,34528.28,552.45,41433.93,119
CPT,0571T,Insj/rplcmt icds ss eltrd,,,2232.47,35684.67,26
CPT,0571U,Onc sol tum dna80&rna10g ngs,,,0.5,2919.6,12
CPT,0572T,Insertion ss dfb electrode,,,7933.85,9211.2,18
CPT,0572U,Onc prst8 httl qfish whl bld,,,0.5,0.5,3
CPT,0573T,Removal ss dfb electrode,,,3488.85,4050.56,18
CPT,0573U,Onc pancreas 3bmrk pclf alg,,,0.5,0.5,3
CPT,0574T,HC REPOS PREV SS IMPL DFB ELTRD,12719.1,9539.33,152.63,11447.19,119
CPT,0574T,Repos prev ss impl dfb eltrd,,,3488.85,4050.56,18
CPT,0574U,Mtb cfp-10 serum/plsm lc-ms,,,0.5,0.5,3
CPT,0575T,Prgrmg dev eval icds ss ip,,,35.75,228.55,26
CPT,0575U,Trnsplj med lar rtpcr 4genes,,,380.0,380.0,9
CPT,0576T,Interrog dev eval icds ss ip,,,35.75,41.5,18
CPT,0576U,Trnsplj med lar quan ddcfdna,,,3240.0,3240.0,9
CPT,0577T,Ephys eval icds ss,,,1163.8,1351.18,18
CPT,0577T,HC EPHYS EVAL ICDS SS,3854.7,2891.02,46.26,3469.23,119
CPT,0577U,Onc ovr serum alys 39 gps,,,246.92,246.92,9
CPT,0578T,Rem interrog dev icds phys,,,90.69,108.21,8
CPT,0578U,Onc cutan mln rna qpcr 10gen,,,3873.0,3873.0,9
CPT,0579T,Rem interrog dev icds tech,,,35.75,63.72,26
CPT,0579U,Nfro dbtc ckd elisa apoa4,,,390.75,390.75,9
CPT,0580T,HC RMVL SS IMPL DFB PG ONLY,12719.1,9539.33,152.63,11447.19,119
CPT,0580T,Rmvl ss impl dfb pg only,,,3488.85,4050.56,18
CPT,0580U,Bbrgdrferi ld antb detcj 31,,,17.21,17.21,9
CPT,0581T,Abltj mal brst tum perq crtx,,,3670.98,4262.01,18
CPT,0581U,Trnspl med antb nohla 39trgt,,,325.8,325.8,9
CPT,0582T,Trurl abltj mal prst8 tiss,,,13358.72,13358.72,9
CPT,0582U,Rare ds rpd whlgen dna vrnts,,,7582.2,7582.2,9
CPT,0583T,Tmpst auto tube dlvr sys,,,1420.05,1648.68,18
CPT,0583U,Rare ds rpd whlgen cmptr dna,,,3791.1,3791.1,9
CPT,0584T,Perq islet cell transplant,,,12954.18,15039.8,18
CPT,0584U,Neuro csf prion prtn qual,,,540.99,540.99,9
CPT,0585T,Laps islet cell transplant,,,12954.18,15039.8,18
CPT,0585U,Tgsap so neo cfdna 521 genes,,,2919.6,2919.6,9
CPT,0586T,Open islet cell transplant,,,12954.18,15039.8,18
CPT,0586U,Onc mrna gen xprsn 216 genes,,,2919.6,2919.6,9
CPT,0587T,Perq impltj/rplcmt isdns ptn,,,6291.59,7304.54,19
CPT,0587U,Ther rx mntr 60150rx&metabl,,,114.43,114.43,9
CPT,0588T,Revision/removal isdns ptn,,,3296.84,3827.63,19
CPT,0588U,Nfct ds bct/vir 32genes mrna,,,760.0,760.0,9
CPT,0589T,Elec alys smpl prgrmg iins,,,88.0,102.16,19
CPT,0589U,Pfas24cmpnd hiperf lc-ms/ms,,,198.74,198.74,9
CPT,0590T,Elec alys cplx prgrmg iins,,,88.0,102.16,19
CPT,0591U,Onc prst8 ca 3prtns plsm srm,,,760.0,760.0,9
CPT,0592U,Onc hl neo dna tgs 417 genes,,,2919.6,2919.6,9
CPT,0593U,Nfct ds gu pthgn dna 46trgt,,,634.84,634.84,9
CPT,0594T,Osteot hum xtrnl lngth dev,,,6848.41,7951.0,18
CPT,0595U,Nfct ds tfp vctrbrn&zoonotic,,,262.99,262.99,9
CPT,0596T,Temp fml iu vlv-pmp 1st insj,,,361.24,742.89,26
CPT,0597T,Temp fml iu valve-pmp rplcmt,,,104.68,742.89,26
CPT,0598T,R-t fluor wound img 1st site,,,20.27,346.59,26
CPT,0598U,Gi ibs igg antb 18food items,,,300.0,300.0,9
CPT,0599T,R-t fluor wound img ea addl,,,20.27,24.18,8
CPT,0599U,Onc pncrtc ca mult ia serum,,,897.0,897.0,9
CPT,0600T,Ablt ire 1+ o/t lv/prst8 prq,,,9980.82,11587.73,19
CPT,0601T,Abltj ire 1+tumors open,,,9980.82,11587.73,18
CPT,0609T,Mrs disc pain acquisj data,,,231.73,269.03,18
CPT,0611T,Mrs disc pain alg alys data,,,231.73,269.03,18
CPT,0614T,Rmvl&rplcmt ss impl dfb pg,,,21518.27,24982.71,18
CPT,0615T,Auto alys binocular eye mvmt,,,123.57,143.47,18
CPT,0616T,Insertion of iris prosthesis,,,928.98,1108.44,8
CPT,0617T,Insj iris prosth w/rmvl&insj,,,1407.2,1679.04,8
CPT,0618T,Insj iris prosth sec io lens,,,1500.14,1789.94,8
CPT,0619T,Cysto w/prst8 commissurotomy,,,8864.87,10292.11,9
CPT,0620T,Evasc ven artlz tibl/prnl vn,,,33553.58,44598.19,18
CPT,0621T,Trabeculostomy interno laser,,,3856.55,4477.46,18
CPT,0625T,Auto quan c plaq cptr alys,,,911.2,1057.91,9
CPT,0627T,Perq njx algc fluor lmbr 1st,,,12334.9,14320.82,18
CPT,0629T,Perq njx algc ct lmbr 1st,,,12334.9,14320.82,18
CPT,0631T,Tc vis lit hyperspectral img,,,23.48,27.26,9
CPT,0632T,Perq tcat us abltj nrv p-art,,,17214.39,19985.91,18
CPT,0633T,Ct breast w/3d uni c-,,,101.95,118.36,18
CPT,0634T,Ct breast w/3d uni c+,,,170.66,198.13,18
CPT,0635T,Ct breast w/3d uni c-/c+,,,170.66,198.13,18
CPT,0636T,Ct breast w/3d bi c-,,,231.73,269.03,18
CPT,0637T,Ct breast w/3d bi c+,,,342.37,397.49,18
CPT,0638T,Ct breast w/3d bi c-/c+,,,342.37,397.49,18
CPT,0640T,Ncntc ifr spctrsc o/t pad 1,,,7.98,43.69,26
CPT,0643T,HC TCAT L VENTR RSTRJ DEV IMPLT,19607.76,14705.82,235.29,17646.98,119
CPT,0643T,Tcat l ventr rstrj dev implt,,,12954.18,15039.8,18
CPT,0644T,Tcat rmvl/dblk icar mas perq,,,4361.87,6345.82,26
CPT,0645T,Tcat impltj c sins rdctj dev,,,17214.39,19985.91,18
CPT,0646T,"HC TTVI PROSTHETIC VALVE, PERCUTANEOUS",51682.99,38762.24,620.2,46514.69,119
CPT,0646T,Ttvi/rplcmt w/prstc vlv perq,,,12954.18,15039.8,18
CPT,0647T,Insj gtube perq mag gastrpxy,,,1818.57,2434.79,26
CPT,0648T,Quan mr tis wo mri 1orgn,,,707.21,1057.91,26
CPT,0649T,Quan mr tiss w/mri 1orgn,,,631.99,1057.91,26
CPT,0650T,HC PRGRMG DEV EVAL SCRMS REMOTE,318.68,239.01,3.82,286.81,119
CPT,0650T,Prgrmg dev eval scrms remote,,,35.75,41.5,18
CPT,0651T,Mag ctrld capsule endoscopy,,,898.8,1043.51,19
CPT,0652T,Egd flx transnasal dx br/wa,,,747.47,2111.36,27
CPT,0653T,Egd flx transnasal bx 1/mlt,,,1818.57,2111.36,19
CPT,0654T,Egd flx transnasal tube/cath,,,351.75,4234.46,27
CPT,0655T,Tprnl focal abltj mal prst8,,,4873.47,5658.09,18
CPT,0656T,Ant lmbr vrt bdy teth <7 seg,,,12954.18,17753.44,18
CPT,0657T,Ant lmbr vrt bdy teth 8+ seg,,,12954.18,17753.44,18
CPT,0658T,Elec impd spectrsc 1+skn les,,,56.94,66.11,18
CPT,0659T,HC TCAT INTRA-C NFS SUPERSAT O2,4791.59,3593.69,57.5,4312.43,119
CPT,0659T,Tcat intra-c nfs supersat o2,,,12954.18,15039.8,18
CPT,0660T,Implt ant sgm io nbio rx sys,,,3856.55,4477.46,18
CPT,0661T,Rmvl&rimpltj ant sgm implt,,,3856.55,4477.46,18
CPT,0662T,Scalp cool 1st meas&calbrj,,,1678.14,1948.32,9
CPT,0671T,Insj ant sgm aq drg dev 1+,,,4946.41,5742.78,18
CPT,0673T,Abltj b9 thyr ndul perq lasr,,,1553.26,6702.15,27
CPT,0674T,Laps insj nw/rpcmt prm isdss,,,29213.81,33917.23,19
CPT,0675T,Laps insj nw/rpcmt isdss 1ld,,,11282.26,13879.51,19
CPT,0677T,Laps repos lead isdss 1st ld,,,9980.82,11587.73,19
CPT,0679T,Laps rmvl lead isdss,,,9980.82,11587.73,19
CPT,0680T,Insj/rplcmt pg only isdss,,,19643.11,23867.69,19
CPT,0681T,Rlcj pulse gen only isdss,,,3296.84,3827.63,19
CPT,0682T,Removal pulse gen only isdss,,,3296.84,3827.63,19
CPT,0683T,Prgrmg dev eval isdss ip,,,35.75,41.5,19
CPT,0685T,Interrog dev eval isdss ip,,,35.75,41.5,19
CPT,0686T,Histotripsy mal hepatcel tis,,,16777.03,19478.14,18
CPT,0689T,Quan us tis charac w/o dx us,,,84.41,98.0,18
CPT,0690T,Quan us tis charac w/dx us,,,86.93,103.72,8
CPT,0692T,HC ULTRAFILTRATION ONLY,2905.86,2179.4,34.87,2615.27,119
CPT,0692T,HC ULTRAFILTRATION OP ONLY,1734.38,1300.79,20.81,1560.94,119
CPT,0692T,Therapeutic ultrafiltration,,,1571.51,1824.53,19
CPT,0693T,Compre ful bdy 3d mtn alys,,,336.01,390.1,18
CPT,0696T,Bdy surf mapg pm/cvdfb f/up,,,35.75,41.5,18
CPT,0697T,Quan mr tis wo mri mlt orgn,,,911.2,1057.91,18
CPT,0698T,Quan mr tiss w/mri mlt orgn,,,631.99,1057.91,26
CPT,0699T,Njx pst chmbr eye medication,,,276.01,2538.46,26
CPT,0707T,Njx b1 sub mtrl sbchdrl dfct,,,3110.48,3611.26,18
CPT,0712T,N-nvs artl plaq alys quan,,,84.41,218.63,18
CPT,0714T,Tpla b9 prst8 hyprplsa<50ml,,,4873.47,5658.09,18
CPT,0716T,Car acous wavfrm rec cad rsk,,,56.94,66.11,19
CPT,0717T,Adrc ther prtl rc tear,,,3509.62,4074.67,18
CPT,0718T,Adrc ther prtl rc tear njx,,,3509.62,4074.67,18
CPT,0720T,Prq elc nrv stim cn wo implt,,,975.33,1132.36,9
CPT,0721T,Quan ct tiss charac w/o ct,,,623.61,724.01,18
CPT,0722T,Quan ct tiss charac w/ct,,,623.61,724.01,18
CPT,0723T,Qmrcp w/o dx mri sm anat ses,,,911.2,1057.91,18
CPT,0724T,Qmrcp w/dx mri same anatomy,,,911.2,1057.91,18
CPT,0731T,Augmnt ai-based fcl phnt a/r,,,56.94,66.11,18
CPT,0733T,Rem r-t mtn nrehab ther sply,,,336.01,390.1,18
CPT,0736T,Colonic lavage 35+l water,,,130.29,174.14,18
CPT,0737T,Xenograft impltj artclr surf,,,12334.9,14320.82,18
CPT,0740T,Rem auton alg nsln cal setup,,,56.94,66.11,18
CPT,0741T,Rem auton alg nsln data coll,,,35.75,41.5,18
CPT,0742T,HC POSITIVE FLOW RESERVE CARDIAC SPECT,162.47,121.85,1.95,146.22,119
CPT,0743T,B1 str & fx rsk vrt fx assmt,,,231.73,269.03,19
CPT,0744T,HC BIOPROSTHETIC VALVE INSERT VIA FEMORAL VEIN OPEN,65066.79,48800.09,780.8,58560.11,119
CPT,0744T,Insj bioprostc vlv fem vn,,,5182.23,6016.57,18
CPT,0745T,HC CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,7655.87,5741.9,91.87,6890.28,119
CPT,0746T,HC CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,23356.39,17517.29,280.28,21020.75,119
CPT,0747T,HC CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,6151.71,4613.78,73.82,5536.54,119
CPT,0751T,Dgtz gls mcrscp sld level ii,,,0.5,0.5,3
CPT,0752T,Dgtz gls mcrscp sld lvl iii,,,0.5,0.5,3
CPT,0753T,Dgtz gls mcrscp sld level iv,,,0.5,0.5,3
CPT,0754T,Dgtz gls mcrscp sld level v,,,0.5,0.5,3
CPT,0755T,Dgtz gls mcrscp sld level vi,,,0.5,0.5,3
CPT,0756T,Dgtz gls mcrscp sld spc grpi,,,0.5,0.5,3
CPT,0757T,Dgtz gls mcrscp sl spc grpii,,,0.5,0.5,3
CPT,0758T,Dgtz gls mcrscp sl spc hchem,,,0.5,0.5,3
CPT,0759T,Dgtz gls mcrscp sl sp grpiii,,,0.5,0.5,3
CPT,0760T,Dgtz gls mcrscp sl imm 1st,,,0.5,0.5,3
CPT,0761T,Dgtz gls mcrscp sl imm ea 1,,,0.5,0.5,3
CPT,0762T,Dgtz gls mcrscp sl imm ea m,,,0.5,0.5,3
CPT,0763T,Dgtz gls mcrscp mphmtrc alys,,,0.5,0.5,3
CPT,0764T,Asstv alg ecg rsk asmt cncrt,,,123.57,143.47,19
CPT,0765T,Asstv alg ecg rsk asmt prev,,,123.57,143.47,19
CPT,0766T,Tc mag stimj pn 1st nerve,,,218.63,346.59,19
CPT,0778T,Smmg cncrnt appl imu snr,,,130.29,174.14,18
CPT,0779T,Gi myoelectrical actv study,,,377.83,590.56,18
CPT,0780T,Instlj fecal microbiota ssp,,,123.57,143.47,18
CPT,0783T,Tc auriculr neurostimulation,,,130.29,174.14,18
CPT,0784T,Ins/rplmt eltrd ra spi nstim,,,11282.26,13879.51,18
CPT,0785T,Revj/rmvl nea spi w/nstim,,,3296.84,3827.63,18
CPT,0786T,Insj/rplcmt prq ra sac nstim,,,11282.26,11282.26,9
CPT,0787T,Revj/rmvl nea sac w/nstim,,,3296.84,3827.63,18
CPT,0788T,Elec aly smp iins sp/sac nrv,,,88.0,102.16,18
CPT,0789T,Elec aly cpx iins sp/sac nrv,,,88.0,102.16,18
CPT,0790T,Revj rplcmt/rmvl vrt tethrg,,,12954.18,17753.44,18
CPT,0793T,Prq tcat thrm ablt nrv p-art,,,17214.39,19985.91,18
CPT,0794T,Pt spec alg rx-onc tx option,,,56.94,66.11,18
CPT,0795T,HC LEADLESS PM INSERT RT ATRIAL & RT VENTRICLE DUALSYS,27266.85,20450.14,327.2,24540.16,119
CPT,0795T,Tcat ins 2chmbr ldls pm cmpl,,,18282.76,21226.29,18
CPT,0796T,HC LEADLESS +RT ATRIAL COMPONENT/EXIST RT VENT DUAL SYS,27266.85,20450.14,327.2,24540.16,119
CPT,0796T,Tcat ins 2chmbr ldls pm ra,,,18282.76,21226.29,18
CPT,0797T,HC LEADLESS +RT VENTRICLE COMPONENT DUAL SYS,27266.85,20450.14,327.2,24540.16,119
CPT,0797T,Tcat ins 2chmbr ldls pm rv,,,18282.76,21226.29,18
CPT,0798T,HC LEADLESS PM SYSTEM REMOVAL COMPLETE DUAL CHAMBER,10323.87,7742.9,123.89,9291.48,119
CPT,0798T,Tcat rmv 2chmbr ldls pm cmpl,,,3017.38,3503.18,18
CPT,0799T,HC LEADLESS PM RT ATRIAL COMPONENT REMOVAL DUAL SYSTEM,10323.87,7742.9,123.89,9291.48,119
CPT,0799T,Tcat rmvl 2chmbr ldls pm ra,,,3017.38,3503.18,18
CPT,0800T,HC LEADLESS PM RT VENTRICLE COMPONENT REMOVAL DUAL SYSTEM,10323.87,7742.9,123.89,9291.48,119
CPT,0800T,Tcat rmvl 2chmbr ldls pm rv,,,3017.38,3503.18,18
CPT,0801T,HC SUBRTA NJX RX AGT W/VTRC,27266.85,20450.14,327.2,24540.16,119
CPT,0801T,Tcat rmv&rpl 2chmbr ldls pm,,,18282.76,21226.29,18
CPT,0802T,HC LEADLESS PM REMOVE & REPLACE RT ATRIAL OF DUAL,27266.85,20450.14,327.2,24540.16,119
CPT,0802T,Tcat rmv&rpl2chmb ldls pm ra,,,18282.76,21226.29,18
CPT,0803T,HC LEADLESS PM REMOVE & REPLACE RT VENTRICLE OF DUAL,27266.85,20450.14,327.2,24540.16,119
CPT,0803T,Tcat rmv&rpl2chmb ldls pm rv,,,18282.76,21226.29,18
CPT,0804T,HC LEADLESS PM PROGRAMMING EVAL DEVICE DUAL CHAMBER SYS,263.07,197.3,3.16,236.76,119
CPT,0804T,Prgrmg evl ldls pm 2chmbr ip,,,35.75,41.5,18
CPT,0805T,Tcat s&ivc prstc vl impl prq,,,12954.18,15039.8,18
CPT,0806T,Tcat s&ivc prstc vl impl opn,,,12954.18,15039.8,18
CPT,0807T,Pulm tiss vntj alys prev ct,,,218.63,346.59,18
CPT,0808T,Pulm tiss vntj alys w/ct,,,218.63,346.59,18
CPT,0810T,HC SUBRTA NJX RX AGT W/VTRC,27266.85,20450.14,327.2,24540.16,119
CPT,0810T,Subrta njx rx agt w/vtrc,,,4074.78,4730.82,18
CPT,0811T,Rem mlt day uroflow setup,,,123.54,143.43,18
CPT,0812T,Rem mlt day uroflow dev sply,,,130.29,174.14,19
CPT,0813T,Egd vol adjmt bariatric balo,,,898.8,1043.51,18
CPT,0816T,Opn insj/rplcmt ins ptn subq,,,19643.11,23867.69,18
CPT,0817T,Opn insj/rplcmt ins ptn subf,,,19643.11,23867.69,18
CPT,0818T,Revj/rmvl ins ptn subq,,,3296.84,3827.63,18
CPT,0819T,Revj/rmvl ins ptn subf,,,3296.84,3827.63,18
CPT,0823T,HC LEADLESS PM INSERT RT ATRIAL SINGLE CHAMBER SYS,49720.48,37290.36,596.65,44748.43,119
CPT,0823T,Tcat ins 1chmbr ldls pm ra,,,18282.76,21226.29,18
CPT,0824T,HC LEADLESS PM REMOVAL RT ATRIAL SINGLE CHAMBER SYS,7532.21,5649.16,90.39,6778.99,119
CPT,0824T,Tcat rmv 1chmbr ldls pm ra,,,3017.38,3503.18,18
CPT,0825T,HC LEADLESS PM REMOVE & REPLACE RT ATRIAL SINGLE CHAM SYS,49720.48,37290.36,596.65,44748.43,119
CPT,0825T,Tcat rmv&rpl1chmb ldls pm ra,,,18282.76,21226.29,18
CPT,0826T,HC LEADLESS PM PROGRAMMING EVAL DEVICE SINGLE CHAMBER SYS,127.7,95.78,1.53,114.93,119
CPT,0826T,Prgrmg evl ldls pm 1chmbr ip,,,35.75,41.5,18
CPT,0827T,Dgtz gls mcrscp cytp smears,,,0.5,0.5,3
CPT,0828T,Dgtz gls mcrscp cytp smpl fl,,,0.5,0.5,3
CPT,0829T,Dgtz gls mcrscp cytp conctrj,,,0.5,0.5,3
CPT,0830T,Dgtz gls mcrscp cytp slctv,,,0.5,0.5,3
CPT,0831T,Dgtz gls mcrscp cytp c/v,,,0.5,0.5,3
CPT,0832T,Dgtz gls mcrscp cytp oth scr,,,0.5,0.5,3
CPT,0833T,Dgtz gls mcrscp cytp oth prp,,,0.5,0.5,3
CPT,0834T,Dgtz gls mcrscp cytp oth xtn,,,0.5,0.5,3
CPT,0835T,Dgtz gls mcrscp fna 1st ea,,,0.5,0.5,3
CPT,0836T,Dgtz gls mcrscp fna ea addl,,,0.5,0.5,3
CPT,0837T,Dgtz gls mcrscp fna i&r,,,0.5,0.5,3
CPT,0838T,Dgtz gls mcrscp cslt sld els,,,0.5,0.5,3
CPT,0839T,Dgtz gls mcrscp cslt mat prp,,,0.5,0.5,3
CPT,0840T,Dgtz gls mcrscp cslt compre,,,0.5,0.5,3
CPT,0841T,Dgtz gls mcrscp pth cslt 1st,,,0.5,0.5,3
CPT,0842T,Dgtz gls mcrscp pth cslt ea,,,0.5,0.5,3
CPT,0843T,Dgtz gls mcrscp cslt cyt 1st,,,0.5,0.5,3
CPT,0844T,Dgtz gls mcrscp cslt cyt ea,,,0.5,0.5,3
CPT,0845T,Dgtz gls mcrscp imfluor 1st,,,0.5,0.5,3
CPT,0846T,Dgtz gls mcrscp imfluor ea,,,0.5,0.5,3
CPT,0847T,Dgtz gls mcrscp xm arch tiss,,,0.5,0.5,3
CPT,0848T,Dgtz gls mcrscp ish 1st,,,0.5,0.5,3
CPT,0849T,Dgtz gls mcrscp ish ea adl 1,,,0.5,0.5,3
CPT,0850T,Dgtz gls mcrscp ish ea mult,,,0.5,0.5,3
CPT,0851T,Dgtz gls mcrscp mphmtrc 1st,,,0.5,0.5,3
CPT,0852T,Dgtz gls mcrscp mphmtrc ea 1,,,0.5,0.5,3
CPT,0853T,Dgtz gls mcrscp mphmtrc ea m,,,0.5,0.5,3
CPT,0854T,Dgtz gls mcrscp bld smr prph,,,0.5,0.5,3
CPT,0855T,Dgtz gls mcrscp b1 marow smr,,,0.5,0.5,3
CPT,0856T,Dgtz gls mcrscp electron mic,,,0.5,0.5,3
CPT,0857T,Opto-acoustic img breast uni,,,101.95,118.36,18
CPT,0861T,Rmvl pg wcs lv both compnt,,,3488.85,4050.56,18
CPT,0862T,Rlcj pg wcs lv battery only,,,1753.61,2089.12,18
CPT,0863T,Rlcj pg wcs lv trnsmtr only,,,1753.61,2089.12,18
CPT,0864T,Low ntsty eswt corpus cvrnsm,,,233.15,270.69,18
CPT,0865T,Quan mri alys brn w/o dx mri,,,231.73,269.03,18
CPT,0866T,Quan mri alys brn w/dx mri,,,231.73,269.03,18
CPT,0867T,Tpla b9 prst8 hyprplsa>50ml,,,4873.47,5658.09,18
CPT,0868T,Hi-res gastric ep mapping,,,377.83,590.56,18
CPT,0869T,Njx b1 sub mtrl hw fixj aug,,,3110.48,3611.26,18
CPT,0870T,Imp subq prtl ascts pmp sys,,,34687.6,34687.6,9
CPT,0871T,Rplcmt subq prtl ascites pmp,,,27254.65,27254.65,9
CPT,0872T,Rplcmt ndwllg bldr&prtl cath,,,3625.25,3625.25,9
CPT,0873T,Revj subq prtl asct pmp sys,,,3625.25,3625.25,9
CPT,0874T,Rmvl pertl ascites pmp sys,,,3625.25,3625.25,9
CPT,0875T,Prgrm subq prtl asct pmp sys,,,37.79,37.79,9
CPT,0877T,Augmnt alys ch ct ild w/o ct,,,623.61,724.01,18
CPT,0878T,Augmnt alys ch ct ild w/ct,,,623.61,724.01,18
CPT,0881T,Cryotherapy oral cavity,,,382.54,452.32,18
CPT,0884T,Esphgsc flx 1st tndsc dilat,,,5706.72,6625.5,18
CPT,0885T,Colsc flx 1st tndsc dilat,,,5706.72,6625.5,18
CPT,0886T,Sgmdsc flx 1st tndsc dilat,,,5706.72,6625.5,18
CPT,0888T,Histotripsy mal renal tissue,,,16777.03,19478.14,18
CPT,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,911.2,1057.91,18
CPT,0890T,Arhfcmrigtbs 1st tx day,,,3595.46,4174.32,18
CPT,0891T,Arhfcmrigtbs sbsq tx day,,,3595.46,4174.32,18
CPT,0892T,Arhfcmrigtbs sbsq per tx day,,,3595.46,4174.32,18
CPT,0893T,N-invas assmt bld oxygnation,,,56.94,134.72,18
CPT,0894T,Cannulation liver allograft,,,12954.18,15039.8,18
CPT,0895T,Connj lvr algrft prfu dev 1,,,12954.18,15039.8,18
CPT,0896T,Connj lvr algrft prfu dev ea,,,12954.18,15039.8,18
CPT,0897T,N-invas augmnt arrhyt alys,,,869.49,1132.36,18
CPT,0898T,N-invas prst8 cancer est map,,,869.49,1132.36,18
CPT,0902T,Qtc ntrvl augmnt alg aly ecg,,,123.57,143.47,19
CPT,0904T,Ecg alg 12 ld rdcd trcg only,,,56.94,66.11,19
CPT,0906T,Coms ther 1st appl<50 sq cm,,,190.49,221.16,18
CPT,0908T,Opn imp int nstm sys vgs nrv,,,31244.22,31244.22,9
CPT,0909T,Rplcmt int nstim sys vgs nrv,,,31244.22,31244.22,9
CPT,0910T,Rmvl int nstim sys vagus nrv,,,3539.9,3539.9,9
CPT,0911T,Elec aly nstm sys vgs nrv wo,,,59.73,59.73,9
CPT,0912T,Elec alys nstim sys vgs smpl,,,96.26,96.26,9
CPT,0913T,"HC CORONARY DRUG-DELIV BLLN, SINGLE ARTERY",18998.73,14249.05,227.98,17098.86,119
CPT,0913T,Prq tcat ther rx ntrac balo1,,,5465.82,11688.79,18
CPT,0914T,"HC CORONARY DRUG-DELIV BLLN, ADDTL LESION",4296.69,3222.52,51.56,3867.02,119
CPT,0915T,Insj perm ccm-d sys pg&eltrd,,,30736.15,35684.67,19
CPT,0916T,Insj perm ccm-d sys pg only,,,21518.27,24982.71,19
CPT,0917T,Insj perm ccm-d sys 1 lead,,,7933.85,9211.2,19
CPT,0918T,Insj perm ccm-d sys dual ld,,,7933.85,9211.2,19
CPT,0919T,Rmvl perm ccm-d sys pg only,,,3488.85,4050.56,19
CPT,0920T,Rmvl perm ccm-d sys 1 pac ld,,,3488.85,4050.56,19
CPT,0921T,Rmvl perm ccm-d sys 1 dfb ld,,,3488.85,4050.56,19
CPT,0922T,Rmvl perm ccm-d sys dual ld,,,3488.85,4050.56,19
CPT,0923T,Rmvl&rplcmt perm ccm-d pg,,,21518.27,24982.71,19
CPT,0924T,Rpos prv ccm-d trnsvns eltrd,,,592.7,688.13,19
CPT,0925T,Rlcj skin pocket ccm-d pg,,,1753.61,2089.12,19
CPT,0926T,Prgrmg dev eval ccm-d ip,,,35.75,41.5,19
CPT,0927T,Interrog dev eval ccm-d ip,,,35.75,41.5,19
CPT,0929T,Rem interrog dev ccm-d tech,,,35.75,41.5,19
CPT,0930T,Ephys eval ccm-d ld 1st impl,,,1163.8,1351.18,18
CPT,0931T,Ephys eval ccm-d ld separate,,,1163.8,1351.18,18
CPT,0932T,N-invs det hrt fail aug echo,,,287.51,333.8,19
CPT,0933T,Tcat impl wrls l atr prs snr,,,3083.45,3579.88,18
CPT,0944T,3d cntr simula trgt lvr les,,,231.73,269.03,18
CPT,0946T,Ortho impl mvmt alys pair ct,,,101.95,118.36,18
CPT,0949T,Rem interrog dev ccm tech,,,35.75,41.5,18
CPT,0950T,Abltj b9 prst8 tissue hifu,,,8864.87,10292.11,18
CPT,0956T,Prt crn ch cr&tun elt s-sclp,,,21570.33,27473.89,18
CPT,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,1534.25,1781.27,18
CPT,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,3110.48,3611.26,18
CPT,0959T,Rmv/rplc magnet coil assem,,,1553.26,1803.33,18
CPT,0960T,Rpl s-sclp eltr ra rcvr&tlmt,,,21570.33,27473.89,18
CPT,0962T,Asstv alg alys acous&ecg rec,,,123.57,143.47,18
CPT,0963T,Anosc sbmcsl njx bulking agt,,,1130.34,1312.32,18
CPT,0964T,I&cust prep jaw xpnsj 1arch,,,3109.0,3609.55,18
CPT,0965T,I&cst prp jw xpn dl arch non,,,3109.0,3609.55,18
CPT,0966T,I&cst prp jw xpn dl arch fxd,,,3109.0,3609.55,18
CPT,0967T,Tranal ins tmp clrc anst dev,,,1130.34,1312.32,18
CPT,0970T,Ablt b9 brst tum perq lsr ea,,,3670.98,4262.01,18
CPT,0971T,Ablt mal brst tum pq lsr uni,,,3670.98,4262.01,18
CPT,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,383.01,444.68,18
CPT,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,383.01,444.68,18
CPT,0977T,Upr gi bld detcj snr capsule,,,898.8,1043.51,18
CPT,0981T,Tcat impl wrls ivc snr,,,17214.39,19985.91,18
CPT,0982T,Rem mntr impl ivc snr set-up,,,123.54,143.43,18
CPT,0983T,Rem mntr impl ivc snr phys,,,35.75,41.5,18
CPT,0989T,Revj/rmvl ins ptn subq&subf,,,3539.9,3539.9,9
CPT,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,9585.03,9585.03,9
CPT,0992T,N-invas assmt car rsk w/o ct,,,241.59,241.59,9
CPT,0993T,N-invas assmt car rsk w/ct,,,241.59,241.59,9
CPT,0996T,Ins&sclr fix caps bag prosth,,,2336.73,2336.73,9
CPT,10004,Fna bx w/o img gdn ea addl,,,41.32,492.86,53
CPT,10005,Fna bx w/us gdn 1st les,,,71.72,1126.35,72
CPT,10005,HC FNA W US GUIDANCE; 1ST LESION,2361.25,1770.94,28.34,2125.12,119
CPT,10006,Fna bx w/us gdn ea addl,,,48.74,556.63,53
CPT,10006,HC FNA W US GUIDANCE; EA ADDITIONAL,1153.99,865.49,13.85,1038.59,119
CPT,10007,Fna bx w/fluor gdn 1st les,,,86.36,862.01,72
CPT,10008,Fna bx w/fluor gdn ea addl,,,51.25,1289.07,53
CPT,10009,Fna bx w/ct gdn 1st les,,,106.25,1163.18,72
CPT,10009,HC FNA W CT GUIDANCE; 1ST LESION,3542.35,2656.76,42.51,3188.12,119
CPT,10010,Fna bx w/ct gdn ea addl,,,70.27,2128.94,53
CPT,10010,HC FNA W CT GUIDANCE; EA ADDITIONAL,1228.09,921.07,14.74,1105.28,119
CPT,10011,Fna bx w/mr gdn 1st les,,,674.5,1126.35,35
CPT,10012,Fna bx w/mr gdn ea addl,,,412.48,1598.43,16
CPT,10021,Fna bx w/o img gdn 1st les,,,53.44,444.68,72
CPT,10021,HC FNA W/O IMAGE GUIDANCE,726.31,544.73,8.72,653.68,119
CPT,1002T,Air displacmnt plethysmograp,,,29.28,29.28,9
CPT,10030,HC SOFT TISSUE DRAINAGE W GUIDANCE,4592.73,3444.55,55.11,4133.46,119
CPT,10030,Img gid flu coll drg sft tis,,,131.19,1717.71,71
CPT,10035,HC PLCMT SOFT TISSUE LOCAL DEVICE PERC W IMG 1ST LESION,2499.07,1874.3,29.99,2249.16,119
CPT,10035,Plmt sft tiss loclzj dev 1st,,,123.51,3162.07,71
CPT,10036,Plmt sft tiss loclzj dev ea,,,41.46,2558.04,52
CPT,1003T,Arthrp 1st crp/mtcrpl prostc,,,12999.5,12999.5,9
CPT,10040,Extraction,,,40.32,1054.42,71
CPT,1004T,Elec alys s-scl eeg wo prgrm,,,134.72,134.72,9
CPT,1005T,Elec alys s-scl eeg prgr 1st,,,96.26,96.26,9
CPT,10060,HC I&D ABSCESS SIMPLE OR SINGLE,543.45,407.59,6.52,489.11,119
CPT,10060,I&d abscess simple/single,,,81.07,359.65,71
CPT,10061,HC I&D ABSC; COMPL OR MULTI,865.38,649.04,10.38,778.84,119
CPT,10061,I&d abscess comp/multiple,,,141.74,605.81,71
CPT,10076,HC PT CONTINOUS PASSIVE MOTION (DAILY),216.25,162.19,2.6,194.62,119
CPT,10080,HC I/D PILONID CYST SIMPLE,2280.26,1710.2,27.36,2052.23,119
CPT,10080,I&d pilonidal cyst simple,,,80.46,783.1,71
CPT,10081,HC I&D PILONID CYST; CPLX,643.27,482.45,7.72,578.94,119
CPT,10081,I&d pilonidal cyst comp,,,132.32,946.73,71
CPT,1008T,Rem mntr s-scl eeg sys setup,,,134.8,134.8,9
CPT,1010T,Cptr oph alys monoc eye mvmt,,,134.72,134.72,9
CPT,10120,"HC INC & REM FB, SQ; SMPL",3983.21,2987.41,47.8,3584.89,119
CPT,10120,Inc&rmvl fb subq tiss smpl,,,80.99,444.68,71
CPT,10121,"HC INC & REM FB, SQ; COMPL",6292.31,4719.23,75.51,5663.08,119
CPT,10121,Inc&rmvl fb subq tiss comp,,,142.18,2091.8,71
CPT,1012T,Mtrz ab ntrno trph scl/tr mw,,,4185.2,4185.2,9
CPT,1013T,Lap srg imp/rpl eso nea&pg/r,,,19643.11,19643.11,9
CPT,10140,"HC I&D HEMATOMA,SEROMA OR FLUID",3509.44,2632.08,42.11,3158.5,119
CPT,10140,I&d hmtma seroma/fluid collj,,,90.95,1803.33,71
CPT,10140,PBB I&D HEMATOMA SEROMA/FLUID COLLECTION,3509.44,2632.08,42.11,3158.5,119
CPT,1014T,Lap rv/rmv eso sph nstm eltr,,,11282.26,11282.26,9
CPT,1015T,Rev/rmv lw esoph sphnc npg/r,,,3539.9,3539.9,9
CPT,10160,"HC PUNCT ASP - ABSC,HEMAT,CYST",1150.96,863.22,13.81,1035.86,119
CPT,10160,PBB PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,610.62,457.96,7.33,549.56,119
CPT,10160,Pnxr aspir absc hmtma bulla,,,74.53,444.68,71
CPT,1017T,Elec aly npgs esoph sbsq w/o,,,59.73,59.73,9
CPT,10180,"HC I&D,COMPLEX,POSTOP WOUND INF",6974.1,5230.58,83.69,6276.69,119
CPT,10180,I&d complex po wound infctj,,,137.82,3236.54,71
CPT,1018T,Elec alys npgs esoph sbsq w/,,,37.79,37.79,9
CPT,1019T,Lymphovenous bypass per xtr,,,6723.34,6723.34,9
CPT,1020T,Raman spectroscopy 1+skn les,,,59.73,59.73,9
CPT,1021T,Active thrc irrigation spx,,,635.16,635.16,9
CPT,1025T,Alt elec fld dos&dlv sim mdl,,,136.1,136.1,9
CPT,11000,Dbrdmt ecz/infected skin<10%,,,26.53,681.3,71
CPT,11000,HC DEBR EXZ/INF SKIN; 10% BS,643.27,482.45,7.72,578.94,119
CPT,11001,Dbrdmt ecz/infct skn ea addl,,,14.48,247.27,52
CPT,11004,Dbrdmt skin xtrnl gent&per,,,550.04,14249.59,71
CPT,11005,Dbrdmt skin abdominal wall,,,318.6,14249.59,71
CPT,11006,Dbrdmt skin xtrnl gent per,,,677.06,15039.8,71
CPT,11008,Rmv prstc mtrl/mesh abd wall,,,263.6,14249.59,71
CPT,11010,Debride skin at fx site,,,213.78,1243.5,71
CPT,11011,Debride skin musc at fx site,,,286.25,1402.21,71
CPT,11012,Deb skin bone at fx site,,,402.06,3236.54,71
CPT,11042,Dbrdmt subq tis 1st 20sqcm/<,,,57.83,689.61,71
CPT,11042,HC DEB SUBQ TISSUE 20 SQ CM/<,973.55,730.16,11.68,876.2,119
CPT,11042,PBB DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1150.96,863.22,13.81,1035.86,119
CPT,11043,Dbrdmt musc&/fsca 1st 20/<,,,148.72,1126.35,71
CPT,11043,HC DEB MUSC/FASCIA 20SQ CM/<,1345.55,1009.16,16.15,1210.99,119
CPT,11044,Dbrdmt bone 1st 20 sq cm/<,,,218.24,2091.8,71
CPT,11044,HC DEB BONE 20SQ CM/<,2735.6,2051.7,32.83,2462.04,119
CPT,11045,Dbrdmt subq tiss each addl,,,24.62,364.55,52
CPT,11045,HC DEB SUBQ TISSUE ADD-ON=<20SQ CM,625.16,468.87,7.5,562.64,119
CPT,11046,Dbrdmt musc&/fsca ea addl,,,53.02,670.26,52
CPT,11046,HC DEB MUSC/FASCIA ADD-ON =<20 SQ CM; EACH ADDL,452.49,339.37,5.43,407.24,119
CPT,11047,Dbrdmt bone each addl,,,93.85,1117.79,52
CPT,11047,HC DEB BONE ADD-ON=<20SQ CM,1953.75,1465.31,23.44,1758.38,119
CPT,11055,HC PARE BENIGN LES SGL,338.66,254.0,4.06,304.79,119
CPT,11055,Paring/cutg b9 hyprker les 1,,,15.54,632.02,71
CPT,11056,HC TRIM SKIN LESIONS 2 TO 4,864.98,648.74,10.38,778.48,119
CPT,11056,Parng/cutg b9 hyprkr les 2-4,,,21.57,736.39,71
CPT,11057,HC TRIM SKIN LESIONS OVER 4,772.03,579.02,9.26,694.83,119
CPT,11057,Parng/cutg b9 hyprkr les >4,,,27.91,247.86,71
CPT,11102,Tangntl bx skin single les,,,36.66,411.6,71
CPT,11103,Tangntl bx skin ea sep/addl,,,20.95,448.32,52
CPT,11104,HC PUNCH BX SKIN; SINGLE LESION,570.59,427.94,6.85,513.53,119
CPT,11104,Punch bx skin single lesion,,,45.49,444.68,71
CPT,11105,HC PUNCH BX SKIN; EA SEP/ADDL LESION,222.33,166.75,2.67,200.1,119
CPT,11105,Punch bx skin ea sep/addl,,,24.85,538.99,52
CPT,11106,HC INCISIONAL BX SKIN; SINGLE LESION,868.57,651.43,10.42,781.71,119
CPT,11106,Incal bx skn single les,,,54.69,748.33,71
CPT,11107,HC INCISIONAL BX SKIN; EA SEP/ADDL LESION,304.72,228.54,3.66,274.25,119
CPT,11107,Incal bx skn ea sep/addl,,,29.76,636.06,52
CPT,11200,HC SKIN TAG REMOVAL UP TO 15 LESIONS,588.92,441.69,7.07,530.03,119
CPT,11200,Rmvl skin tags up to&inc 15,,,58.71,847.26,71
CPT,11201,Rmvl skin tags ea addl 10,,,16.02,169.71,52
CPT,11300,Shave skin lesion 0.5 cm/<,,,33.05,890.13,71
CPT,11301,Shave skin lesion 0.6-1.0 cm,,,49.75,1086.84,71
CPT,11302,Shave skin lesion 1.1-2.0 cm,,,57.95,1232.8,71
CPT,11303,Shave skin lesion >2.0 cm,,,68.74,1370.87,71
CPT,11305,Shave skin lesion 0.5 cm/<,,,36.69,939.01,71
CPT,11306,Shave skin lesion 0.6-1.0 cm,,,48.01,1094.14,71
CPT,11307,Shave skin lesion 1.1-2.0 cm,,,61.13,381.5,71
CPT,11308,Shave skin lesion >2.0 cm,,,68.37,1309.97,71
CPT,11310,Shave skin lesion 0.5 cm/<,,,44.48,317.53,71
CPT,11311,Shave skin lesion 0.6-1.0 cm,,,60.88,379.92,71
CPT,11312,Shave skin lesion 1.1-2.0 cm,,,72.88,444.68,71
CPT,11313,Shave skin lesion >2.0 cm,,,92.62,504.61,71
CPT,11400,Exc tr-ext b9+marg 0.5 cm<,,,64.62,783.1,71
CPT,11401,Exc tr-ext b9+marg 0.6-1 cm,,,81.85,444.68,71
CPT,11401,HC EXCISION BENIGN TRUNK/ARMS/LEGS 0.6-1.0CM,767.31,575.48,9.21,690.58,119
CPT,11402,Exc tr-ext b9+marg 1.1-2 cm,,,89.2,783.1,71
CPT,11402,HC EXC TR-EXT B9+MARG 1.1-2 CM,1523.98,1142.98,18.29,1371.58,119
CPT,11403,Exc tr-ext b9+marg 2.1-3cm,,,114.95,783.1,71
CPT,11404,Exc tr-ext b9+marg 3.1-4 cm,,,126.91,2091.8,71
CPT,11406,Exc tr-ext b9+marg >4.0 cm,,,191.5,2091.8,71
CPT,11420,Exc h-f-nk-sp b9+marg 0.5/<,,,63.39,1803.33,71
CPT,11420,HC EXC BLES S/N/EX G; 0.5CM/<,3509.44,2632.08,42.11,3158.5,119
CPT,11421,Exc h-f-nk-sp b9+marg 0.6-1,,,84.74,783.1,71
CPT,11422,Exc h-f-nk-sp b9+marg 1.1-2,,,104.68,1803.33,71
CPT,11422,HC EXCISION BENIGN LESION S/N/EX G: 1.1-2.0 CM,96.47,72.35,1.16,86.82,119
CPT,11423,Exc h-f-nk-sp b9+marg 2.1-3,,,120.67,1803.33,71
CPT,11424,Exc h-f-nk-sp b9+marg 3.1-4,,,137.94,2091.8,71
CPT,11426,Exc h-f-nk-sp b9+marg >4 cm,,,208.96,3236.54,71
CPT,11440,Exc face-mm b9+marg 0.5 cm/<,,,81.5,783.1,71
CPT,11441,Exc face-mm b9+marg 0.6-1 cm,,,102.42,783.1,71
CPT,11442,Exc face-mm b9+marg 1.1-2 cm,,,113.13,783.1,71
CPT,11443,Exc face-mm b9+marg 2.1-3 cm,,,137.98,1803.33,71
CPT,11444,Exc face-mm b9+marg 3.1-4 cm,,,174.37,2091.8,71
CPT,11446,Exc face-mm b9+marg >4 cm,,,244.78,3236.54,71
CPT,11450,Exc skn hdrdnt ax smpl/ntrm,,,179.54,3236.54,107
CPT,11451,Exc skn hdrdnt ax complex,,,228.19,3236.54,107
CPT,11462,Exc skn hdrdnt ing smpl/ntrm,,,170.14,3236.54,107
CPT,11463,Exc skn hdrdnt ing complex,,,229.56,3236.54,107
CPT,11470,Exc skn h/p/p/u smpl/ntrm,,,197.61,3236.54,71
CPT,11471,Exc skn h/p/p/u complex,,,240.86,3236.54,71
CPT,11600,Exc tr-ext mal+marg 0.5 cm/<,,,94.28,783.1,71
CPT,11601,Exc tr-ext mal+marg 0.6-1 cm,,,114.45,783.1,71
CPT,11602,Exc tr-ext mal+marg 1.1-2 cm,,,124.38,687.95,71
CPT,11603,Exc tr-ext mal+marg 2.1-3 cm,,,149.18,785.87,71
CPT,11604,Exc tr-ext mal+marg 3.1-4 cm,,,164.32,1126.35,71
CPT,11606,Exc tr-ext mal+marg >4 cm,,,244.42,2091.8,71
CPT,11620,Exc h-f-nk-sp mal+marg 0.5/<,,,94.81,1803.33,71
CPT,11621,Exc s/n/h/f/g mal+mrg 0.6-1,,,115.2,783.1,71
CPT,11622,Exc s/n/h/f/g mal+mrg 1.1-2,,,130.41,783.1,71
CPT,11623,Exc s/n/h/f/g mal+mrg 2.1-3,,,161.72,1803.33,71
CPT,11624,Exc s/n/h/f/g mal+mrg 3.1-4,,,183.65,2091.8,71
CPT,11626,Exc s/n/h/f/g mal+mrg >4 cm,,,225.41,3236.54,71
CPT,11640,Exc f/e/e/n/l mal+mrg 0.5cm<,,,97.41,783.1,71
CPT,11641,Exc f/e/e/n/l mal+mrg 0.6-1,,,119.89,783.1,71
CPT,11642,Exc f/e/e/n/l mal+mrg 1.1-2,,,140.06,783.1,71
CPT,11643,Exc f/e/e/n/l mal+mrg 2.1-3,,,175.33,1803.33,71
CPT,11644,Exc f/e/e/n/l mal+mrg 3.1-4,,,217.58,2091.8,71
CPT,11646,Exc f/e/e/n/l mal+mrg >4 cm,,,301.42,3236.54,71
CPT,11719,HC TRIM NONDYSTROPHIC NAILS ANY NUMBER,175.89,131.92,2.11,158.3,119
CPT,11719,Trim nail(s) any number,,,7.31,131.47,71
CPT,11720,Debride nail 1-5,,,14.21,301.28,71
CPT,11720,HC DEBRIDE NAIL ANY MEHOD 1TO 5,542.93,407.2,6.52,488.64,119
CPT,11721,Debride nail 6 or more,,,23.24,413.04,71
CPT,11721,HC DEBRIDE NAIL ANY METHOD 6 OR MORE,292.6,219.45,3.51,263.34,119
CPT,11730,Avulsion nail plate simple 1,,,52.32,1039.54,71
CPT,11730,HC AVLSION NAIL PLATE PARTL/COMPL SGL,572.41,429.31,6.87,515.17,119
CPT,11732,Avlsn nail plate simple each,,,16.87,299.6,52
CPT,11740,Evacuation subungual hmtma,,,30.66,522.43,71
CPT,11740,HC EVAC SUBUNGUAL HEMATOMA,371.33,278.5,4.46,334.2,119
CPT,11750,Excision nail&nail matrix,,,78.03,449.93,71
CPT,11750,HC REMOVAL NAILBED PARTL/COMPLETE,726.31,544.73,8.72,653.68,119
CPT,11755,Biopsy nail unit,,,59.1,783.1,71
CPT,11760,HC REPAIR NAIL BED,1983.84,1487.88,23.81,1785.46,119
CPT,11760,Repair of nail bed,,,85.54,748.33,71
CPT,11762,Reconstruction of nail bed,,,144.71,2089.12,71
CPT,11765,HC WEDGE EXC NAIL FOLD,546.11,409.58,6.55,491.5,119
CPT,11765,Wedge excision skn nail fold,,,71.06,1495.25,71
CPT,11770,Exc pilonidal cyst simple,,,143.69,3236.54,71
CPT,11771,Exc pilonidal cyst xtnsv,,,309.15,3236.54,71
CPT,11772,Exc pilonidal cyst comp,,,397.94,3236.54,71
CPT,11900,Inject skin lesions </w 7,,,29.11,522.63,71
CPT,11901,HC INTRALESIONAL INJECTION; 8 OR MORE LESIONS,501.85,376.39,6.02,451.66,119
CPT,11901,Inject skin lesions >7,,,44.2,641.58,71
CPT,11920,Correct skin color 6.0 cm/<,,,105.17,748.33,71
CPT,11921,Correct skn color 6.1-20.0cm,,,126.5,748.33,71
CPT,11922,Correct skin color ea 20.0cm,,,28.32,557.61,52
CPT,11950,Subq njx filling matrl 1cc/<,,,50.71,233.51,71
CPT,11951,Subq njx fil matrl 1.1-5.0cc,,,70.62,748.33,71
CPT,11952,Subq njx fil matrl 5.1-10cc,,,99.01,748.33,71
CPT,11954,Subq njx fil matrl>10.0 cc,,,108.43,748.33,71
CPT,11960,Insert tissue expander(s),,,694.2,4854.81,71
CPT,11970,Rplcmt tiss xpndr perm implt,,,386.33,9254.47,107
CPT,11971,Rmvl tis xpndr wo insj implt,,,378.93,3236.54,107
CPT,11976,Remove contraceptive capsule,,,90.47,783.1,71
CPT,11980,Implant hormone pellet(s),,,54.5,865.1,71
CPT,11981,"HC INSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",217.02,162.76,2.6,195.32,119
CPT,11981,Insertion drug dlvr implant,,,60.81,925.31,71
CPT,11982,HC REMOVE DRUG IMPLANT DEVICE,643.27,482.45,7.72,578.94,119
CPT,11982,Remove drug implant device,,,71.88,1012.93,71
CPT,11983,Remove/insert drug implant,,,100.74,1304.55,71
CPT,12001,HC REPAIR SIMPLE S/N/A/G/TR/E TO 2.5CM,572.41,429.31,6.87,515.17,119
CPT,12001,Rpr s/n/ax/gen/trnk 2.5cm/<,,,43.8,856.52,71
CPT,12002,HC REPAIR SIMP 2.6-7.5CM (SUPERFICIAL) S/N/A/G/TR/E,572.41,429.31,6.87,515.17,119
CPT,12002,Rpr s/n/ax/gen/trnk2.6-7.5cm,,,57.32,1044.27,71
CPT,12004,HC REPAIR SIMP 7.6-12.5CM (SUPERFICIAL) S/N/A/G/TR/E,643.97,482.98,7.73,579.57,119
CPT,12004,Rpr s/n/ax/gen/trk7.6-12.5cm,,,71.15,1217.23,71
CPT,12005,HC REPAIR SIMP 12.6-20.0 CM (SUPERFICIAL) S/N/A/G/TR/E,1294.82,971.12,15.54,1165.34,119
CPT,12005,Rpr s/n/a/gen/trk12.6-20.0cm,,,92.35,689.61,71
CPT,12006,HC SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1294.82,971.12,15.54,1165.34,119
CPT,12006,Rpr s/n/a/gen/trk20.1-30.0cm,,,113.62,689.61,71
CPT,12007,HC RESUPERF WND BODY >30 CM,726.31,544.73,8.72,653.68,119
CPT,12007,Rpr s/n/ax/gen/trnk >30.0 cm,,,141.05,648.96,71
CPT,12011,HC REPAIR SIMP WOUND <=2.5CM FACE,643.97,482.98,7.73,579.57,119
CPT,12011,Rpr f/e/e/n/l/m 2.5 cm/<,,,53.73,1024.95,71
CPT,12013,HC REPAIR SIMPLE  FACE 2.6-5.0CM,643.97,482.98,7.73,579.57,119
CPT,12013,Rpr f/e/e/n/l/m 2.6-5.0 cm,,,57.14,1069.79,71
CPT,12014,HC REPAIR SIMPLE FACE 5.1-7.5 CM,643.97,482.98,7.73,579.57,119
CPT,12014,Rpr f/e/e/n/l/m 5.1-7.5 cm,,,72.98,1300.31,71
CPT,12015,HC REPAIR SIMPLE FACE 7.6-12.5CM,643.97,482.98,7.73,579.57,119
CPT,12015,Rpr f/e/e/n/l/m 7.6-12.5 cm,,,92.04,488.19,71
CPT,12016,HC REPAR SIMPL FACE 12.6 - 20.0CM,1294.82,971.12,15.54,1165.34,119
CPT,12016,Rpr fe/e/en/l/m 12.6-20.0 cm,,,124.91,689.61,71
CPT,12017,HC SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,726.31,544.73,8.72,653.68,119
CPT,12017,Rpr fe/e/en/l/m 20.1-30.0 cm,,,150.01,689.61,71
CPT,12018,HC SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,726.31,544.73,8.72,653.68,119
CPT,12018,Rpr f/e/e/n/l/m >30.0 cm,,,27.11,500.63,71
CPT,12020,HC TREATMENT OF SUPERFICIAL WOUND DEHISCENCE,1983.84,1487.88,23.81,1785.46,119
CPT,12020,Tx supfc wnd dehsn smpl clsr,,,145.73,1126.35,71
CPT,12021,HC TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,998.8,749.1,11.99,898.92,119
CPT,12021,Tx supfc wnd dehsn w/packing,,,108.98,689.61,71
CPT,12031,HC REPR INTMD WOUND SCALP <2.5 CM,1294.82,971.12,15.54,1165.34,119
CPT,12031,Intmd rpr s/a/t/ext 2.5 cm/<,,,116.82,729.23,71
CPT,12032,HC REPR INTMD WOUND SCALP 2.6-7.5,1294.82,971.12,15.54,1165.34,119
CPT,12032,Intmd rpr s/a/t/ext 2.6-7.5,,,146.16,848.94,71
CPT,12034,HC REPR INTMD WND SCALP  7.6-12.5,1294.82,971.12,15.54,1165.34,119
CPT,12034,Intmd rpr s/tr/ext 7.6-12.5,,,158.43,934.29,71
CPT,12035,HC REPR INTMD WOUND SCALP 12.6-20,1294.82,971.12,15.54,1165.34,119
CPT,12035,Intmd rpr s/a/t/ext 12.6-20,,,186.21,1092.48,71
CPT,12036,HC REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1983.84,1487.88,23.81,1785.46,119
CPT,12036,Intmd rpr s/a/t/ext 20.1-30,,,217.46,1224.51,71
CPT,12037,HC REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5928.31,4446.23,71.14,5335.48,119
CPT,12037,Intmd rpr s/tr/ext >30.0 cm,,,252.87,3080.23,71
CPT,12041,HC REPR INTM WND N-HF/GENT =< 2.5,1150.96,863.22,13.81,1035.86,119
CPT,12041,Intmd rpr n-hf/genit 2.5cm/<,,,111.98,733.53,71
CPT,12042,HC INTMD WND REP N-HF/GEN 2.6-7.5,1294.82,971.12,15.54,1165.34,119
CPT,12042,Intmd rpr n-hf/genit2.6-7.5,,,150.69,866.26,71
CPT,12044,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1983.84,1487.88,23.81,1785.46,119
CPT,12044,Intmd rpr n-hf/genit7.6-12.5,,,165.08,1126.35,71
CPT,12045,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,998.8,749.1,11.99,898.92,119
CPT,12045,Intmd rpr n-hf/genit12.6-20,,,212.02,1158.21,71
CPT,12046,HC RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,583.94,437.96,7.01,525.55,119
CPT,12046,Intmd rpr n-hf/genit20.1-30,,,245.07,1404.4,71
CPT,12047,HC REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,583.94,437.96,7.01,525.55,119
CPT,12047,Intmd rpr n-hf/genit >30.0cm,,,54.54,3080.23,107
CPT,12051,HC REPR INTM WND FACE/MM =< 2.5CM,583.94,437.96,7.01,525.55,119
CPT,12051,Intmd rpr face/mm 2.5 cm/<,,,130.7,787.24,71
CPT,12052,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1294.82,971.12,15.54,1165.34,119
CPT,12052,Intmd rpr face/mm 2.6-5.0 cm,,,154.04,881.43,71
CPT,12053,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1294.82,971.12,15.54,1165.34,119
CPT,12053,Intmd rpr face/mm 5.1-7.5 cm,,,166.34,1012.53,71
CPT,12054,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1294.82,971.12,15.54,1165.34,119
CPT,12054,Intmd rpr face/mm 7.6-12.5cm,,,170.3,1066.87,71
CPT,12055,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,998.8,749.1,11.99,898.92,119
CPT,12055,Intmd rpr face/mm 12.6-20 cm,,,232.1,1403.94,71
CPT,12056,HC REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1294.82,971.12,15.54,1165.34,119
CPT,12056,Intmd rpr face/mm 20.1-30.0,,,297.0,1626.22,71
CPT,12057,"HC LAYR CLOS WND FACE,FACIAL >30 CM",125.29,93.97,1.5,112.76,119
CPT,12057,Intmd rpr face/mm >30.0 cm,,,64.81,1699.47,107
CPT,12207,HC RESUPERF WND BODY >30 CM,726.31,544.73,8.72,653.68,119
CPT,13100,Cmplx rpr trunk 1.1-2.5 cm,,,154.78,1126.35,71
CPT,13100,HC CMPLX RPR TRUNK 1.1-2.5 CM,998.8,749.1,11.99,898.92,119
CPT,13101,Cmplx rpr trunk 2.6-7.5 cm,,,190.61,1126.35,71
CPT,13101,HC CMPLX RPR TRUNK 2.6-7.5 CM,998.8,749.1,11.99,898.92,119
CPT,13102,Cmplx rpr trunk addl 5cm/<,,,69.24,1058.36,52
CPT,13102,HC CMPLX RPR TRUNK ADDL 5CM/<,998.8,749.1,11.99,898.92,119
CPT,13120,Cmplx rpr s/a/l 1.1-2.5 cm,,,178.78,989.12,71
CPT,13120,HC CMPLX RPR S/A/L 1.1-2.5 CM,1983.84,1487.88,23.81,1785.46,119
CPT,13121,Cmplx rpr s/a/l 2.6-7.5 cm,,,198.58,1185.54,71
CPT,13121,HC REP COMPLEX S/A/L; 2.6-7.5CM,1983.84,1487.88,23.81,1785.46,119
CPT,13122,Cmplx rpr s/a/l addl 5 cm/>,,,80.04,1151.89,52
CPT,13122,HC REP CPLX S/A/L; EA ADD 5 CM/<,1325.87,994.4,15.91,1193.28,119
CPT,13131,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,186.5,1084.86,71
CPT,13131,"HC RECMPL WND HEAD,FAC,HAND 1.1-2.5 CM",998.8,749.1,11.99,898.92,119
CPT,13132,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,233.86,1315.21,71
CPT,13132,"HC RECMPL WND HEAD,FAC,HAND 2.6-7.5 CM",1983.84,1487.88,23.81,1785.46,119
CPT,13133,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,120.72,1542.55,52
CPT,13133,HC CMPLX RPR F/C/C/M/N/AX/G/H/F,998.8,749.1,11.99,898.92,119
CPT,13151,Cmplx rpr e/n/e/l 1.1-2.5 cm,,,214.92,1184.1,71
CPT,13151,"HC RECMPL WND LID,NOS,EAR 1.1-2.5 CM",1983.84,1487.88,23.81,1785.46,119
CPT,13152,Cmplx rpr e/n/e/l 2.6-7.5 cm,,,259.17,1389.38,71
CPT,13152,"HC RECMPL WND LID,NOS,EAR 2.5-7.5 CM",1983.84,1487.88,23.81,1785.46,119
CPT,13153,Cmplx rpr e/n/e/l addl 5cm/<,,,132.31,1704.18,52
CPT,13153,HC CMPLX RPR E/N/E/L ADDL 5CM/<,998.8,749.1,11.99,898.92,119
CPT,13160,Sec clsr surg wnd/dehsn xtn,,,547.57,4854.81,71
CPT,14000,Tis trnfr trunk 10 sq cm/<,,,344.36,3080.23,71
CPT,14001,Tis trnfr trunk 10.1-30sqcm,,,447.07,3080.23,71
CPT,14020,Tis trnfr s/a/l 10 sq cm/<,,,386.77,3080.23,71
CPT,14021,Tis trnfr s/a/l 10.1-30 sqcm,,,484.8,3080.23,71
CPT,14040,Tis trnfr f/c/c/m/n/a/g/h/f,,,426.76,3080.23,71
CPT,14041,Tis trnfr f/c/c/m/n/a/g/h/f,,,521.54,3080.23,71
CPT,14060,Tis trnfr e/n/e/l 10 sq cm/<,,,455.25,3080.23,71
CPT,14061,Tis trnfr e/n/e/l10.1-30sqcm,,,559.58,3080.23,71
CPT,14301,Tis trnfr any 30.1-60 sq cm,,,134.21,4854.81,107
CPT,14302,Tis trnfr addl 30 sq cm,,,33.41,1991.46,52
CPT,14350,Filleted finger/toe flap,,,465.86,3080.23,71
CPT,15002,Wound prep trk/arm/leg,,,211.78,2035.94,71
CPT,15003,Wound prep addl 100 cm,,,43.68,629.66,52
CPT,15004,Wound prep f/n/hf/g,,,252.1,1105.99,71
CPT,15005,Wnd prep f/n/hf/g addl cm,,,86.53,1074.82,52
CPT,15011,Hrv skn cll ssp agrft 1st 25,,,1753.61,2089.12,19
CPT,15012,Hrv skn cll ssp agrft ea add,,,,,0
CPT,15013,Prepj skn cll ssp agrft 1st,,,6950.77,8069.84,18
CPT,15014,Prepj skn cll ssp agrft ea,,,,,0
CPT,15015,App skn cl ssp agrft t/a/l 1,,,1753.61,2089.12,19
CPT,15016,App skn cl ssp agrf t/a/l ea,,,,,0
CPT,15017,App skn cll ssp f/n/g/hf 1st,,,1753.61,2089.12,19
CPT,15018,App skn cll ssp f/n/g/hf ea,,,,,0
CPT,15040,Harvest cultured skin graft,,,119.73,3080.23,71
CPT,15050,Pinch graft up to 2 cm diam,,,316.38,1653.62,71
CPT,15100,Splt agrft t/a/l 1st 100sqcm,,,491.17,3080.23,71
CPT,15101,Splt agrft t/a/l ea addl 100,,,106.81,1678.16,52
CPT,15110,Epidrm agrft t/a/l 1st 100,,,490.89,3080.23,71
CPT,15110,HC EPIDRM AUTOGRFT TRNK/ARM/LEG,7495.06,5621.3,89.94,6745.55,119
CPT,15111,Epidrm agrft t/a/l ea addl,,,98.87,1059.25,52
CPT,15111,HC EPIDRM AUTOGRFT T/A/L ADD-ON,2718.91,2039.18,32.63,2447.02,119
CPT,15115,Epdrm agrft f/s/n/h/f/g/m 1,,,475.22,3080.23,71
CPT,15115,HC EPIDRM A-GRFT FACE/NCK/HF/G,4107.13,3080.35,49.29,3696.42,119
CPT,15116,Epdrm agrft f/s/n/h/f/g/m ea,,,135.04,1426.95,52
CPT,15116,HC EPIDRM A-GRFT F/N/HF/G ADDL,1549.76,1162.32,18.6,1394.78,119
CPT,15120,Splt agrft f/s/n/h/f/g/m 1st,,,473.75,4854.81,71
CPT,15121,Splt agrft f/s/n/h/f/g/m ea,,,128.77,1871.52,52
CPT,15130,Drm agrft t/a/l 1st 100 sqcm,,,408.9,3080.23,71
CPT,15131,Drm agrft t/a/l ea addl,,,86.67,909.15,52
CPT,15135,Drm agrft f/s/n/h/f/g/m 1st,,,522.06,4854.81,71
CPT,15136,Drm agrft f/s/n/h/f/g/m ea,,,86.67,897.33,52
CPT,15150,Tis cltr skn agrft t/a/l 1st,,,439.46,3080.23,71
CPT,15151,Tis cltr skn agrft t/a/l add,,,105.94,1103.99,52
CPT,15152,Tis cltr skn agrft t/a/l ea,,,136.7,1427.05,52
CPT,15155,Tis cltr agrft f/s/n/h/f/g 1,,,501.05,4854.81,71
CPT,15156,Tis clt agrft f/s/n/h/f/g ad,,,145.11,1485.69,52
CPT,15157,Tis clt agrft f/s/n/h/f/g ea,,,158.48,1651.55,52
CPT,15200,Fth/gft fr trnk 20 sq cm/<,,,460.41,3080.23,71
CPT,15201,Fth/gft fr trnk each addl,,,74.02,1262.27,52
CPT,15220,Fth/gft fr s/a/l 20 sq cm/<,,,416.9,3080.23,71
CPT,15221,Fth/gft fr s/a/l each addl,,,66.58,1158.39,52
CPT,15240,Fth/gft f/c/c/m/n/ax/g/h/f20,,,543.42,3080.23,71
CPT,15241,Fth/gft f/c/c/m/n/a/g/h/f ea,,,101.97,1580.1,52
CPT,15260,Fth/gft fr n/e/e/l 20 sqcm/<,,,578.2,3080.23,71
CPT,15261,Fth/gft fr n/e/e/l each addl,,,131.1,1864.62,52
CPT,15271,HC SKIN SUB GRAFT TRNK/ARM/LEG UP TO 100CM (HIGH),3783.31,2837.48,45.4,3404.98,119
CPT,15271,HC SKIN SUB GRAFT TRNK/ARM/LEG UP TO 100CM (LOW),3783.31,2837.48,45.4,3404.98,119
CPT,15271,Skin sub graft trnk/arm/leg,,,80.81,2035.94,71
CPT,15272,HC SKIN SUB GRAFT T/A/L ADD-ON ADDL 25 SQ CM (HIGH),430.5,322.88,5.17,387.45,119
CPT,15272,HC SKIN SUB GRAFT T/A/L ADD-ON ADDL 25 SQ CM (LOW),430.5,322.88,5.17,387.45,119
CPT,15272,Skin sub graft t/a/l add-on,,,16.12,224.11,52
CPT,15273,Skin sub grft t/arm/lg child,,,189.43,4074.67,71
CPT,15274,Skn sub grft t/a/l child add,,,43.37,724.76,52
CPT,15275,HC SKIN SUB GRAFT FACE/NK/HF/G UP TO 100CM (HIGH),3753.46,2815.1,45.04,3378.11,119
CPT,15275,HC SKIN SUB GRAFT FACE/NK/HF/G UP TO 100CM (LOW),3753.46,2815.1,45.04,3378.11,119
CPT,15275,Skin sub graft face/nk/hf/g,,,90.49,2035.94,71
CPT,15276,HC SKIN SUB GRAFT F/N/HF/G ADDL 25 SQ CM (HIGH),465.93,349.45,5.59,419.34,119
CPT,15276,Skin sub graft f/n/hf/g addl,,,24.33,302.06,52
CPT,15277,HC SKIN SUB GRFT F/N/HF/G  CHILD=/> TO 100CM (HIGH),3433.26,2574.95,41.2,3089.93,119
CPT,15277,Skn sub grft f/n/hf/g child,,,217.22,3080.23,71
CPT,15278,HC SKIN SUB GRFT F/N/HF/G CHILD  ADD 100CM (HIGH),1573.85,1180.39,18.89,1416.46,119
CPT,15278,Skn sub grft f/n/hf/g ch add,,,53.89,859.87,52
CPT,15570,Skin pedicle flap trunk,,,501.66,3080.23,71
CPT,15572,Skin pedicle flap arms/legs,,,505.39,4854.81,71
CPT,15574,Pedcle fh/ch/ch/m/n/ax/g/h/f,,,505.07,3080.23,71
CPT,15576,Pedicle e/n/e/l/ntroral,,,445.04,3080.23,71
CPT,15600,Delay flap trunk,,,144.3,4854.81,71
CPT,15610,Delay flap arms/legs,,,166.94,3080.23,71
CPT,15620,Delay flap f/c/c/n/ax/g/h/f,,,223.49,3080.23,71
CPT,15630,Delay flap eye/nos/ear/lip,,,235.05,3080.23,71
CPT,15650,Transfer skin pedicle flap,,,276.16,3080.23,71
CPT,15730,Mdfc flap w/prsrv vasc pedcl,,,627.82,4854.81,71
CPT,15731,Forehead flap w/vasc pedicle,,,685.74,4854.81,71
CPT,15733,Musc myoq/fscq flp h&n pedcl,,,709.15,4854.81,71
CPT,15734,Muscle-skin graft trunk,,,232.45,4854.81,107
CPT,15736,Muscle-skin graft arm,,,834.55,3479.35,71
CPT,15738,Muscle-skin graft leg,,,196.59,4854.81,107
CPT,15740,Island pedicle flap graft,,,576.99,3080.23,71
CPT,15750,Neurovascular pedicle flap,,,143.13,4854.81,107
CPT,15756,Free myo/skin flap microvasc,,,355.11,21145.04,143
CPT,15757,Free skin flap microvasc,,,353.21,21015.84,143
CPT,15758,Free fascial flap microvasc,,,351.89,20930.29,143
CPT,15760,Composite skin graft,,,480.56,3080.23,71
CPT,15769,Grfg autol soft tiss dir exc,,,321.33,4854.81,71
CPT,15770,Derma-fat-fascia graft,,,104.06,4854.81,107
CPT,15771,Grfg autol fat lipo 50 cc/<,,,338.96,4854.81,71
CPT,15772,Grfg autol fat lipo ea addl,,,143.43,1780.95,52
CPT,15773,Grfg autol fat lipo 25 cc/<,,,334.54,3080.23,71
CPT,15774,Gfrg autol fat lipo ea addl,,,139.44,1737.39,52
CPT,15775,Hair trnspl 1-15 punch grfts,,,246.59,1060.62,70
CPT,15776,Hair trnspl >15 punch grafts,,,337.25,1435.41,70
CPT,15777,Acellular derm matrix implt,,,311.42,1986.73,52
CPT,15778,Impl absrb msh/prsth dly cls,,,373.44,15039.8,71
CPT,15780,Dermabrasion total face,,,453.35,3185.47,71
CPT,15781,Dermabrasion segmental face,,,293.4,1478.86,71
CPT,15782,Dermabrasion other than face,,,251.89,3185.47,71
CPT,15783,Dermabrasion suprfl any site,,,242.03,1277.07,71
CPT,15786,Abrasion lesion single,,,104.22,2075.62,71
CPT,15787,Abrasion lesions add-on,,,16.16,274.67,52
CPT,15788,Chemical peel facial epidrm,,,146.61,3488.58,71
CPT,15789,Chemical peel facial dermal,,,279.48,1506.54,71
CPT,15792,Chem peel nonfacial epidrm,,,142.01,3016.71,71
CPT,15793,Chemical peel nonfacial drm,,,241.83,4349.14,71
CPT,15819,Plastic surgery neck,,,549.5,2607.19,52
CPT,15820,Blepharoplasty lower eyelid,,,351.12,3080.23,107
CPT,15821,Blepharp lwr eyelid fat pad,,,375.26,3080.23,107
CPT,15822,Blepharoplasty upper eyelid,,,272.38,3080.23,107
CPT,15823,Blepharp upr eyelid xcsv skn,,,375.77,3080.23,107
CPT,15824,Rhytidectomy forehead,,,1753.61,3080.23,27
CPT,15825,Rhytdct nck pltysml tghtg,,,3509.62,4854.81,27
CPT,15826,Rhytidectomy glblr frn lines,,,3509.62,4854.81,27
CPT,15828,Rhytidectomy cheek chn & nck,,,3509.62,4854.81,27
CPT,15829,Rhytidectomy smas flap,,,3509.62,4854.81,27
CPT,15830,Exc excessive skin abdomen,,,181.65,7258.41,107
CPT,15832,Exc excessive skin thigh,,,142.93,3236.54,143
CPT,15833,Exc excessive skin leg,,,603.1,3236.54,107
CPT,15834,Exc excessive skin hip,,,613.99,3236.54,107
CPT,15835,Exc excessive skin buttock,,,640.38,3236.54,71
CPT,15836,Exc excessive skin arm,,,547.89,3236.54,107
CPT,15837,Exc excsv skin forearm/hand,,,492.6,3236.54,71
CPT,15838,Exc excsv submental fat pad,,,446.27,3236.54,71
CPT,15839,Exc excessive skn other area,,,509.37,3236.54,71
CPT,15840,Nerve palsy fascial graft,,,697.95,4854.81,71
CPT,15841,Nerve palsy muscle graft,,,275.58,5092.8,107
CPT,15842,Nerve palsy microsurg graft,,,417.88,7710.12,107
CPT,15845,Skin and muscle repair face,,,164.26,4854.81,107
CPT,15847,Exc skin abd add-on,,,1155.07,4476.08,16
CPT,15850,Remove sutures same surgeon,,,230.49,893.19,16
CPT,15851,Removal sutr/staple req anes,,,55.54,3080.23,71
CPT,15852,Dressing change not for burn,,,44.8,748.33,71
CPT,15853,HC REMOVAL SUT/STPL WO ANES NOT PLACED BY ED,327.45,245.59,3.93,294.7,119
CPT,15853,Removal sutr/stapl xreq anes,,,10.65,101.12,52
CPT,15854,Removal sutr&stapl xreq anes,,,15.02,127.92,52
CPT,15860,Iv njx tst vasc flo flap/grf,,,103.31,990.06,71
CPT,15876,Suction lipectomy head&neck,,,3509.62,4854.81,27
CPT,15877,Suction lipectomy trunk,,,3509.62,4854.81,27
CPT,15878,Suction lipectomy upr extrem,,,1753.61,3080.23,27
CPT,15879,Suction lipectomy lwr extrem,,,3509.62,4854.81,27
CPT,15920,Exc coccygl pr ulc prim sutr,,,440.76,3236.54,71
CPT,15922,Exc coccygl pr ulc flap clsr,,,123.64,4854.81,107
CPT,15931,Exc sacral pr ulc prim sutr,,,485.92,3236.54,71
CPT,15933,Exc sac pr ulc prim str ostc,,,599.28,3236.54,71
CPT,15934,Exc sacral pr ulc skn flap,,,653.38,4854.81,71
CPT,15935,Exc sac pr ulc skn flp ostc,,,179.16,4854.81,107
CPT,15936,Exc sac pr ulc prep mus flap,,,621.16,3080.23,71
CPT,15937,Exc sac pr ulc prep mus ostc,,,719.07,3080.23,71
CPT,15940,Exc ischial pr ulc prim sutr,,,488.65,3236.54,71
CPT,15941,Exc isch pr ulc prm sut ostc,,,644.3,3236.54,71
CPT,15944,Exc isch pr ulc skn flp clsr,,,643.12,4854.81,71
CPT,15945,Exc isch pr ulc skn flp ostc,,,701.7,3080.23,71
CPT,15946,Exc isch pr ulc prep mus flp,,,1113.53,4589.66,71
CPT,15950,Exc trchntr pr ulc prim sutr,,,437.93,2091.8,71
CPT,15951,Exc trchntr pr ulc ostc,,,618.22,3236.54,71
CPT,15952,Exc trchntr pr ulc flp clsr,,,142.12,3080.23,107
CPT,15953,Exc trchntr pr ulc flp ostc,,,694.52,4854.81,71
CPT,15956,Exc trchntr pr ulc prep flap,,,801.11,3336.68,71
CPT,15958,Exc trchntr pr ulc prep ostc,,,812.07,4854.81,71
CPT,15999,Unlisted px exc pressure ulc,,,674.5,783.1,19
CPT,16000,HC INITIL TREATMENT 1ST DEGR BURN,572.41,429.31,6.87,515.17,119
CPT,16000,Initial treatment of burn(s),,,44.62,738.65,71
CPT,16020,Dress/debrid p-thick burn s,,,53.31,782.41,71
CPT,16020,HC DRSG/DEBRIDE PARTL THICK BURN-SMALL,572.41,429.31,6.87,515.17,119
CPT,16025,Dress/debrid p-thick burn m,,,106.73,441.8,71
CPT,16025,HC DRSG/DEBRIDE PARTL THICK BURN-MEDIUM,588.64,441.48,7.06,529.78,119
CPT,16030,Dress/debrid p-thick burn l,,,127.08,689.61,71
CPT,16030,HC DRSG/DEBRIDE PARTL THICK BURN-LARGE,822.12,616.59,9.87,739.91,119
CPT,16035,Escharotomy 1st incision,,,189.01,689.61,71
CPT,16036,Escharotomy ea addl incision,,,80.0,15039.8,71
CPT,16036,HC ESCHAROTOMY EACH ADDITIONAL INCISION,125.29,93.97,1.5,112.76,119
CPT,16997,HC CATHETER IABALLON SUPPLY LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,17000,Destruct premalg lesion,,,42.04,622.66,71
CPT,17003,Destruct premalg les 2-14,,,1.98,60.31,52
CPT,17004,Destroy premal lesions 15/>,,,76.52,466.86,71
CPT,17106,Dstr cut vsc prlf les<10sqcm,,,188.87,980.24,71
CPT,17106,HC SKIN LESION DESTRUCTION <10 SQ CM,7247.77,5435.83,86.97,6522.99,119
CPT,17107,Dstr cut vsc prlf les10-50sq,,,245.01,1274.07,71
CPT,17107,HC SKIN LESN DESTRCTN 10-50 SQ CM,685.85,514.39,8.23,617.26,119
CPT,17108,Dstr cut vsc prlf les>50sqcm,,,360.13,2089.12,71
CPT,17108,HC SKIN LESION DESTRUCTION >50 SQ CM,8163.38,6122.54,97.96,7347.04,119
CPT,17110,Destruction b9 les up to 14,,,51.5,1026.13,71
CPT,17110,HC DESTRUCT BENIGN LESION 1-14,620.22,465.16,7.44,558.2,119
CPT,17111,Destruction b9 lesions 15/>,,,63.29,1207.37,71
CPT,17250,Chem caut of granltj tissue,,,35.92,766.05,71
CPT,17250,HC CHEM CAUT GRANULATION TISS,789.89,592.42,9.48,710.9,119
CPT,17260,Dstrj mal les t/a/l 0.5 cm/<,,,54.48,912.7,71
CPT,17261,Dstrj mal les t/a/l .6-1.0cm,,,66.77,1352.44,71
CPT,17262,Dstrj mal les t/a/l 1.1-2.0,,,85.31,1625.93,71
CPT,17263,Dstrj mal les t/a/l 2.1-3.0,,,94.26,1764.2,71
CPT,17264,Dstrj mal les t/a/l 3.1-4.0,,,100.56,583.57,71
CPT,17266,Dstrj mal les t/a/l >4.0 cm,,,118.6,664.01,71
CPT,17270,Dstr mal les s/n/h/f/g .5 /<,,,73.76,422.89,71
CPT,17271,Dstr mal les s/n/h/f/g 0.6-1,,,81.38,468.89,71
CPT,17272,Dstr mal les s/n/h/f/g 1.1-2,,,93.46,1722.12,71
CPT,17273,Dstr mal les s/n/h/f/g 2.1-3,,,105.77,589.79,71
CPT,17274,Dstr mal les s/n/h/f/g 3.1-4,,,129.62,692.23,71
CPT,17276,Dstr mal les s/n/h/f/g >4.0,,,156.31,803.36,71
CPT,17280,Dstr mal ls f/e/e/n/l/m .5/<,,,66.51,1287.0,71
CPT,17281,Dstr mal ls f/e/e/n/l/m .6-1,,,91.35,507.03,71
CPT,17282,Dstr mal ls f/e/e/n/l/m1.1-2,,,105.5,579.65,71
CPT,17283,Dstr mal ls f/e/e/n/l/m2.1-3,,,131.47,687.98,71
CPT,17284,Dstr mal ls f/e/e/n/l/m3.1-4,,,153.72,782.87,71
CPT,17286,Dstr mal ls f/e/e/n/l/m>4.0,,,207.8,1013.8,71
CPT,17311,Mohs 1 stage h/n/hf/g,,,344.0,1912.46,71
CPT,17312,Mohs addl stage,,,183.28,3743.34,52
CPT,17313,Mohs 1 stage t/a/l,,,308.34,1795.64,71
CPT,17314,Mohs addl stage t/a/l,,,169.29,3580.63,52
CPT,17315,Mohs surg addl block,,,48.73,738.26,52
CPT,17340,Cryotherapy for acne,,,38.28,489.32,71
CPT,17360,Chemical exfoliation acne,,,72.18,1134.44,70
CPT,17380,Electrolysis epilation ea 30,,,586.82,1126.35,27
CPT,17999,HC CT SUBCUTANEOUS TISSUE RF ABLATION,726.31,544.73,8.72,653.68,119
CPT,17999,HC UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,737.96,553.47,8.86,664.16,119
CPT,17999,Unlistd px skn muc memb subq,,,190.49,221.16,19
CPT,18097,HC DEVICE DELIVERY SYSTEM SUPPLY NON IMPLANT LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,19000,HC PUNCT ASP BREAST CYST - INITIAL,1098.29,823.72,13.18,988.46,119
CPT,19000,Puncture aspir cyst breast,,,40.02,783.1,72
CPT,19001,HC PUNCT ASP BREAST CYST EACH ADDL,310.28,232.71,3.72,279.25,119
CPT,19001,Puncture aspir cyst brst ea,,,19.86,240.96,53
CPT,19020,HC MASTOTOMY EXPL DRG ABSC DP,726.31,544.73,8.72,653.68,119
CPT,19020,Mastotomy expl drg absc dp,,,215.39,2091.8,107
CPT,19030,HC INJECTION DUCTOGRAM BILATERAL,2607.67,1955.75,31.29,2346.9,119
CPT,19030,HC INJECTION DUCTOGRAM UNILATERAL,1303.83,977.87,15.65,1173.45,119
CPT,19030,Njx px only mam ducto/glcto,,,111.6,1475.04,52
CPT,19081,Bx breast 1st lesion strtctc,,,238.2,2091.8,72
CPT,19081,HC BX BREAST 1ST LESION STEREO,5592.33,4194.25,67.11,5033.1,119
CPT,19082,Bx breast add lesion strtctc,,,80.02,3330.6,53
CPT,19082,HC BX BREAST ADD LESION STEREO,4425.45,3319.09,53.11,3982.9,119
CPT,19083,Bx breast 1st lesion us imag,,,223.92,2091.8,72
CPT,19083,HC BX BREAST 1ST LESION US GUIDE,3185.67,2389.25,38.23,2867.1,119
CPT,19084,Bx breast add lesion us imag,,,75.39,3265.95,53
CPT,19084,HC BX BREAST ADD LESION US GUIDE,2860.57,2145.43,34.33,2574.51,119
CPT,19085,Bx breast 1st lesion mr imag,,,260.79,2091.8,72
CPT,19085,HC BX BREAST 1ST LESION MRI GUIDE,6555.31,4916.48,78.66,5899.78,119
CPT,19086,Bx breast add lesion mr imag,,,87.37,5074.1,53
CPT,19086,HC BX BREAST ADD LESION MRI GUIDE,3468.37,2601.28,41.62,3121.53,119
CPT,19100,Bx breast percut w/o image,,,65.69,2091.8,72
CPT,19101,Biopsy of breast open,,,173.65,4266.34,108
CPT,19105,Cryosurg ablate fa each,,,304.31,6465.03,71
CPT,19110,Nipple exploration,,,242.23,4266.34,107
CPT,19112,Excise breast duct fistula,,,221.28,4266.34,107
CPT,19120,Removal of breast lesion,,,287.81,4266.34,108
CPT,19125,Excision breast lesion,,,318.49,4266.34,108
CPT,19126,Excision addl breast lesion,,,152.08,1483.62,53
CPT,19281,HC PL NDL LOC 1ST LESION MAMMO GUIDE,1980.55,1485.41,23.77,1782.5,119
CPT,19281,Perq device breast 1st imag,,,143.94,2175.06,72
CPT,19282,HC PL NDL LOC EA  ADD LESION MAMMO GUIDE,1237.76,928.32,14.85,1113.98,119
CPT,19282,Perq device breast ea imag,,,48.43,1517.32,53
CPT,19283,HC PL NDL LOC 1ST LESION STEREO,1925.3,1443.98,23.1,1732.77,119
CPT,19283,Perq dev breast 1st strtctc,,,144.81,2314.81,72
CPT,19284,HC PL NDL LOC EA  ADD LESION STEREO,1497.89,1123.42,17.97,1348.1,119
CPT,19284,Perq dev breast add strtctc,,,48.41,1657.07,53
CPT,19285,HC PL NEEDLE LOC 1ST LESION US GUIDE,2015.01,1511.26,24.18,1813.51,119
CPT,19285,Perq dev breast 1st us imag,,,79.17,3188.88,72
CPT,19286,HC PL NDL LOC EA  ADD LESION US GUIDE,1979.76,1484.82,23.76,1781.78,119
CPT,19286,Perq dev breast add us imag,,,41.46,2575.98,53
CPT,19287,Perq dev breast 1st mr guide,,,183.06,5482.31,72
CPT,19288,Perq dev breast add mr guide,,,61.35,4188.21,53
CPT,19294,Prepj tum cav iort prtl mast,,,158.81,1526.68,52
CPT,19296,Place po breast cath for rad,,,305.12,11033.64,71
CPT,19297,Place breast cath for rad,,,91.31,869.14,52
CPT,19298,Place breast rad tube/caths,,,463.65,13953.57,71
CPT,19300,Mastectomy for gynecomastia,,,298.16,4266.34,107
CPT,19301,Partial mastectomy,,,455.31,4266.34,107
CPT,19302,P-mastectomy w/ln removal,,,140.89,7258.41,143
CPT,19303,Mast simple complete,,,148.8,7258.41,143
CPT,19305,Mast radical,,,178.8,15039.8,143
CPT,19306,Mast rad urban type,,,189.43,15039.8,143
CPT,19307,Mast mod rad,,,183.24,7258.41,143
CPT,19316,Mastopexy,,,122.88,7258.41,143
CPT,19318,Breast reduction,,,169.64,7258.41,143
CPT,19325,Breast augmentation w/implt,,,423.12,10650.39,107
CPT,19328,Rmvl intact breast implant,,,381.5,4266.34,107
CPT,19330,Rmvl ruptured breast implant,,,445.57,4266.34,107
CPT,19340,Insj breast implt sm d mast,,,522.8,8275.77,107
CPT,19342,Insj/rplcmt brst implt sep d,,,524.05,10650.39,107
CPT,19350,Nipple/areola reconstruction,,,463.38,4266.34,107
CPT,19355,Correct inverted nipple(s),,,425.08,4266.34,107
CPT,19357,Tiss xpndr plmt brst rcnstj,,,179.36,19364.44,143
CPT,19361,Brst rcnstj latsms drsi flap,,,241.63,14506.51,143
CPT,19364,Brst rcnstj free flap,,,421.94,25252.04,143
CPT,19367,Brst rcnstj 1 pdcl tram flap,,,274.55,16474.02,143
CPT,19368,Brst rcnstj 1pdcl tram anast,,,336.63,20151.92,143
CPT,19369,Brst rcnstj 2 pdcl tram flap,,,312.74,18723.0,143
CPT,19370,Revj peri-implt capsule brst,,,462.14,4266.34,107
CPT,19371,Peri-implt capslc brst compl,,,490.96,4266.34,107
CPT,19380,Revj reconstructed breast,,,555.85,7258.41,107
CPT,19396,Design custom breast implant,,,206.57,4266.34,71
CPT,19499,Unlisted procedure breast,,,3670.98,4262.01,19
CPT,20100,Expl pentrg wound neck,,,93.14,1722.47,143
CPT,20101,Expl pentrg wound chest,,,162.56,3080.23,71
CPT,20102,Expl pentrg wnd abd/flnk/bk,,,196.78,3080.23,71
CPT,20103,Expl pentrg wound extremity,,,267.66,2091.8,71
CPT,20150,Excision epiphyseal bar,,,155.81,4266.34,143
CPT,20200,Muscle biopsy superficial,,,91.7,2091.8,71
CPT,20205,Deep muscle biopsy,,,149.21,3236.54,71
CPT,20206,Biopsy muscle perq needle,,,55.31,2091.8,71
CPT,20206,HC MUSCLE BX PERC NEEDLE,1374.49,1030.87,16.49,1237.04,119
CPT,20220,Bone biopsy trocar/ndl supfc,,,85.06,2091.8,71
CPT,20220,HC BONE BIOPSY SUPERFICIAL,1740.63,1305.47,20.89,1566.57,119
CPT,20225,Bone biopsy trocar/ndl deep,,,125.18,2091.8,71
CPT,20225,HC BIOPSY BONE PERCUTAN DEEP,2095.77,1571.83,25.15,1886.19,119
CPT,20240,Bone biopsy open superficial,,,135.86,3236.54,71
CPT,20245,Bone biopsy open deep,,,333.93,3236.54,71
CPT,20250,Biopsy vrt bdy open thoracic,,,300.9,4266.34,71
CPT,20251,Biopsy vrt bdy open lmbr/crv,,,65.34,9254.47,107
CPT,20500,HC INJECT SINUS TRACT THERAPEUTIC,1806.44,1354.83,21.68,1625.8,119
CPT,20500,Njx sinus tract therapeutic,,,69.06,1648.68,71
CPT,20501,HC INJECT SINUS TRACT DIAGNOSTIC,1443.68,1082.76,17.32,1299.31,119
CPT,20501,Njx sinus tract diagnostic,,,35.65,1247.48,52
CPT,20520,HC REMOVE FB MUSCLE SIMPLE,726.31,544.73,8.72,653.68,119
CPT,20520,Rmvl fb musc/tdn simple,,,113.82,1803.33,71
CPT,20525,HC RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1701.62,1276.21,20.42,1531.46,119
CPT,20525,Rmvl fb musc/tdn deep/comp,,,191.54,3236.54,71
CPT,20526,HC THER INJECTION CARP TUNNEL,569.94,427.46,6.84,512.95,119
CPT,20526,Ther injection carp tunnel,,,83.0,328.55,71
CPT,20527,Njx nzm palmar fascial cord,,,95.43,328.55,71
CPT,20550,HC INJ SGL TENDON SHTH OR LIGAMENT,470.27,352.7,5.64,423.24,119
CPT,20550,Njx 1 tendon sheath/ligament,,,57.11,328.55,71
CPT,20551,HC INJ SINGLE TENDON ORIGIN,942.56,706.92,11.31,848.3,119
CPT,20551,Njx 1 tendon origin/insj,,,38.07,328.55,71
CPT,20552,"HC INJECT TRIGGER POINT(S), 1 - 2 MUSCLE",553.0,414.75,6.64,497.7,119
CPT,20552,Njx 1/mlt trigger point 1/2,,,36.01,328.55,71
CPT,20552,PBB INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,553.0,414.75,6.64,497.7,119
CPT,20553,HC INJECT TRIGGER POINTS 3+ MUSCLE,794.79,596.09,9.54,715.31,119
CPT,20553,Njx 1/mlt trigger points 3/>,,,41.21,328.55,71
CPT,20555,Place ndl musc/tis for rt,,,326.32,4266.34,71
CPT,20560,HC PT NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,50.78,38.08,0.61,45.7,119
CPT,20560,Ndl insj w/o njx 1 or 2 musc,,,14.59,232.88,70
CPT,20561,HC PERF BY CERT ACUPUNCT PT NDL INSERT W/O INJECTN 3 + MUSCLS,71.07,53.3,0.85,63.96,119
CPT,20561,HC PT NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,71.07,53.3,0.85,63.96,119
CPT,20561,Ndl insj w/o njx 3+ musc,,,21.87,340.4,70
CPT,20600,Drain/inj joint/bursa w/o us,,,51.66,328.55,71
CPT,20600,HC SMALL JOINT ASPRNT/INJECT BILATERAL W/O US GUIDE,1538.94,1154.2,18.47,1385.05,119
CPT,20600,HC SMALL JOINT ASPRNT/INJECT UNILATERAL W/O US GUIDE,769.36,577.02,9.23,692.42,119
CPT,20600,PBB ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,769.36,577.02,9.23,692.42,119
CPT,20604,Drain/inj joint/bursa w/us,,,67.05,328.55,71
CPT,20604,HC SMALL JT ASPRNT/INJECT BILATERAL INCLUDE US GUIDE,3005.33,2254.0,36.06,2704.8,119
CPT,20604,HC SMALL JT ASPRNT/INJECT UNILATERAL INCLUD US GUIDE,1502.51,1126.88,18.03,1352.26,119
CPT,20605,Drain/inj joint/bursa w/o us,,,54.03,328.55,71
CPT,20605,HC MEDIUM JOINT ASPIRTN/INJECT BILATERAL W/O US GUIDE,1333.17,999.88,16.0,1199.85,119
CPT,20605,HC MEDIUM JOINT ASPIRTN/INJECT UNILATERAL W/O US GUIDE,666.58,499.94,8.0,599.92,119
CPT,20605,PBB ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,666.58,499.94,8.0,599.92,119
CPT,20606,Drain/inj joint/bursa w/us,,,75.87,770.78,71
CPT,20606,HC MEDIUM  JT ASPRNT/INJECT UNILATERAL INCLUD US GUIDE,1910.7,1433.02,22.93,1719.63,119
CPT,20610,Drain/inj joint/bursa w/o us,,,65.67,328.55,71
CPT,20610,HC MAJOR JOINT ASPRTN/INJ BILATERAL W/O US GUIDE,1850.85,1388.14,22.21,1665.76,119
CPT,20610,HC MAJOR JOINT ASPRTN/INJ UNILATERAL W/O US GUIDE,925.4,694.05,11.1,832.86,119
CPT,20610,PBB ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,943.69,707.77,11.32,849.32,119
CPT,20611,Drain/inj joint/bursa w/us,,,87.39,328.55,71
CPT,20611,HC MAJOR JT ASPRNT/INJECT BILATERAL INCLUD  US GUIDE,3595.56,2696.67,43.15,3236.0,119
CPT,20611,HC MAJOR JT ASPRNT/INJECT UNILATERAL INCLUD  US GUIDE,1797.97,1348.48,21.58,1618.17,119
CPT,20612,Aspirate/inj ganglion cyst,,,39.83,328.55,71
CPT,20612,HC ASPIRATE/INJ GANGLION CYST,877.75,658.31,10.53,789.98,119
CPT,20612,PBB ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,850.38,637.78,10.2,765.34,119
CPT,20615,Treatment of bone cyst,,,125.18,783.1,71
CPT,20650,Insert and remove bone pin,,,127.0,4266.34,71
CPT,20660,Apply rem fixation device,,,233.92,2387.17,71
CPT,20661,Application halo cranial,,,345.17,14249.59,71
CPT,20662,Application halo pelvic,,,349.58,2387.17,71
CPT,20663,Application halo femoral,,,322.03,4266.34,107
CPT,20664,Appl halo cranial 6+pins,,,592.74,15039.8,71
CPT,20665,Rmvl tongs/halo anthr indiv,,,75.6,724.08,71
CPT,20670,Removal implant superficial,,,111.84,2091.8,71
CPT,20680,Removal of implant deep,,,280.8,3236.54,71
CPT,20690,Appl unipln uni ext fixj sys,,,400.17,12688.69,71
CPT,20692,Appl mltpln uni ext fixj sys,,,174.44,24411.94,107
CPT,20693,Adjmt/revj ext fixj sys anes,,,297.09,9254.47,71
CPT,20694,Rmvl ext fixj sys under anes,,,228.67,2387.17,71
CPT,20696,App mltpln uni xtrnl fix 1st,,,181.98,31193.03,107
CPT,20697,App mltpln uni xtrnl fix xch,,,275.62,4648.55,71
CPT,20697,HC HEMOSTATIC SUPPLY LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,20700,Mnl prep&insj dp rx dlvr dev,,,81.97,778.27,52
CPT,20701,Rmvl deep rx delivery device,,,62.63,592.01,52
CPT,20702,Mnl prep&insj imed rx dev,,,137.99,1325.93,52
CPT,20703,Rmvl imed rx delivery device,,,99.5,972.03,52
CPT,20704,Mnl prep&insj i-artic rx dev,,,142.32,1393.44,52
CPT,20705,Rmvl i-artic rx delivery dev,,,120.61,1151.89,52
CPT,20802,Replantation arm complete,,,424.61,25519.91,143
CPT,20805,Replant forearm complete,,,504.63,30311.16,143
CPT,20808,Replantation hand complete,,,608.84,36559.32,143
CPT,20816,Replantation digit complete,,,318.01,19107.65,107
CPT,20822,Replantation digit complete,,,274.47,5084.18,107
CPT,20824,Replantation thumb complete,,,318.56,19146.29,143
CPT,20827,Replantation thumb complete,,,281.92,16960.77,143
CPT,20838,Replantation foot complete,,,430.97,25888.3,143
CPT,20900,Removal of bone for graft,,,28.15,11309.48,71
CPT,20902,Removal of bone for graft,,,42.73,9254.47,71
CPT,20910,Remove cartilage for graft,,,318.68,1381.34,71
CPT,20912,Remove cartilage for graft,,,323.44,4854.81,71
CPT,20920,Removal of fascia for graft,,,268.88,3080.23,71
CPT,20922,Removal of fascia for graft,,,76.54,3080.23,107
CPT,20924,Removal of tendon for graft,,,78.49,9254.47,107
CPT,20930,Sp bone algrft morsel add-on,,,1435.05,1712.32,8
CPT,20931,Sp bone algrft struct add-on,,,106.58,1028.5,52
CPT,20932,Osteoart algrft w/surf & b1,,,116.71,6985.24,52
CPT,20933,Hemicrt intrclry algrft prtl,,,107.17,6406.44,52
CPT,20934,Intercalary algrft compl,,,116.66,6979.13,52
CPT,20936,Sp bone agrft local add-on,,,,,0
CPT,20937,Sp bone agrft morsel add-on,,,25.81,1551.91,52
CPT,20938,Sp bone agrft struct add-on,,,28.22,1696.49,52
CPT,20939,Bone marrow aspir bone grfg,,,101.69,649.07,52
CPT,20950,Mntr intrstitial fluid press,,,84.61,1126.35,71
CPT,20955,Fibula bone graft microvasc,,,382.49,22658.12,107
CPT,20956,Iliac bone graft microvasc,,,408.56,24543.64,107
CPT,20957,Mt bone graft microvasc,,,425.41,25561.4,107
CPT,20962,Other bone graft microvasc,,,412.42,24864.82,107
CPT,20969,Bone/skin graft microvasc,,,422.36,25153.49,107
CPT,20970,Bone/skin graft iliac crest,,,440.58,26489.37,107
CPT,20972,Bone/skin graft metatarsal,,,439.35,9254.47,107
CPT,20973,Bone/skin graft great toe,,,464.12,9254.47,143
CPT,20974,Estim aid bone healg n-invas,,,48.7,786.35,71
CPT,20975,Estim aid bone healg invasiv,,,27.04,1660.91,52
CPT,20979,Lw ntsty us stimj bone healg,,,23.47,512.87,71
CPT,20982,Ablate bone tumor(s) perq,,,532.88,20343.28,71
CPT,20982,HC ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,12396.44,9297.33,148.76,11156.8,119
CPT,20983,Ablate bone tumor(s) perq,,,496.61,13357.87,71
CPT,20983,HC CT BONE CRYO ABLATION INCLUDE GUIDANCE,10301.75,7726.31,123.62,9271.58,119
CPT,20985,Cptr-asst dir ms px,,,140.15,1340.72,52
CPT,20999,Unlisted px muscskel general,,,229.97,266.99,19
CPT,21010,Incision of jaw joint,,,497.96,3825.0,107
CPT,21011,Exc face les sc <2 cm,,,40.24,1803.33,107
CPT,21012,Exc face les sbq 2 cm/>,,,52.7,2091.8,107
CPT,21013,Exc face tum deep < 2 cm,,,62.56,1803.33,107
CPT,21014,Exc face tum deep 2 cm/>,,,81.2,3236.54,107
CPT,21015,Resect face/scalp tum < 2 cm,,,468.12,3236.54,71
CPT,21016,Resect face/scalp tum 2 cm/>,,,156.71,3236.54,107
CPT,21025,Excision of bone lower jaw,,,442.21,7571.84,71
CPT,21026,Excision of facial bone(s),,,285.32,7571.84,71
CPT,21029,Contour of face bone lesion,,,416.13,3825.0,71
CPT,21030,Excise max/zygoma b9 tumor,,,241.02,6584.15,107
CPT,21031,Remove exostosis mandible,,,181.26,3609.55,107
CPT,21032,Remove exostosis maxilla,,,173.31,3609.55,71
CPT,21034,Excise max/zygoma mal tumor,,,175.28,7571.84,107
CPT,21040,Excise mandible lesion,,,242.94,3825.0,71
CPT,21044,Removal of jaw bone lesion,,,134.15,7571.84,107
CPT,21045,Extensive jaw surgery,,,186.74,14249.59,107
CPT,21046,Remove mandible cyst complex,,,661.75,7571.84,71
CPT,21047,Excise lwr jaw cyst w/repair,,,189.3,7571.84,107
CPT,21048,Remove maxilla cyst complex,,,666.84,7571.84,71
CPT,21049,Excis uppr jaw cyst w/repair,,,179.41,7571.84,107
CPT,21050,Removal of jaw joint,,,578.36,7571.84,107
CPT,21060,Remove jaw joint cartilage,,,121.81,7571.84,143
CPT,21070,Remove coronoid process,,,410.5,7571.84,107
CPT,21073,Mnpj of tmj w/anesth,,,161.77,1648.68,107
CPT,21076,Impres&prep surg obt prosth,,,551.41,2535.62,71
CPT,21077,Impres&prep orbital prosth,,,1171.45,6584.15,107
CPT,21079,Impres&prep intrm obt prosth,,,786.29,4239.68,71
CPT,21080,Impres&prep def obt prosth,,,892.8,4819.06,71
CPT,21081,Impres&prep mndbl res prosth,,,817.01,6584.15,71
CPT,21082,Impres&prep paltl aug prosth,,,747.11,4173.26,71
CPT,21083,Impres&prep paltl lft prosth,,,693.11,3948.7,71
CPT,21084,Impres&prep sp aid prosth,,,802.16,4506.38,71
CPT,21085,Impres&prep oral surg splint,,,222.62,1959.13,71
CPT,21086,Impres&prep auricular prosth,,,863.98,4566.04,107
CPT,21087,Impres&prep nasal prosth,,,863.98,6584.15,71
CPT,21088,Impres&prep facial prosth,,,3109.0,3825.0,27
CPT,21089,Unlisted maxlfcl prosth px,,,222.62,258.46,19
CPT,21100,Maxillofacial fixation,,,236.64,7571.84,71
CPT,21110,Interdental fixation,,,475.7,2377.23,71
CPT,21116,Injection jaw joint x-ray,,,65.4,1858.32,52
CPT,21120,Genioplasty augmentation,,,338.15,7571.84,71
CPT,21121,Geniop sldg osteot 1,,,82.32,5459.36,107
CPT,21122,Geniop sldg osteot 2/>,,,115.84,7571.84,107
CPT,21123,Geniop sldg augmentation,,,131.5,3825.0,107
CPT,21125,Augmentation mndblr prostc,,,103.71,9534.91,107
CPT,21127,Augmentation mndblr b1 grf,,,118.98,10823.66,107
CPT,21137,Rdctj forehead cntrg only,,,116.56,3825.0,107
CPT,21138,Rdctj forehead cntrg&prostc,,,141.91,7571.84,107
CPT,21139,Rdctj forehead cntrg&setback,,,169.11,7571.84,107
CPT,21141,Rcnstj midface lefort i 1pc,,,206.92,12330.95,107
CPT,21142,Rcnstj midface lefort i 2pcs,,,212.41,12658.34,107
CPT,21143,Rcnstj mdface lefort i 3/>pc,,,218.87,13049.5,107
CPT,21145,Rcnstj mdfc lefort i 1 w/grf,,,240.92,14351.19,107
CPT,21146,Rcnstj mdfc lefort i 2 w/grf,,,251.46,14986.66,107
CPT,21147,Rcnstj mdfc lefort i 3/>grf,,,264.89,15764.24,107
CPT,21150,Rcnstj mdfc lefrtii ant ntru,,,256.16,9534.91,107
CPT,21151,Rcnstj mdfc lefrtii w/b1 grf,,,282.05,16733.31,107
CPT,21154,Rcnstj mdfc lefort iii w/o i,,,303.49,18021.8,107
CPT,21155,Rcnstj mdfc lefort iii w/i,,,336.72,19996.8,107
CPT,21159,Rcnst mdfc lfrtiii advm wo i,,,403.64,23977.85,107
CPT,21160,Rcnst mdfc lfrtiii advm w/i,,,437.9,26005.97,107
CPT,21172,Rcnst supr-lat orb rm&lw fhd,,,328.42,7571.84,107
CPT,21175,Rcnst bfrnt sp orb rm&lw fhd,,,342.83,7571.84,107
CPT,21179,Rcnstj forehead with grafts,,,235.78,15039.8,107
CPT,21180,Rcnstj forehead w/autograft,,,263.39,15761.19,107
CPT,21181,Rcnst cntrg b9 tum crnl xtrc,,,496.46,7571.84,71
CPT,21182,Reconstruct cranial bone,,,327.99,19639.15,107
CPT,21183,Reconstruct cranial bone,,,356.87,21358.9,107
CPT,21184,Reconstruct cranial bone,,,383.78,22967.48,107
CPT,21188,Reconstruction of midface,,,245.45,15039.8,107
CPT,21193,Reconst lwr jaw w/o graft,,,191.41,7571.84,107
CPT,21194,Reconst lwr jaw w/graft,,,221.36,13187.77,107
CPT,21195,Reconst lwr jaw w/o fixation,,,208.13,10095.79,107
CPT,21196,Reconst lwr jaw w/fixation,,,222.41,13202.46,107
CPT,21198,Reconstr lwr jaw segment,,,159.1,7571.84,107
CPT,21199,Reconstr lwr jaw w/advance,,,158.34,7571.84,107
CPT,21206,Reconstruct upper jaw bone,,,151.15,7571.84,107
CPT,21208,Augmentation of facial bones,,,492.58,7571.84,71
CPT,21209,Reduction of facial bones,,,96.18,7571.84,107
CPT,21210,Face bone graft,,,506.88,7571.84,71
CPT,21215,Lower jaw bone graft,,,526.15,11050.35,71
CPT,21230,Rib cartilage graft,,,502.29,7571.84,71
CPT,21235,Ear cartilage graft,,,380.9,7571.84,71
CPT,21240,Reconstruction of jaw joint,,,163.6,7571.84,143
CPT,21242,Reconstruction of jaw joint,,,157.09,7571.84,143
CPT,21243,Reconstruction of jaw joint,,,260.12,31193.03,143
CPT,21244,Reconstruction of lower jaw,,,156.41,10376.22,107
CPT,21245,Reconstruction of jaw,,,147.07,11033.64,107
CPT,21246,Reconstruction of jaw,,,132.03,12412.85,107
CPT,21247,Reconstruct lower jaw bone,,,245.54,15039.8,143
CPT,21248,Reconstruction of jaw,,,530.22,7571.84,71
CPT,21249,Reconstruction of jaw,,,743.14,7571.84,71
CPT,21255,Reconstruct lower jaw bone,,,207.37,12313.31,143
CPT,21256,Reconstruction of orbit,,,192.15,9815.35,143
CPT,21260,Revise eye sockets,,,211.97,7571.84,107
CPT,21261,Revise eye sockets,,,375.84,7571.84,107
CPT,21263,Revise eye sockets,,,347.54,7571.84,107
CPT,21267,Revise eye sockets,,,247.86,12412.85,143
CPT,21268,Revise eye sockets,,,311.1,18585.52,143
CPT,21270,Augmentation cheek bone,,,116.14,10376.22,143
CPT,21275,Revision orbitofacial bones,,,130.95,7571.84,107
CPT,21280,HC TREAT STERNUM,643.27,482.45,7.72,578.94,119
CPT,21280,Medial canthopexy,,,389.97,3825.0,107
CPT,21282,Lateral canthopexy,,,264.5,3825.0,107
CPT,21295,Revision of jaw muscle/bone,,,131.08,1850.43,107
CPT,21296,Revision of jaw muscle/bone,,,273.2,3825.0,107
CPT,21299,Unlisted cranfcl&maxlfcl px,,,222.62,258.46,19
CPT,21315,Clsd tx nsl fx mnpj wo stblj,,,58.54,1850.43,71
CPT,21315,HC CLSD TX NSL FX MNPJ WO STBLJ,1701.62,1276.21,20.42,1531.46,119
CPT,21320,Clsd tx nsl fx w/mnpj&stablj,,,92.32,3825.0,71
CPT,21320,HC CLSD TX NSL FX W/MNPJ&STABLJ,1701.62,1276.21,20.42,1531.46,119
CPT,21325,Open tx nose fx uncomplicatd,,,297.18,3825.0,71
CPT,21330,Open tx nose fx w/skele fixj,,,358.1,7571.84,71
CPT,21335,Open tx nose & septal fx,,,479.69,3825.0,71
CPT,21336,Open tx septal fx w/wo stabj,,,425.19,4266.34,71
CPT,21337,Closed tx septal&nose fx,,,201.09,3825.0,71
CPT,21337,HC CLOSED TX SEPTAL&NOSE FX,1701.62,1276.21,20.42,1531.46,119
CPT,21338,Open nasoethmoid fx w/o fixj,,,448.96,7571.84,71
CPT,21339,Open nasoethmoid fx w/ fixj,,,117.89,7571.84,107
CPT,21340,Perq tx nasoethmoid fx,,,507.11,3825.0,71
CPT,21343,Open tx dprsd front sinus fx,,,169.3,14249.59,107
CPT,21344,Open tx compl front sinus fx,,,217.71,14249.59,143
CPT,21345,Closed tx nose/jaw fx,,,430.22,2281.82,71
CPT,21345,HC CLOSED TX NOSE/JAW FX,1701.62,1276.21,20.42,1531.46,119
CPT,21346,Opn tx nasomax fx w/fixj,,,685.89,7571.84,71
CPT,21347,Opn tx nasomax fx multple,,,161.79,9614.34,107
CPT,21348,Opn tx nasomax fx w/graft,,,170.89,15039.8,143
CPT,21355,Perq tx malar fracture,,,256.63,3825.0,107
CPT,21356,Opn tx dprsd zygomatic arch,,,312.52,7571.84,107
CPT,21360,Opn tx dprsd malar fracture,,,81.77,7571.84,143
CPT,21365,Opn tx complx malar fx,,,168.55,7571.84,143
CPT,21366,Opn tx complx malar w/grft,,,198.0,11877.61,179
CPT,21385,Opn tx orbit fx transantral,,,113.73,7571.84,143
CPT,21386,Opn tx orbit fx periorbital,,,107.4,7571.84,143
CPT,21387,Opn tx orbit fx combined,,,118.73,7571.84,143
CPT,21390,Opn tx orbit periorbtl implt,,,124.65,7571.84,143
CPT,21395,Opn tx orbit periorbt w/grft,,,156.6,7571.84,143
CPT,21400,Closed tx orbit w/o manipulj,,,111.57,896.48,107
CPT,21400,HC CLOSED TX ORBIT W/O MANIPULJ UNILAT,583.94,437.96,7.01,525.55,119
CPT,21401,Closed tx orbit w/manipulj,,,50.91,1850.43,143
CPT,21406,Opn tx orbit fx w/o implant,,,90.5,7571.84,143
CPT,21407,Opn tx orbit fx w/implant,,,100.35,7571.84,143
CPT,21408,Opn tx orbit fx w/bone grft,,,140.18,7571.84,179
CPT,21421,Cltx palatal/max fx wire fix,,,362.76,3825.0,71
CPT,21421,HC TREAT MOUTH ROOF FRACTURE,1701.62,1276.21,20.42,1531.46,119
CPT,21422,Optx palatal/max fracture,,,97.76,10095.79,107
CPT,21423,Optx palatal/max fx comp,,,123.85,15039.8,143
CPT,21431,Cltx craniofacial separation,,,107.31,15039.8,107
CPT,21431,HC TREAT CRANIOFACIAL FRACTURE,1701.62,1276.21,20.42,1531.46,119
CPT,21432,Optx cranfcl sep w/wiring,,,110.96,15039.8,107
CPT,21433,Optx cranfcl sep comp mlt,,,268.95,16121.2,107
CPT,21435,Optx crnfc sep comp int&/xtr,,,218.19,15039.8,107
CPT,21436,Optx crnfcl sep comp mlt int,,,315.71,18942.48,143
CPT,21440,Cltx mndblr/max alv ridge fx,,,365.49,3609.55,71
CPT,21440,HC TREAT DENTAL RIDGE FRACTURE,1701.62,1276.21,20.42,1531.46,119
CPT,21445,Optx mndblr/max alv ridge fx,,,98.24,7571.84,107
CPT,21450,Cltx mndblr fx w/o mnpj,,,319.01,1646.16,71
CPT,21450,HC CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,583.94,437.96,7.01,525.55,119
CPT,21451,Cltx mndblr fx w/mnpj,,,426.89,2151.56,71
CPT,21451,HC CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,1701.62,1276.21,20.42,1531.46,119
CPT,21452,Perq tx mndblr fx xtrnl fixj,,,306.27,7571.84,71
CPT,21453,Cltx mndblr fx ntrdntl fixj,,,617.34,7571.84,71
CPT,21453,HC CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,643.27,482.45,7.72,578.94,119
CPT,21454,Optx mndblr fx xtrnl fixj,,,326.78,7571.84,71
CPT,21461,Optx mndblr fx wo ntrdntl,,,702.91,9534.91,71
CPT,21462,Optx mndblr fx w/ntrdntl,,,180.24,9815.35,107
CPT,21465,Optx mndblr cndylr fx,,,124.0,9534.91,143
CPT,21470,Optx complicated mndblr fx,,,180.15,9815.35,107
CPT,21480,Cltx tmprmand dislc 1st/sbsq,,,45.69,441.34,71
CPT,21480,HC REDUCE TEMPOROMANDIBL DISLOC BILAT,643.27,482.45,7.72,578.94,119
CPT,21480,HC REDUCE TEMPOROMANDIBL DISLOC UNILAT,643.27,482.45,7.72,578.94,119
CPT,21485,Cltx tmprmand dislc comp,,,524.2,2621.08,107
CPT,21485,HC RESET DISLOCATED JAW BILAT,583.94,437.96,7.01,525.55,119
CPT,21485,HC RESET DISLOCATED JAW UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,21490,Optx tmprmand dislocation,,,122.13,4854.81,143
CPT,21497,Interdental wirg oth/thn fx,,,391.07,1979.19,71
CPT,21499,Unlisted muscskel px head,,,222.62,258.46,19
CPT,21501,HC I&D DEEP ABSC SFT TISS NK/THOR,9275.55,6956.66,111.31,8347.99,119
CPT,21501,I&d dp absc/hmtma sft ts nck,,,224.23,3236.54,71
CPT,21502,I&d dp abs/hmtm nck rib ostc,,,78.75,4266.34,107
CPT,21510,Inc deep opng b1 crtx thorax,,,243.99,14249.59,71
CPT,21550,Biopsy of neck/chest,,,120.97,2091.8,71
CPT,21550,HC SOFT TISS BX NECK/THORAX,1904.8,1428.6,22.86,1714.32,119
CPT,21552,Exc neck les sc 3 cm/>,,,69.59,3236.54,107
CPT,21554,Exc neck tum deep 5 cm/>,,,113.84,3236.54,107
CPT,21555,Exc neck les sc < 3 cm,,,205.79,2091.8,71
CPT,21556,Exc neck tum deep < 5 cm,,,356.92,3236.54,71
CPT,21557,Resect neck thorax tumor<5cm,,,148.4,3236.54,107
CPT,21558,Resect neck tumor 5 cm/>,,,208.77,3844.95,107
CPT,21600,Partial removal of rib,,,87.63,9254.47,107
CPT,21601,Exc chest wall tumor w/ribs,,,176.77,3272.38,107
CPT,21602,Exc ch wal tum w/o lymphadec,,,237.71,15039.8,107
CPT,21603,Exc ch wal tum w/lymphadec,,,259.43,15515.99,107
CPT,21610,Costotransversectomy,,,176.09,4266.34,107
CPT,21615,Excision 1st &/cervical rib,,,96.31,14249.59,143
CPT,21616,Exc 1st&/crv rib w/sympth,,,110.21,14249.59,143
CPT,21620,Ostectomy sternum partial,,,78.18,14249.59,107
CPT,21627,Sternal debridement,,,84.43,14249.59,107
CPT,21630,Radical resection sternum,,,203.87,15039.8,107
CPT,21632,Extensive sternum surgery,,,187.23,11529.22,88
CPT,21685,Hyoid myotomy & suspension,,,153.42,10095.79,107
CPT,21700,Revision of neck muscle,,,55.04,9254.47,143
CPT,21705,Revision of neck muscle/rib,,,82.31,14249.59,143
CPT,21720,Revision of neck muscle,,,82.53,4266.34,107
CPT,21725,Revision of neck muscle,,,84.6,1575.3,107
CPT,21740,Reconstruction of sternum,,,158.23,15039.8,107
CPT,21742,Repair stern/nuss w/o scope,,,2919.24,4266.34,35
CPT,21743,Repair sternum/nuss w/scope,,,3110.48,4266.34,27
CPT,21750,Repair of sternum separation,,,104.56,15039.8,107
CPT,21811,Optx of rib fx w/fixj scope,,,91.76,7951.0,107
CPT,21812,Treatment of rib fracture,,,111.2,7951.0,107
CPT,21813,Treatment of rib fracture,,,151.86,9104.23,107
CPT,21820,HC TREAT STERNUM,643.27,482.45,7.72,578.94,119
CPT,21820,Treat sternum fracture,,,99.84,443.86,71
CPT,21825,Treat sternum fracture,,,85.22,14249.59,107
CPT,21899,Unlisted px neck/thorax,,,222.62,258.46,19
CPT,21920,Biopsy soft tissue of back,,,119.97,1803.33,71
CPT,21925,Biopsy soft tissue of back,,,252.58,2091.8,71
CPT,21930,Exc back les sc < 3 cm,,,244.34,1803.33,71
CPT,21931,Exc back les sc 3 cm/>,,,73.07,2091.8,107
CPT,21932,Exc back tum deep < 5 cm,,,103.52,3236.54,107
CPT,21933,Exc back tum deep 5 cm/>,,,114.83,3236.54,107
CPT,21935,Resect back tum < 5 cm,,,682.92,3236.54,71
CPT,21936,Resect back tum 5 cm/>,,,219.39,4054.4,107
CPT,21997,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,21997,HC KYPHOPLASTY SUPPLY NON IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,22010,I&d p-spine c/t/cerv-thor,,,647.54,14249.59,71
CPT,22015,I&d abscess p-spine l/s/ls,,,636.89,14249.59,71
CPT,22100,Remove part of neck vertebra,,,133.85,9254.47,107
CPT,22101,Remove part thorax vertebra,,,134.84,9254.47,107
CPT,22102,Remove part lumbar vertebra,,,120.98,9254.47,107
CPT,22103,Remove extra spine segment,,,20.93,1236.15,52
CPT,22110,Remove part of neck vertebra,,,164.76,15039.8,107
CPT,22112,Remove part thorax vertebra,,,176.33,15039.8,107
CPT,22114,Remove part lumbar vertebra,,,176.33,15039.8,107
CPT,22116,Remove extra spine segment,,,21.77,15039.8,62
CPT,22206,Incis spine 3 column thorac,,,379.24,22964.82,107
CPT,22207,Incis spine 3 column lumbar,,,371.88,22378.33,107
CPT,22208,Incis spine 3 column adl seg,,,90.68,15039.8,62
CPT,22210,Incis 1 vertebral seg cerv,,,276.92,16741.4,107
CPT,22212,Incis 1 vertebral seg thorac,,,234.71,15039.8,107
CPT,22214,Incis 1 vertebral seg lumbar,,,234.76,14249.59,107
CPT,22216,Incis addl spine segment,,,55.97,15039.8,62
CPT,22220,Osteot dsc ant 1 vrt sgm crv,,,251.27,15262.41,107
CPT,22222,Osteot dsc ant 1vrt sgm thrc,,,273.22,16574.84,107
CPT,22224,Osteot dsc ant 1vrt sgm lmbr,,,245.71,15039.8,107
CPT,22226,Osteot dsc ant 1vrt sgm ea,,,55.4,15039.8,62
CPT,22310,Closed tx vert fx w/o manj,,,199.55,901.61,71
CPT,22315,Closed tx vert fx w/manj,,,517.75,4266.34,71
CPT,22315,HC CLOSED TX VERT FX W/MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,22318,Treat odontoid fx w/o graft,,,256.49,15511.65,143
CPT,22319,Treat odontoid fx w/graft,,,284.62,17234.46,143
CPT,22325,Treat spine fracture,,,229.0,14249.59,107
CPT,22326,Treat neck spine fracture,,,234.76,14249.59,107
CPT,22327,Treat thorax spine fracture,,,238.61,15039.8,107
CPT,22328,Treat each add spine fx,,,43.66,15039.8,62
CPT,22505,Manipulation of spine,,,100.79,2387.17,70
CPT,22510,HC PERC VERTEBROPLAST CERV/THORAC INCL IMAGING,11470.83,8603.12,137.65,10323.75,119
CPT,22510,Perq cervicothoracic inject,,,335.84,4802.73,71
CPT,22511,HC PERC VERTEBROPLAST LUMBOSACRAL INCL IMAGING,12055.07,9041.3,144.66,10849.56,119
CPT,22511,Perq lumbosacral injection,,,315.02,4794.45,71
CPT,22512,HC PERC VERTEBROPLAST EACH ADDED LEVEL,9415.09,7061.32,112.98,8473.58,119
CPT,22512,Vertebroplasty addl inject,,,200.37,6354.5,52
CPT,22513,HC PERC VERTEBRAL AUGMENTATION THORACIC,22711.19,17033.39,272.53,20440.07,119
CPT,22513,Perq vertebral augmentation,,,395.02,14796.98,71
CPT,22514,HC PERC VERTEBRAL AUGMENTATION LUMBAR,23021.87,17266.4,276.26,20719.68,119
CPT,22514,Perq vertebral augmentation,,,368.3,14724.0,71
CPT,22515,HC PERC VERTEBRAL AUGMENTATION EA ADD ALL SITES,19484.31,14613.23,233.81,17535.88,119
CPT,22515,Perq vertebral augmentation,,,211.11,24512.3,52
CPT,22526,Idet single level,,,4317.92,16732.62,16
CPT,22527,Idet 1 or more levels,,,3529.56,13677.58,16
CPT,22532,Arthrd lat xtrcvtry tq thrc,,,278.81,16768.89,143
CPT,22533,Arthrd lat xtrcvtry tq lmbr,,,256.84,17753.44,143
CPT,22534,Arthrd lat xtrcvtry tq ea ad,,,55.6,15039.8,98
CPT,22548,Arthrd ant toral/xoral c1-c2,,,305.07,18484.21,143
CPT,22551,Arthrd ant ntrbdy cervical,,,264.05,21699.51,143
CPT,22552,Arthrd ant ntrbd cervical ea,,,61.16,16495.91,88
CPT,22554,Arthrd ant ntrbd min dsc crv,,,195.91,21699.51,143
CPT,22556,Arthrd ant ntrbd min dsc thc,,,259.48,17753.44,143
CPT,22558,Arthrd ant ntrbd min dsc lum,,,237.09,29697.68,143
CPT,22585,Arthrd ant ntrbd min dsc ea,,,50.29,3007.34,88
CPT,22586,Arthrd pre-sac ntrbdy l5-s1,,,315.54,19116.23,143
CPT,22590,Arthrd pst tq craniocervical,,,246.81,15039.8,143
CPT,22595,Arthrd pst tq atlas-axis,,,235.43,14293.63,143
CPT,22600,Arthrd pst tq 1ntrspc crv,,,202.17,17867.49,143
CPT,22610,Arthrd pst tq 1ntrspc thrc,,,198.83,17753.44,143
CPT,22612,Arthrd pst tq 1ntrspc lumbar,,,245.85,31193.03,143
CPT,22614,Arthrd pst tq 1ntrspc ea add,,,60.36,3633.06,88
CPT,22630,Arthrd pst tq 1ntrspc lum,,,241.9,30087.09,143
CPT,22632,Arthrd pst tq 1ntrspc lm ea,,,49.51,2976.99,88
CPT,22633,Arthrd cmbn 1ntrspc lumbar,,,280.51,37361.54,143
CPT,22634,Arthrd cmbn 1ntrspc ea addl,,,74.77,4498.06,88
CPT,22800,Arthrd pst dfrm<6 vrt sgm,,,212.31,17753.44,107
CPT,22802,Arthrd pst dfrm 7-12 vrt sgm,,,328.52,19680.05,107
CPT,22804,Arthrd pst dfrm 13+ vrt sgm,,,377.36,22598.7,107
CPT,22808,Arthrd ant dfrm 2-3 vrt sgm,,,283.09,17753.44,107
CPT,22810,Arthrd ant dfrm 4-7 vrt sgm,,,311.24,18714.43,107
CPT,22812,Arthrd ant dfrm 8+ vrt sgm,,,340.98,20503.66,107
CPT,22818,Kyphectomy 1-2 segments,,,333.12,20023.51,143
CPT,22819,Kyphectomy 3 or more,,,383.61,23042.18,143
CPT,22830,Exploration of spinal fusion,,,127.73,14249.59,107
CPT,22836,Ant thrc vrt body tethrg <7,,,4127.53,17753.44,34
CPT,22837,Ant thrc vrt body tethrg 8+,,,4549.68,17753.44,34
CPT,22838,Rev rplc/rmv thrc vrt tethrg,,,4609.22,17861.45,34
CPT,22840,Insert spine fixation device,,,116.99,6997.56,52
CPT,22841,Insert spine fixation device,,,1627.84,14249.59,10
CPT,22842,Insert spine fixation device,,,117.82,7081.43,88
CPT,22843,Insert spine fixation device,,,126.11,14249.59,98
CPT,22844,Insert spine fixation device,,,152.18,14249.59,98
CPT,22845,Insert spine fixation device,,,112.19,6735.21,88
CPT,22846,Insert spine fixation device,,,116.73,20867.84,98
CPT,22847,Insert spine fixation device,,,123.6,15039.8,98
CPT,22848,Insert pelv fixation device,,,55.52,3335.53,91
CPT,22849,Reinsert spinal fixation,,,202.8,14249.59,107
CPT,22850,Remove spine fixation device,,,114.24,19881.4,107
CPT,22852,Remove spine fixation device,,,109.95,14249.59,107
CPT,22853,Insj biomechanical device,,,39.83,2391.59,88
CPT,22854,Insj biomechanical device,,,51.78,3113.78,88
CPT,22855,Removal anterior instrmj,,,172.26,14249.59,107
CPT,22856,Tot disc arthrp 1ntrspc crv,,,252.08,37507.38,143
CPT,22857,Tot disc arthrp 1ntrspc lmbr,,,273.82,17753.44,143
CPT,22858,Tot disc arthrp 2nd lvl crv,,,78.17,28352.55,88
CPT,22859,Insj biomechanical device,,,51.41,3110.83,88
CPT,22860,Tot disc arthrp 2ntrspc lmbr,,,987.62,15039.8,26
CPT,22861,Rev rplcm arthrp 1ntrspc crv,,,359.77,21763.06,143
CPT,22862,Rev rplcm rthrp 1ntrspc lmbr,,,359.57,21756.76,143
CPT,22864,Rmvl tot arthrp 1ntrspc crv,,,321.16,19431.6,143
CPT,22865,Rmvl tot arthrp 1ntrspc lmbr,,,350.95,21244.58,143
CPT,22867,Insj stablj dev w/dcmprn,,,167.02,31193.03,106
CPT,22868,Insj stablj dev w/dcmprn,,,37.63,2243.56,88
CPT,22869,Insj stablj dev w/o dcmprn,,,67.12,27124.38,106
CPT,22870,Insj stablj dev w/o dcmprn,,,18.39,1087.83,88
CPT,22899,Unlisted procedure spine,,,229.97,266.99,19
CPT,22900,Exc abdl tum deep < 5 cm,,,88.01,3236.54,107
CPT,22901,Exc abdl tum deep 5 cm/>,,,103.58,3236.54,107
CPT,22902,Exc abd les sc < 3 cm,,,51.79,2091.8,107
CPT,22903,Exc abd les sc 3 cm/>,,,68.53,3236.54,107
CPT,22904,Radical resect abd tumor<5cm,,,163.05,3236.54,107
CPT,22905,Rad resect abd tumor 5 cm/>,,,205.98,3832.0,107
CPT,22999,Unlisted px abdomen muscskel,,,229.97,266.99,19
CPT,23000,Rmvl sbdltd clcreous dep opn,,,55.47,3236.54,143
CPT,23020,Capsular contracture release,,,107.72,4266.34,143
CPT,23030,HC DRAIN SHOULDER LESION,726.31,544.73,8.72,653.68,119
CPT,23030,I&d shoulder deep absc/hmtma,,,197.86,3236.54,71
CPT,23031,I&d shoulder infected bursa,,,172.62,3236.54,107
CPT,23035,Incision bone cortex sho,,,106.39,2387.17,143
CPT,23040,Arthrt gh jt expl/drg/rmv fb,,,111.98,4266.34,143
CPT,23044,Arthrt ac sc jt exp/rmvl fb,,,382.87,4266.34,107
CPT,23065,Biopsy shoulder tissues,,,123.8,1803.33,107
CPT,23066,Biopsy shoulder tissues,,,245.25,3236.54,107
CPT,23071,Exc shoulder les sc 3 cm/>,,,65.34,2091.8,143
CPT,23073,Exc shoulder tum deep 5 cm/>,,,108.46,3236.54,143
CPT,23075,Exc shoulder les sc < 3 cm,,,255.26,2091.8,107
CPT,23076,Exc shoulder tum deep < 5 cm,,,364.98,3236.54,107
CPT,23077,Rad rescj tum shoulder<5 cm,,,175.26,3255.2,143
CPT,23078,Rad rescj tum shoulder 5cm/>,,,222.45,4142.4,143
CPT,23100,Arthrotomy glenhumrl jt w/bx,,,79.19,4266.34,143
CPT,23101,Arthrt acrmclv/strnclav jt,,,308.37,5315.69,107
CPT,23105,Arthrotomy glenohumeral jt,,,99.8,9254.47,143
CPT,23106,Arthrotomy strnclav joint,,,338.81,4266.34,107
CPT,23107,Arthrt glenhumrl jt w/expl,,,103.3,9254.47,143
CPT,23120,Claviculectomy partial,,,91.74,4266.34,143
CPT,23125,Claviculectomy total,,,110.82,4266.34,143
CPT,23130,Acromp/acromionectomy prtl,,,416.33,4266.34,107
CPT,23140,Removal of bone lesion,,,374.45,4266.34,107
CPT,23145,Removal of bone lesion,,,108.68,4266.34,143
CPT,23146,Removal of bone lesion,,,420.02,9254.47,107
CPT,23150,Removal of humerus lesion,,,104.2,4266.34,143
CPT,23155,Removal of humerus lesion,,,124.43,9254.47,143
CPT,23156,Removal of humerus lesion,,,106.07,9254.47,143
CPT,23170,Sequestrectomy clavicle,,,380.44,5746.69,107
CPT,23172,Sequestrectomy scapula,,,89.2,5746.69,143
CPT,23174,Sqstrctmy humrl head srg nck,,,119.14,9254.47,143
CPT,23180,Prtl excision bone clavicle,,,443.96,9254.47,107
CPT,23182,Prtl excision bone scapula,,,104.85,9254.47,143
CPT,23184,Prtl excision bone prox hum,,,115.53,11861.17,143
CPT,23190,Ostectomy scapula partial,,,89.96,4266.34,143
CPT,23195,Resection humeral head,,,115.92,9254.47,143
CPT,23200,Radical rescj tumor clavicle,,,233.38,15039.8,143
CPT,23210,Radical rescj tumor scapula,,,273.79,16476.19,143
CPT,23220,Radical rescj tumor prox hum,,,300.07,18044.76,143
CPT,23330,HC REMOVE SHOULDER FOREIGN BODY BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23330,HC REMOVE SHOULDER FOREIGN BODY UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23330,Remove shoulder foreign body,,,129.47,2091.8,107
CPT,23333,HC REMOVE SHOULDER FB DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23333,HC REMOVE SHOULDER FB DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23333,Remove shoulder fb deep,,,318.51,3236.54,107
CPT,23334,Shoulder prosthesis removal,,,708.59,7347.11,107
CPT,23335,Shoulder prosthesis removal,,,848.24,15039.8,107
CPT,23350,HC SHOULDER INJ ARTHROGRAPHY BILATERAL,1324.31,993.23,15.89,1191.88,119
CPT,23350,HC SHOULDER INJ ARTHROGRAPHY UNILATERAL,662.16,496.62,7.95,595.94,119
CPT,23350,Injection for shoulder x-ray,,,73.11,1425.08,52
CPT,23395,Muscle transfer shoulder/arm,,,198.95,9254.47,107
CPT,23397,Muscle transfers,,,177.03,9254.47,107
CPT,23400,Fixation of shoulder blade,,,151.44,9254.47,143
CPT,23405,Incision of tendon & muscle,,,96.25,9254.47,107
CPT,23406,Incise tendon(s) & muscle(s),,,116.59,9254.47,107
CPT,23410,Repair rotator cuff acute,,,127.79,9254.47,143
CPT,23412,Repair rotator cuff chronic,,,132.74,9254.47,143
CPT,23415,Release of shoulder ligament,,,469.75,9254.47,107
CPT,23420,Repair of shoulder,,,151.59,11585.33,143
CPT,23430,Repair biceps tendon,,,116.05,9254.47,143
CPT,23440,Remove/transplant tendon,,,117.9,12964.53,143
CPT,23450,Repair shoulder capsule,,,147.22,9254.47,143
CPT,23455,Repair shoulder capsule,,,153.88,11585.33,143
CPT,23460,Repair shoulder capsule,,,169.52,12412.85,143
CPT,23462,Repair shoulder capsule,,,166.02,9254.47,143
CPT,23465,Repair shoulder capsule,,,173.85,9254.47,143
CPT,23466,Repair shoulder capsule,,,174.26,9254.47,143
CPT,23470,Reconstruct shoulder joint,,,186.03,31588.01,143
CPT,23472,Reconstruct shoulder joint,,,224.31,38056.43,143
CPT,23473,Revis reconst shoulder joint,,,249.78,23055.72,143
CPT,23474,Revis reconst shoulder joint,,,269.7,32282.07,143
CPT,23480,Revision of collar bone,,,551.45,9254.47,107
CPT,23485,Revision of collar bone,,,148.47,21699.51,143
CPT,23490,Reinforce clavicle,,,134.11,9254.47,143
CPT,23491,Reinforce shoulder bones,,,158.0,21699.51,143
CPT,23500,Cltx clavicular fx w/o mnpj,,,152.59,667.35,107
CPT,23500,HC CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,23505,Cltx clavicular fx w/mnpj,,,227.06,2387.17,107
CPT,23505,HC CLTX CLAVICULAR FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23505,HC CLTX CLAVICULAR FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23515,Optx clavicular fx w/int fix,,,112.46,11861.17,143
CPT,23520,Cltx strnclav dislc w/o mnpj,,,162.26,2387.17,107
CPT,23520,HC CLTX STRNCLAV DISLC W/O MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23520,HC CLTX STRNCLAV DISLC W/O MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23525,Cltx strnclav dislc w/mnpj,,,229.97,1175.84,107
CPT,23525,HC CLTX STRNCLAV DISLC W/MNPJ BILAT,643.27,482.45,7.72,578.94,119
CPT,23525,HC CLTX STRNCLAV DISLC W/MNPJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,23530,Optx strnclav dislc aqt/chrn,,,90.11,11309.48,143
CPT,23532,Optx strclv dslc aq/chrn grf,,,97.93,9254.47,143
CPT,23540,Cltx acromclav dislc wo mnpj,,,161.49,705.88,107
CPT,23540,HC CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,23545,Cltx acromclav dislc w/mnpj,,,219.91,1069.09,107
CPT,23545,HC CLTX ACROMCLAV DISLC W/MNPJ BILAT,643.27,482.45,7.72,578.94,119
CPT,23545,HC CLTX ACROMCLAV DISLC W/MNPJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,23550,Optx acromclv dislc aqt/chrn,,,89.52,11861.17,143
CPT,23552,Optx acrclv dslc aq/chrn grf,,,101.24,11309.48,143
CPT,23570,Cltx scapular fx w/o mnpj,,,160.0,700.39,107
CPT,23570,HC CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,23575,Cltx scap fx w/mnpj +-tractj,,,257.72,2387.17,107
CPT,23575,HC CLTX SCAP FX W/MNPJ +-TRACTJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23575,HC CLTX SCAP FX W/MNPJ +-TRACTJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23585,Optx scapular fx w/int fixj,,,152.0,11861.17,143
CPT,23600,Cltx prox humrl fx w/o mnpj,,,215.04,989.37,107
CPT,23600,HC CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,23605,Cltx prx hmrl fx mnpj+-tract,,,290.3,2387.17,107
CPT,23605,HC CLTX PRX HMRL FX MNPJ+-TRACT BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23605,HC CLTX PRX HMRL FX MNPJ+-TRACT UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23615,Optx prox humrl fx w/int fix,,,137.54,23055.72,143
CPT,23616,Optx prx hmrl fx fix rpr rpl,,,192.03,31193.03,179
CPT,23620,Cltx gr hmrl tbrs fx wo mnpj,,,177.34,806.02,107
CPT,23620,HC CLTX GREATER HUMERAL TUBEROSITY FX W/O MNPJ,643.27,482.45,7.72,578.94,119
CPT,23625,Cltx gr hmrl tbrs fx w/mnpj,,,242.15,2387.17,107
CPT,23625,HC CLTX GR HMRL TBRS FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23625,HC CLTX GR HMRL TBRS FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23630,Optx gr hmrl tbrs fx int fix,,,121.69,11309.48,143
CPT,23650,Cltx sho dslc w/mnpj wo anes,,,204.5,989.15,107
CPT,23650,HC CLOSED RX SHLDR DISLOCATION BILAT,643.27,482.45,7.72,578.94,119
CPT,23650,HC CLOSED RX SHLDR DISLOCATION UNILAT,643.27,482.45,7.72,578.94,119
CPT,23655,Cltx sho dslc w/mnpj w/anes,,,276.06,2387.17,107
CPT,23655,"HC CLOSED RX SHLDR DISLOC,ANESTHESIA BILAT",1701.62,1276.21,20.42,1531.46,119
CPT,23655,"HC CLOSED RX SHLDR DISLOC,ANESTHESIA UNILAT",1701.62,1276.21,20.42,1531.46,119
CPT,23660,Optx acute shoulder dislc,,,91.74,9254.47,143
CPT,23665,Cltx sho dslc fx gr hmrl tbr,,,271.35,2387.17,107
CPT,23665,HC CLTX SHO DSLC FX GR HMRL TBR BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23665,HC CLTX SHO DSLC FX GR HMRL TBR UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,23670,Optx sho dislc fx,,,135.63,9254.47,143
CPT,23675,Cltx sho dislc neck fx mnpj,,,338.88,2387.17,107
CPT,23680,Optx sho dislc neck fx fixj,,,144.74,23055.72,143
CPT,23700,Mnpj anes sho jt fixj aprats,,,152.69,2387.17,107
CPT,23800,Arthrodesis glenohumeral jt,,,159.72,9254.47,143
CPT,23802,Arthrd glenohumeral jt w/grf,,,199.21,16550.47,143
CPT,23900,Interthoracoscplr amputation,,,214.94,15039.8,107
CPT,23920,Disarticulation shoulder,,,174.43,15039.8,143
CPT,23921,Disarticulation sho sec clsr,,,317.24,3080.23,107
CPT,23929,Unlisted procedure shoulder,,,229.97,266.99,19
CPT,23930,HC I&D UPR A/E DP ABSC/HMTMA BILAT,6974.1,5230.58,83.69,6276.69,119
CPT,23930,HC I&D UPR A/E DP ABSC/HMTMA UNILAT,6974.1,5230.58,83.69,6276.69,119
CPT,23930,I&d upr a/e dp absc/hmtma,,,167.61,3236.54,107
CPT,23931,HC I&D UPR A/E BURSA BILAT,5251.0,3938.25,63.01,4725.9,119
CPT,23931,HC I&D UPR A/E BURSA UNILAT,5251.0,3938.25,63.01,4725.9,119
CPT,23931,I&d upr a/e bursa,,,125.12,2091.8,107
CPT,23935,Inc dp opn b1 crtx hum/elbw,,,346.0,4266.34,107
CPT,24000,Arthrt elbw expl drg/rmvl fb,,,322.78,4266.34,107
CPT,24006,Arthrt elbw capsl exc rls,,,111.19,4266.34,179
CPT,24065,Biopsy arm/elbow soft tissue,,,125.78,1803.33,107
CPT,24066,Biopsy arm/elbow soft tissue,,,282.85,3236.54,107
CPT,24071,Exc arm/elbow les sc 3 cm/>,,,63.12,3236.54,143
CPT,24073,Ex arm/elbow tum deep 5 cm/>,,,107.87,3236.54,143
CPT,24075,Exc arm/elbow les sc < 3 cm,,,221.72,2091.8,107
CPT,24076,Ex arm/elbow tum deep < 5 cm,,,368.09,3236.54,107
CPT,24077,Rad rescj tum tiss a/e <5cm,,,692.42,3236.54,107
CPT,24079,Rad rescj tum tiss a/e 5 cm+,,,205.62,3816.55,143
CPT,24100,Arthrt elbw synovial bx only,,,65.71,4266.34,143
CPT,24101,Arthrt elbw jt expl bx rmvl,,,78.94,4266.34,143
CPT,24102,Arthrt elbow w/synovectomy,,,96.28,4266.34,143
CPT,24105,Excision olecranon bursa,,,242.79,4266.34,107
CPT,24110,Exc/curtg b1 cst/b9 tum hum,,,398.27,4266.34,107
CPT,24115,Exc/crtg b1 cst/tum hum agrf,,,115.1,9254.47,143
CPT,24116,Exc/crtg b1 cst/tum hum algr,,,134.03,11309.48,143
CPT,24120,Exc/crtg b1 cst/b9 tum rds,,,359.41,4266.34,107
CPT,24125,Exc/crtg b1 cst/tum rds agrf,,,97.32,4266.34,143
CPT,24126,Exc/crtg b1 cst/tum rds algr,,,101.64,9254.47,143
CPT,24130,Excision radial head,,,346.24,4266.34,107
CPT,24134,Sequestrectomy shft/dstl hum,,,116.64,9254.47,143
CPT,24136,Sequestrectomy radial h/n,,,426.32,4266.34,107
CPT,24138,Sequestrectomy olecrn proces,,,107.33,9254.47,143
CPT,24140,Partial exc bone humerus,,,109.89,4266.34,143
CPT,24145,Prtl exc bone radial h/n,,,400.79,9254.47,107
CPT,24147,Prtl exc bone olecrn process,,,423.65,4266.34,107
CPT,24149,Radical resection of elbow,,,183.52,9254.47,143
CPT,24150,Rad rescj tum dstl/shft hum,,,239.41,12688.69,143
CPT,24152,Rad resection tum radial h/n,,,208.32,12137.01,143
CPT,24155,Resection of elbow joint,,,132.78,4266.34,143
CPT,24160,Rmvl prosthhumrl&ulnar cmpnt,,,841.24,4266.34,107
CPT,24164,Removal prosth radial head,,,487.53,4266.34,107
CPT,24200,HC REMOVE F.B. UP ARM OR ELBOW; SQ,643.27,482.45,7.72,578.94,119
CPT,24200,Rmvl fb upper arm/elbw subq,,,108.3,1803.33,107
CPT,24201,HC RMVL FB UPPER ARM/ELBW DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24201,HC RMVL FB UPPER ARM/ELBW DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24201,Rmvl fb upper arm/elbw deep,,,246.87,3236.54,107
CPT,24220,HC ELBOW ARTHRO INJECT BILATERAL,1269.32,951.99,15.23,1142.39,119
CPT,24220,HC ELBOW ARTHRO INJECT UNILATERAL,634.66,476.0,7.62,571.19,119
CPT,24220,Injection px for elbow arthg,,,97.22,1690.48,52
CPT,24300,Mnpj elbow under anes,,,293.47,2387.17,107
CPT,24301,Musc/tdn transfer upr a/e 1,,,117.45,9254.47,107
CPT,24305,Tendon lngth upr a/e ea tdn,,,390.53,4266.34,71
CPT,24310,Tnot opn elbw to sho ea tdn,,,321.14,4266.34,71
CPT,24320,Tenoplasty elbow to sho 1,,,121.72,9254.47,107
CPT,24330,Flexor-plasty elbow,,,112.13,9254.47,143
CPT,24331,Flexor-plasty elbw w/advmnt,,,122.46,9254.47,143
CPT,24332,Tenolysis triceps,,,414.78,5315.69,107
CPT,24340,Tenodesis biceps tdn at elbw,,,93.84,9254.47,143
CPT,24341,HC RPR TDN/MUSC UPR A/E EACH BILAT,125.29,93.97,1.5,112.76,119
CPT,24341,HC RPR TDN/MUSC UPR A/E EACH UNILAT,125.29,93.97,1.5,112.76,119
CPT,24341,Rpr tdn/musc upr a/e each,,,116.53,9254.47,143
CPT,24342,Repair of ruptured tendon,,,120.8,9254.47,143
CPT,24343,Repr elbow lat ligmnt w/tiss,,,111.49,4266.34,143
CPT,24344,Reconstruct elbow lat ligmnt,,,169.85,12412.85,143
CPT,24345,Repr elbw med ligmnt w/tissu,,,110.89,9254.47,143
CPT,24346,Reconstruct elbow med ligmnt,,,171.73,16550.47,143
CPT,24357,Repair elbow perc,,,281.92,4266.34,107
CPT,24358,Repair elbow w/deb open,,,356.81,4266.34,107
CPT,24359,Repair elbow deb/attch open,,,446.79,4266.34,107
CPT,24360,Reconstruct elbow joint,,,140.6,12412.85,143
CPT,24361,Reconstruct elbow joint,,,156.75,31193.03,143
CPT,24362,Reconstruct elbow joint,,,165.03,23055.72,143
CPT,24363,Replace elbow joint,,,224.87,31193.03,143
CPT,24365,Reconstruct head of radius,,,100.14,24411.94,143
CPT,24366,Reconstruct head of radius,,,106.24,24411.94,143
CPT,24370,Revise reconst elbow joint,,,238.81,21699.51,143
CPT,24371,Revise reconst elbow joint,,,274.22,28480.59,143
CPT,24400,Osteot humerus w/wo int fixj,,,129.01,11309.48,143
CPT,24410,Mlt osteot rlgnm imed rd hum,,,164.52,16550.47,143
CPT,24420,Osteoplasty humerus,,,165.66,9254.47,143
CPT,24430,Rpr non/mal humerus wo graft,,,164.19,21699.51,143
CPT,24435,Rpr non/mal hum with agrft,,,167.76,21699.51,143
CPT,24470,Hemiepiphyseal arrest,,,104.96,4266.34,143
CPT,24495,Decompression fasct forearm,,,618.83,9254.47,107
CPT,24498,Proph tx w/wo mthylmthcrylt,,,135.05,21699.51,143
CPT,24500,Cltx humrl shft fx w/o mnpj,,,227.54,1073.54,107
CPT,24500,HC CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,24505,Cltx humrl shft fx w/mnpj,,,307.26,2387.17,107
CPT,24505,HC CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24515,Optx humrl shft fx plate/scr,,,137.22,21699.51,143
CPT,24516,Tx humrl shaft fx imed implt,,,133.88,21699.51,179
CPT,24530,Cltx sprcndylr humeral fx wo,,,229.97,1133.09,107
CPT,24530,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,643.27,482.45,7.72,578.94,119
CPT,24535,Cltx sprcndylr humeral fx w/,,,386.41,2387.17,107
CPT,24535,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24535,HC CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24538,Prq skel fix sprcndlr hum fx,,,531.36,9254.47,107
CPT,24545,Optx hum fx wo ntrcndylr xtn,,,144.31,21699.51,143
CPT,24546,Optx hum fx w/ntrcndylr xtn,,,161.26,19110.44,179
CPT,24560,Cltx hum epcndylr fx wo mnpj,,,201.36,984.67,107
CPT,24560,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,24565,Cltx hum epcndylr fx w/mnpj,,,335.71,2387.17,107
CPT,24565,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24565,HC CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24566,Prq skel fix epcndylr hum fx,,,484.89,2387.17,107
CPT,24575,Optx humeral epcndylr fx,,,114.23,21699.51,143
CPT,24576,Cltx humrl cndylr fx wo mnpj,,,213.4,1041.04,107
CPT,24576,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,24577,Cltx humrl cndylr fx w/mnpj,,,344.29,2387.17,107
CPT,24577,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ BILAT,6240.25,4680.19,74.88,5616.22,119
CPT,24577,HC CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ UNILAT,3120.12,2340.09,37.44,2808.11,119
CPT,24579,Optx humrl cndylr fracture,,,130.12,21699.51,143
CPT,24582,Prq skel fix humrl cndylr fx,,,548.78,9254.47,107
CPT,24586,Optx partclr fx&/dislc elbow,,,168.99,21699.51,143
CPT,24587,Optx partclr fx&/dslc elbw w,,,169.26,23055.72,143
CPT,24600,HC TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CPT,24600,Tx clsd elbow dislc w/o anes,,,229.97,1118.27,107
CPT,24605,"HC CLOSED RX ELBOW DISLOCATN,ANESTHESIA BILAT",1701.62,1276.21,20.42,1531.46,119
CPT,24605,"HC CLOSED RX ELBOW DISLOCATN,ANESTHESIA UNILAT",1701.62,1276.21,20.42,1531.46,119
CPT,24605,Tx clsd elbow dislc req anes,,,323.41,2387.17,107
CPT,24615,Optx aqt/chrnc elbow dislc,,,111.51,13240.37,143
CPT,24620,Cltx monteggia fx dislc elbw,,,396.91,2387.17,107
CPT,24620,HC CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24620,HC CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24635,Optx monteggia fx dislc elbw,,,105.59,12137.01,143
CPT,24640,Cltx rdl head sublxtj nrsemd,,,62.34,294.83,107
CPT,24640,HC REDUCE ELBOW DISLOCATION,643.27,482.45,7.72,578.94,119
CPT,24650,Cltx rdl head/nck fx wo mnpj,,,167.49,787.97,107
CPT,24650,HC CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,24655,Cltx rdl head/nck fx w/mnpj,,,274.97,2387.17,107
CPT,24655,HC CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24655,HC CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24665,Optx radial head/neck fx,,,102.59,9254.47,143
CPT,24666,Optx radial head/nck fx rplc,,,114.33,23055.72,143
CPT,24670,Cltx ulnar fx prox w/o mnpj,,,182.75,869.23,107
CPT,24670,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,24675,Cltx ulnar fx prox w/mnpj,,,283.87,2387.17,107
CPT,24675,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24675,HC CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,24685,Optx ulnar fx prox end w/fix,,,102.03,11585.33,143
CPT,24800,Arthrodesis elbw joint local,,,129.89,9254.47,143
CPT,24802,Arthrd elbow jt autog graft,,,155.97,16550.47,143
CPT,24900,Amputation of upper arm,,,114.87,15039.8,143
CPT,24920,Amputation of upper arm,,,114.4,15039.8,143
CPT,24925,Amputation follow-up surgery,,,89.05,4266.34,143
CPT,24930,Amputation follow-up surgery,,,120.56,15039.8,143
CPT,24931,Amputate upper arm & implant,,,144.88,15039.8,143
CPT,24935,Revision of amputation,,,819.66,9254.47,107
CPT,24940,Revision of upper arm,,,12954.18,15039.8,19
CPT,24999,Unlisted px humerus/elbow,,,229.97,266.99,19
CPT,25000,Incision of tendon sheath,,,233.19,2387.17,107
CPT,25001,Incise flexor carpi radialis,,,233.79,4266.34,107
CPT,25020,Decompress forearm 1 space,,,496.69,2387.17,107
CPT,25023,Decompress forearm 1 space,,,874.36,4266.34,107
CPT,25024,Decompress forearm 2 spaces,,,520.6,4266.34,107
CPT,25025,Decompress forearm 2 spaces,,,822.05,3536.46,107
CPT,25028,HC DRAINAGE OF FOREARM LESION BILAT,125.29,93.97,1.5,112.76,119
CPT,25028,HC DRAINAGE OF FOREARM LESION UNILAT,125.29,93.97,1.5,112.76,119
CPT,25028,I&d f/arm&/wrst dp absc/hmtm,,,462.51,4266.34,107
CPT,25031,HC DRAINAGE OF FOREARM BURSA BILAT,726.31,544.73,8.72,653.68,119
CPT,25031,HC DRAINAGE OF FOREARM BURSA UNILAT,726.31,544.73,8.72,653.68,119
CPT,25031,I&d forearm&/wrist bursa,,,248.66,2387.17,107
CPT,25035,Inc dp bone crtx f/arm&/wrst,,,395.27,9254.47,107
CPT,25040,Arthrt rdcrpl/midcarpl jt,,,377.13,4266.34,107
CPT,25065,Biopsy forearm soft tissues,,,122.35,1803.33,107
CPT,25066,Biopsy forearm soft tissues,,,247.63,3236.54,107
CPT,25071,Exc forearm les sc 3 cm/>,,,66.07,2091.8,143
CPT,25073,Exc forearm tum deep 3 cm/>,,,83.72,3236.54,143
CPT,25075,Exc forearm les sc < 3 cm,,,212.5,2091.8,107
CPT,25076,Exc forearm tum deep < 3 cm,,,349.77,2091.8,107
CPT,25077,Resect forearm/wrist tum<3cm,,,594.7,3236.54,107
CPT,25078,Resect forarm/wrist tum 3cm>,,,181.19,3360.74,143
CPT,25085,Incision of wrist capsule,,,70.2,4266.34,143
CPT,25100,Biopsy of wrist joint,,,236.41,4266.34,107
CPT,25101,Explore/treat wrist joint,,,273.38,4266.34,107
CPT,25105,Remove wrist joint lining,,,329.47,4266.34,107
CPT,25107,Remove wrist joint cartilage,,,96.46,4266.34,143
CPT,25109,Excise tendon forearm/wrist,,,362.02,4266.34,107
CPT,25110,Remove wrist tendon lesion,,,234.57,2387.17,107
CPT,25111,Remove wrist tendon lesion,,,219.3,2387.17,107
CPT,25112,Reremove wrist tendon lesion,,,263.84,2387.17,107
CPT,25115,Remove wrist/forearm lesion,,,509.34,2387.17,107
CPT,25116,Remove wrist/forearm lesion,,,406.91,4266.34,107
CPT,25118,Excise wrist tendon sheath,,,258.66,2387.17,107
CPT,25119,Partial removal of ulna,,,78.64,4266.34,143
CPT,25120,Removal of forearm lesion,,,338.92,4266.34,107
CPT,25125,Remove/graft forearm lesion,,,401.66,2387.17,107
CPT,25126,Remove/graft forearm lesion,,,93.77,4266.34,143
CPT,25130,Removal of wrist lesion,,,304.84,4266.34,107
CPT,25135,Remove & graft wrist lesion,,,87.63,9254.47,143
CPT,25136,Remove & graft wrist lesion,,,77.97,9254.47,143
CPT,25145,Remove forearm bone lesion,,,81.57,4266.34,143
CPT,25150,Partial removal of ulna,,,382.76,4266.34,107
CPT,25151,Partial removal of radius,,,91.47,4266.34,143
CPT,25170,Resect radius/ulnar tumor,,,227.64,9254.47,143
CPT,25208,HC DRAINAGE OF FOREARM LESION UNILAT,125.29,93.97,1.5,112.76,119
CPT,25210,Removal of wrist bone,,,333.1,4266.34,71
CPT,25215,Removal of wrist bones,,,96.91,4266.34,143
CPT,25230,Partial removal of radius,,,292.62,4266.34,107
CPT,25240,Partial removal of ulna,,,290.57,4266.34,107
CPT,25246,HC WRIST INJ ARTHOGRAPHY BILATERAL,709.26,531.95,8.51,638.33,119
CPT,25246,HC WRIST INJ ARTHOGRAPHY UNILATERAL,354.63,265.97,4.26,319.17,119
CPT,25246,Injection for wrist x-ray,,,106.22,1723.2,52
CPT,25248,HC REMOVE FOREARM FOREIGN BODY BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25248,HC REMOVE FOREARM FOREIGN BODY UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25248,Remove forearm foreign body,,,280.49,2387.17,107
CPT,25250,Removal of wrist prosthesis,,,83.46,2387.17,143
CPT,25251,Removal of wrist prosthesis,,,112.34,4266.34,143
CPT,25259,Manipulate wrist w/anesthes,,,290.86,2387.17,107
CPT,25260,HC RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,10515.38,7886.54,126.18,9463.84,119
CPT,25260,Repair forearm tendon/muscle,,,428.31,4266.34,71
CPT,25263,Repair forearm tendon/muscle,,,99.09,9254.47,107
CPT,25265,Repair forearm tendon/muscle,,,117.1,4266.34,107
CPT,25270,HC RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,125.29,93.97,1.5,112.76,119
CPT,25270,Repair forearm tendon/muscle,,,333.83,4266.34,71
CPT,25272,Repair forearm tendon/muscle,,,377.84,4266.34,71
CPT,25274,Repair forearm tendon/muscle,,,448.82,4266.34,71
CPT,25275,Repair forearm tendon sheath,,,453.09,5459.36,107
CPT,25280,Revise wrist/forearm tendon,,,381.77,4266.34,71
CPT,25290,Incise wrist/forearm tendon,,,294.45,4266.34,71
CPT,25295,Release wrist/forearm tendon,,,356.06,4266.34,71
CPT,25300,Fusion of tendons at wrist,,,107.85,4266.34,143
CPT,25301,Fusion of tendons at wrist,,,100.62,4266.34,143
CPT,25301,HC DRAINAGE OF FOREARM BURSA BILAT,726.31,544.73,8.72,653.68,119
CPT,25310,Transplant forearm tendon,,,97.19,4266.34,107
CPT,25312,Transplant forearm tendon,,,112.13,4266.34,107
CPT,25315,Revise palsy hand tendon(s),,,120.11,9254.47,143
CPT,25316,Revise palsy hand tendon(s),,,142.73,9254.47,143
CPT,25320,Repair/revise wrist joint,,,153.8,9254.47,143
CPT,25332,Revise wrist joint,,,131.81,5315.69,143
CPT,25335,Centralization wrist on ulna,,,147.12,4266.34,143
CPT,25337,Reconstruct ulna/radioulnar,,,596.64,9254.47,107
CPT,25350,Revision of radius,,,105.51,11585.33,143
CPT,25355,Revision of radius,,,119.31,4266.34,143
CPT,25360,Revision of ulna,,,102.52,12688.69,143
CPT,25365,Revise radius & ulna,,,142.89,16550.47,143
CPT,25370,Revise radius or ulna,,,157.6,4266.34,143
CPT,25375,Revise radius & ulna,,,148.53,4266.34,143
CPT,25390,Shorten radius or ulna,,,120.07,11861.17,143
CPT,25391,Lengthen radius or ulna,,,155.05,23055.72,143
CPT,25392,Shorten radius & ulna,,,157.76,9254.47,143
CPT,25393,Lengthen radius & ulna,,,175.54,11585.33,143
CPT,25394,Repair carpal bone shorten,,,122.28,4266.34,143
CPT,25400,Repair radius or ulna,,,125.32,11861.17,143
CPT,25405,Repair/graft radius or ulna,,,161.33,11861.17,143
CPT,25415,Repair radius & ulna,,,150.72,11861.17,143
CPT,25420,Repair/graft radius & ulna,,,181.13,12412.85,143
CPT,25425,Repair/graft radius or ulna,,,150.04,15171.26,143
CPT,25426,Repair/graft radius & ulna,,,174.55,5459.36,143
CPT,25430,Vasc graft into carpal bone,,,492.52,4266.34,107
CPT,25431,Repair nonunion carpal bone,,,122.89,12964.53,143
CPT,25440,Repair nonu scphd carpl b1,,,119.92,9254.47,143
CPT,25441,Arthrp w/prostc dstl rds,,,146.18,27124.38,143
CPT,25442,Arthrp w/prostc dstl ulna,,,126.28,31193.03,143
CPT,25443,Arthrp prostc dstl scph crpl,,,122.51,12964.53,143
CPT,25444,Arthrp w/prostc lunate,,,129.04,27124.38,143
CPT,25445,Arthrp w/prostc trapezium,,,485.8,12412.85,107
CPT,25446,Arthrp w/prostc dst rds&crps,,,182.32,33480.6,143
CPT,25447,Arthrp ntrcrp/crp/mtcr ntrps,,,129.76,4266.34,143
CPT,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,2147.81,4266.34,35
CPT,25449,Revj arthrp wrist joint,,,160.86,9254.47,143
CPT,25450,Epiphysl arrst dstl rds/ulna,,,416.53,4266.34,107
CPT,25455,Epiphysl arrst dstl rds&ulna,,,491.86,4266.34,107
CPT,25490,Prophylactic tx radius,,,112.26,9254.47,143
CPT,25491,Prophylactic tx ulna,,,115.36,21699.51,143
CPT,25492,Prophylactic tx radius&ulna,,,141.2,4266.34,143
CPT,25500,Cltx rdl shft fx w/o mnpj,,,175.72,847.57,107
CPT,25500,HC CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,25505,Cltx rdl shft fx w/mnpj,,,313.43,2387.17,107
CPT,25505,HC CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,1701.62,1276.21,20.42,1531.46,119
CPT,25515,Optx radial shaft fracture,,,104.64,11309.48,143
CPT,25520,Cltx rdl shft fx&dislc,,,369.03,2387.17,107
CPT,25520,HC TREAT FRACTURE OF RADIUS BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25520,HC TREAT FRACTURE OF RADIUS UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25525,Optx rdl shft fx&cltx rad/ul,,,123.4,12137.01,179
CPT,25526,Optx rdl shft fx&dstl rad/ul,,,148.95,12137.01,179
CPT,25530,Cltx ulnar shft fx w/o mnpj,,,165.43,789.37,107
CPT,25530,HC CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,25535,Cltx ulnar shft fx w/mnpj,,,229.97,1453.49,107
CPT,25535,HC TREAT FRACTURE OF ULNA BILAT,643.27,482.45,7.72,578.94,119
CPT,25535,HC TREAT FRACTURE OF ULNA UNILAT,643.27,482.45,7.72,578.94,119
CPT,25545,Optx ulnar shft fx int fixj,,,97.72,11309.48,143
CPT,25560,Cltx rdl&uln shft fx wo mnpj,,,176.76,863.07,107
CPT,25560,HC CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,643.27,482.45,7.72,578.94,119
CPT,25565,Cltx rdl&uln shft fx w/mnpj,,,317.41,2387.17,107
CPT,25565,HC CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,25574,Optx rdl&uln shft fx rds/uln,,,105.59,12412.85,179
CPT,25575,Optx rdl&uln shft fx rds&uln,,,140.9,11861.17,143
CPT,25600,Cltx dst rdl fx/ephys sep wo,,,220.34,1004.42,107
CPT,25600,HC CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,25605,Cltx dst rdl fx/ephys sep w/,,,347.45,2387.17,107
CPT,25605,HC CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,1701.62,1276.21,20.42,1531.46,119
CPT,25606,Perq skel fixj dstl rdl fx,,,450.07,4266.34,107
CPT,25607,Optx dst rd xartc fx/epi sep,,,115.54,12137.01,143
CPT,25608,Optx dst rd xart fx/epi sep2,,,129.1,12137.01,143
CPT,25609,Optx dst rd xart fx/ep sep3+,,,163.82,12137.01,143
CPT,25622,Cltx carpl scphd fx w/o mnpj,,,193.96,914.75,107
CPT,25622,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,25624,Cltx carpl scphd fx w/mnpj,,,302.21,2387.17,107
CPT,25624,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25624,HC CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25628,Optx carpl scphd fx int fixj,,,112.34,9254.47,143
CPT,25630,Cltx carpl fx w/o mnpj ea b1,,,194.3,909.9,107
CPT,25630,HC CLTX CARPAL BONE FX W/O MANJ EACH BONE,643.27,482.45,7.72,578.94,119
CPT,25635,Cltx carpl fx w/mnpj ea b1,,,287.07,2387.17,107
CPT,25635,HC CLTX CARPAL BONE FX W/MANJ EACH BONE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25635,HC CLTX CARPAL BONE FX W/MANJ EACH BONE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25645,Optx crpl fx oth/thn scph ea,,,89.49,4266.34,143
CPT,25650,Cltx ulnar styloid fracture,,,209.5,976.23,107
CPT,25650,HC CLOSED TREATMENT ULNAR STYLOID FRACTURE,643.27,482.45,7.72,578.94,119
CPT,25651,Perq skel fix ulnar styld fx,,,330.88,4266.34,107
CPT,25652,Optx ulnar styloid fracture,,,420.31,11585.33,107
CPT,25660,Cltx rdcrpl/ntrcrpl dislc 1+,,,229.97,1321.89,107
CPT,25660,HC CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ BILAT,643.27,482.45,7.72,578.94,119
CPT,25660,HC CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,25670,Optx rdcrpl/ntrcrpl dislc 1+,,,95.16,9254.47,143
CPT,25671,Perq skel fix rad/uln dislc,,,358.64,4266.34,107
CPT,25675,Cltx dstl rad/uln dislc mnpj,,,229.97,1353.36,107
CPT,25675,HC CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ BILAT,643.27,482.45,7.72,578.94,119
CPT,25675,HC CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,25676,Optx rad/uln dislc aqt/chrnc,,,98.61,9254.47,143
CPT,25680,Cltx trns-scphprlnr fx mnpj,,,229.97,1556.22,107
CPT,25680,HC TREAT WRIST FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CPT,25680,HC TREAT WRIST FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CPT,25685,Optx trns-scphprlnr fx dislc,,,114.79,9254.47,143
CPT,25690,Cltx lunate dislc w/mnpj,,,332.84,2387.17,107
CPT,25690,HC TREAT WRIST DISLOCATION BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25690,HC TREAT WRIST DISLOCATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,25695,Optx lunate dislocation,,,99.2,9254.47,143
CPT,25800,Arthrd wrist complete wo grf,,,114.38,12688.69,143
CPT,25805,Arthrd wrist w/sliding graft,,,132.16,9254.47,143
CPT,25810,Arthrd wrst iliac/oth agrft,,,135.2,21699.51,143
CPT,25820,Arthrd wrist lmtd w/o b1 grf,,,101.45,12137.01,143
CPT,25825,Arthrd wrist with autograft,,,123.75,11309.48,143
CPT,25830,Arthrd dst rad/ul jt sgm rsc,,,157.64,9254.47,143
CPT,25900,Amputation of forearm,,,481.86,15039.8,107
CPT,25905,Amputation of forearm,,,109.55,15039.8,143
CPT,25907,Amputation follow-up surgery,,,96.04,4266.34,143
CPT,25909,Amputation follow-up surgery,,,107.09,9254.47,143
CPT,25915,Amputation of forearm,,,181.34,15039.8,143
CPT,25920,Amputate hand at wrist,,,491.34,15039.8,107
CPT,25922,Amputate hand at wrist,,,100.92,2387.17,143
CPT,25924,Amputation follow-up surgery,,,111.3,15039.8,143
CPT,25927,Amputation of hand,,,580.6,15039.8,107
CPT,25929,Amputation follow-up surgery,,,93.59,3080.23,143
CPT,25931,Amputation follow-up surgery,,,536.89,4266.34,107
CPT,25999,Unlisted px forearm/wrist,,,229.97,266.99,19
CPT,26010,Drainage of finger abscess,,,109.43,929.83,71
CPT,26010,HC DRAINAGE FINGER ABSCESS SIMPLE,643.97,482.98,7.73,579.57,119
CPT,26011,Drainage of finger abscess,,,144.4,2091.8,71
CPT,26011,"HC DRAIN FINGER ABSCESS,COMPLICATED",5251.0,3938.25,63.01,4725.9,119
CPT,26020,Drain hand tendon sheath,,,374.84,4266.34,71
CPT,26025,Drainage of palm bursa,,,282.83,4266.34,107
CPT,26030,Drainage of palm bursas,,,331.32,4266.34,107
CPT,26034,Treat hand bone lesion,,,371.28,2387.17,71
CPT,26035,Decompress fingers/hand,,,578.28,4266.34,71
CPT,26037,Decompress fingers/hand,,,378.68,4266.34,107
CPT,26040,Release palm contracture,,,213.8,2387.17,107
CPT,26045,Release palm contracture,,,319.04,4266.34,107
CPT,26055,Incise finger tendon sheath,,,196.39,2387.17,71
CPT,26060,Incision of finger tendon,,,172.4,2387.17,71
CPT,26070,Explore/treat hand joint,,,218.27,2387.17,107
CPT,26075,Explore/treat finger joint,,,228.97,4266.34,107
CPT,26080,Explore/treat finger joint,,,268.98,2387.17,71
CPT,26100,Biopsy hand joint lining,,,229.37,4266.34,107
CPT,26105,Biopsy finger joint lining,,,231.14,4266.34,107
CPT,26110,Biopsy finger joint lining,,,220.14,2387.17,71
CPT,26111,Exc hand les sc 1.5 cm/>,,,64.9,2091.8,107
CPT,26113,Exc hand tum deep 1.5 cm/>,,,85.42,2091.8,107
CPT,26115,Exc hand les sc < 1.5 cm,,,223.63,2091.8,71
CPT,26116,Exc hand tum deep < 1.5 cm,,,353.94,2091.8,71
CPT,26117,Rad resect hand tumor < 3 cm,,,498.48,3236.54,71
CPT,26118,Rad resect hand tumor 3 cm/>,,,163.99,3236.54,107
CPT,26121,Release palm contracture,,,404.51,4266.34,107
CPT,26123,Release palm contracture,,,563.54,4266.34,107
CPT,26125,Release palm contracture,,,260.21,2494.67,52
CPT,26130,Remove wrist joint lining,,,316.81,4266.34,107
CPT,26135,Revise finger joint each,,,374.21,4266.34,71
CPT,26140,Revise finger joint each,,,342.77,2387.17,71
CPT,26145,Tendon excision palm/finger,,,348.37,2387.17,71
CPT,26160,Remove tendon sheath lesion,,,213.31,2387.17,71
CPT,26170,Removal of palm tendon each,,,276.13,2387.17,71
CPT,26180,Removal of finger tendon,,,303.86,2387.17,71
CPT,26185,Remove finger bone,,,87.03,2387.17,143
CPT,26200,Remove hand bone lesion,,,305.11,2387.17,71
CPT,26205,Remove/graft bone lesion,,,408.1,9254.47,71
CPT,26210,Removal of finger lesion,,,302.72,2387.17,71
CPT,26215,Remove/graft finger lesion,,,383.09,4266.34,71
CPT,26230,Partial removal of hand bone,,,337.94,4266.34,71
CPT,26235,Partial removal finger bone,,,332.57,2387.17,71
CPT,26236,Partial removal finger bone,,,297.69,2387.17,71
CPT,26250,Extensive hand surgery,,,713.73,6034.02,71
CPT,26260,Resect prox finger tumor,,,124.13,4266.34,107
CPT,26262,Resect distal finger tumor,,,98.37,2387.17,107
CPT,26320,Removal of implant from hand,,,236.19,2091.8,71
CPT,26340,Manipulate finger w/anesth,,,238.17,2387.17,107
CPT,26341,Manipulat palm cord post inj,,,60.78,331.95,107
CPT,26350,Repair finger/hand tendon,,,501.47,4266.34,71
CPT,26352,Repair/graft hand tendon,,,130.04,9254.47,107
CPT,26356,Repair finger/hand tendon,,,535.21,4266.34,71
CPT,26357,Repair finger/hand tendon,,,138.93,4266.34,107
CPT,26358,Repair/graft hand tendon,,,153.13,9254.47,107
CPT,26370,Repair finger/hand tendon,,,527.75,4266.34,71
CPT,26372,Repair/graft hand tendon,,,142.7,9254.47,107
CPT,26373,Repair finger/hand tendon,,,137.37,4266.34,107
CPT,26390,Revise hand/finger tendon,,,137.05,9254.47,107
CPT,26392,Repair/graft hand tendon,,,156.1,9254.47,107
CPT,26410,Repair hand tendon,,,404.51,2387.17,71
CPT,26412,Repair/graft hand tendon,,,482.59,4266.34,71
CPT,26415,Excision hand/finger tendon,,,572.85,4266.34,71
CPT,26416,Graft hand or finger tendon,,,619.61,4266.34,71
CPT,26418,HC REPAIR EXTENSOR TENDON FINGER,5186.73,3890.05,62.24,4668.06,119
CPT,26418,Repair finger tendon,,,419.03,2387.17,71
CPT,26420,Repair/graft finger tendon,,,115.93,4266.34,107
CPT,26426,Repair finger/hand tendon,,,340.31,4266.34,71
CPT,26428,Repair/graft finger tendon,,,536.16,4266.34,71
CPT,26432,Repair finger tendon,,,366.17,2387.17,71
CPT,26433,Repair finger tendon,,,385.57,4266.34,71
CPT,26434,Repair/graft finger tendon,,,108.58,4266.34,107
CPT,26437,Realignment of tendons,,,449.17,4266.34,71
CPT,26440,Release palm/finger tendon,,,437.59,2387.17,71
CPT,26442,Release palm & finger tendon,,,665.2,4266.34,71
CPT,26445,Release hand/finger tendon,,,407.74,4266.34,71
CPT,26449,Release forearm/hand tendon,,,470.35,4266.34,71
CPT,26450,Incision of palm tendon,,,313.0,4266.34,71
CPT,26455,Incision of finger tendon,,,311.22,2387.17,71
CPT,26460,Incise hand/finger tendon,,,302.33,2387.17,71
CPT,26471,Fusion of finger tendons,,,444.33,4266.34,71
CPT,26474,Fusion of finger tendons,,,101.74,3234.24,107
CPT,26476,Tendon lengthening,,,432.96,4266.34,71
CPT,26477,Tendon shortening,,,421.16,4266.34,71
CPT,26478,Lengthening of hand tendon,,,446.97,4266.34,71
CPT,26479,Shortening of hand tendon,,,105.4,4266.34,107
CPT,26480,Transplant hand tendon,,,528.06,4266.34,71
CPT,26483,Transplant/graft hand tendon,,,135.79,4266.34,107
CPT,26485,Transplant palm tendon,,,130.36,4266.34,107
CPT,26489,Transplant/graft palm tendon,,,648.84,4266.34,71
CPT,26490,Revise thumb tendon,,,564.75,4266.34,71
CPT,26492,Tendon transfer with graft,,,144.77,4266.34,107
CPT,26494,Hand tendon/muscle transfer,,,131.48,4266.34,107
CPT,26496,Revise thumb tendon,,,610.62,4266.34,71
CPT,26497,Finger tendon transfer,,,141.44,4266.34,107
CPT,26497,HC VALVE IMPLANT LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,26498,Finger tendon transfer,,,183.95,4266.34,107
CPT,26499,Correction claw finger other,,,136.16,4266.34,107
CPT,26500,Hand tendon reconstruction,,,446.36,9254.47,71
CPT,26502,Hand tendon reconstruction,,,117.97,4266.34,107
CPT,26508,Release thumb contracture,,,455.56,4266.34,107
CPT,26510,Thumb tendon transfer,,,432.77,4266.34,71
CPT,26516,Fusion of knuckle joint,,,500.74,5315.69,107
CPT,26517,Fusion of knuckle joints,,,135.33,4266.34,143
CPT,26518,Fusion of knuckle joints,,,137.05,9254.47,143
CPT,26520,Release knuckle contracture,,,458.83,4266.34,71
CPT,26525,Release finger contracture,,,460.8,2387.17,71
CPT,26530,Revise knuckle joint,,,84.48,12137.01,107
CPT,26531,Revise knuckle with implant,,,98.76,12137.01,107
CPT,26535,Revise finger joint,,,295.98,4266.34,71
CPT,26536,Revise/implant finger joint,,,503.95,11585.33,71
CPT,26540,Repair hand joint,,,471.31,4266.34,71
CPT,26541,Repair hand joint with graft,,,130.17,5603.02,107
CPT,26542,Repair hand joint with graft,,,485.92,5315.69,71
CPT,26545,Reconstruct finger joint,,,493.7,4266.34,71
CPT,26546,Repair nonunion hand,,,161.78,9254.47,143
CPT,26548,Reconstruct finger joint,,,539.03,4266.34,71
CPT,26550,Pollicization digit,,,257.34,4701.93,143
CPT,26551,Great toe-hand transfer,,,511.32,30512.8,143
CPT,26553,Single transfer toe-hand,,,507.95,30309.88,143
CPT,26554,Double transfer toe-hand,,,591.29,35300.4,143
CPT,26555,Positional change of finger,,,216.18,9254.47,107
CPT,26556,Toe joint transfer,,,528.12,31530.06,107
CPT,26560,Repair of web finger,,,99.3,2387.17,107
CPT,26561,Repair of web finger,,,153.43,4266.34,107
CPT,26562,Repair of web finger,,,214.29,4266.34,107
CPT,26565,Correct metacarpal flaw,,,111.5,4266.34,107
CPT,26567,Correct finger deformity,,,484.65,4266.34,71
CPT,26568,Lengthen metacarpal/finger,,,145.18,12688.69,107
CPT,26580,Repair cleft hand,,,239.88,4404.52,143
CPT,26587,Reconstruct extra finger,,,162.41,4266.34,107
CPT,26590,Repair finger deformity,,,223.29,4087.95,107
CPT,26591,Repair muscles of hand,,,327.33,4266.34,71
CPT,26593,Release muscles of hand,,,433.75,4266.34,71
CPT,26596,Excision constricting tissue,,,127.72,4266.34,107
CPT,26600,HC TREAT METACARPEL FX EACH,643.27,482.45,7.72,578.94,119
CPT,26600,Treat metacarpal fracture,,,195.2,895.21,71
CPT,26605,HC CLTX METACARPAL FX W/MANIPULATION EACH BONE,643.27,482.45,7.72,578.94,119
CPT,26605,Treat metacarpal fracture,,,202.96,974.93,71
CPT,26607,Treat metacarpal fracture,,,343.5,4266.34,71
CPT,26608,Treat metacarpal fracture,,,325.72,4266.34,71
CPT,26615,Treat metacarpal fracture,,,387.75,4266.34,71
CPT,26641,HC CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,643.27,482.45,7.72,578.94,119
CPT,26641,Treat thumb dislocation,,,229.97,1237.59,107
CPT,26645,HC TREAT THUMB FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,26645,HC TREAT THUMB FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,26645,Treat thumb fracture,,,268.62,2387.17,107
CPT,26650,Treat thumb fracture,,,325.71,4266.34,107
CPT,26665,Treat thumb fracture,,,422.38,4266.34,107
CPT,26670,HC CL TX CMC DISL NON THUMB,643.27,482.45,7.72,578.94,119
CPT,26670,Treat hand dislocation,,,212.98,1047.9,71
CPT,26675,Treat hand dislocation,,,286.93,2387.17,71
CPT,26676,Pin hand dislocation,,,344.68,4266.34,71
CPT,26685,Treat hand dislocation,,,387.76,4266.34,71
CPT,26686,Treat hand dislocation,,,97.37,4266.34,107
CPT,26700,HC CLOSED RX MC-P DISLOC,643.27,482.45,7.72,578.94,119
CPT,26700,Treat knuckle dislocation,,,214.28,1011.28,71
CPT,26705,Treat knuckle dislocation,,,269.6,2387.17,71
CPT,26706,Pin knuckle dislocation,,,302.37,4266.34,71
CPT,26715,Treat knuckle dislocation,,,386.61,4266.34,71
CPT,26720,HC CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,643.27,482.45,7.72,578.94,119
CPT,26720,Treat finger fracture each,,,128.79,601.23,71
CPT,26725,HC CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,643.27,482.45,7.72,578.94,119
CPT,26725,Treat finger fracture each,,,207.95,1012.64,71
CPT,26727,Treat finger fracture each,,,320.81,4266.34,71
CPT,26735,Treat finger fracture each,,,400.82,4266.34,71
CPT,26740,HC CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,26740,Treat finger fracture each,,,150.29,695.75,71
CPT,26742,HC CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,26742,Treat finger fracture each,,,229.47,2387.17,71
CPT,26746,Treat finger fracture each,,,499.59,4266.34,71
CPT,26750,HC CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,643.27,482.45,7.72,578.94,119
CPT,26750,Treat finger fracture each,,,128.42,563.97,71
CPT,26755,"HC CLOSE RX DIST FINGER FX, MANIPULATION",643.27,482.45,7.72,578.94,119
CPT,26755,Treat finger fracture each,,,188.07,955.17,71
CPT,26756,Pin finger fracture each,,,287.32,4266.34,71
CPT,26765,Treat finger fracture each,,,339.41,4266.34,71
CPT,26770,HC CLOSED RX IP JT DISLOCATION,643.27,482.45,7.72,578.94,119
CPT,26770,Treat finger dislocation,,,179.32,862.13,71
CPT,26775,Treat finger dislocation,,,241.93,1166.52,71
CPT,26776,Pin finger dislocation,,,304.14,4266.34,71
CPT,26785,Treat finger dislocation,,,369.72,4266.34,71
CPT,26820,Thumb fusion with graft,,,129.56,9254.47,143
CPT,26841,Fusion of thumb,,,519.57,9254.47,107
CPT,26842,Thumb fusion with graft,,,129.97,9254.47,143
CPT,26843,Fusion of hand joint,,,122.15,9254.47,107
CPT,26844,Fusion/graft of hand joint,,,134.35,12412.85,107
CPT,26850,Fusion of knuckle,,,494.83,9254.47,71
CPT,26852,Fusion of knuckle with graft,,,130.1,9254.47,107
CPT,26860,Fusion of finger joint,,,411.82,4266.34,71
CPT,26861,Fusion of finger jnt add-on,,,97.86,944.04,52
CPT,26862,Fusion/graft of finger joint,,,119.56,4266.34,107
CPT,26863,Fuse/graft added joint,,,35.27,2101.94,52
CPT,26910,Amputate metacarpal bone,,,513.68,4266.34,71
CPT,26951,Amputation of finger/thumb,,,470.66,4266.34,71
CPT,26952,Amputation of finger/thumb,,,460.73,4266.34,71
CPT,26989,Unlisted px hands/fingers,,,229.97,266.99,19
CPT,26990,Drainage of pelvis lesion,,,456.57,4266.34,71
CPT,26990,HC DRAINAGE PELVIC/HIP AREA DEEP,726.31,544.73,8.72,653.68,119
CPT,26991,Drainage of pelvis bursa,,,355.06,2387.17,71
CPT,26992,Drainage of bone lesion,,,675.48,15039.8,71
CPT,27000,Tenotomy adductor hip perq,,,265.22,2387.17,107
CPT,27001,Tenotomy adductor hip open,,,84.48,4266.34,143
CPT,27003,Tnot adductr subq opn neurct,,,93.59,9254.47,143
CPT,27005,Tenotomy hip flexor open,,,111.64,14249.59,143
CPT,27006,Tenotomy abductor&/xtnsr hip,,,111.03,4266.34,143
CPT,27025,Fasciotomy hip/thigh any typ,,,617.98,14249.59,107
CPT,27027,Dcmprn fasct pel compartment,,,599.46,9254.47,107
CPT,27030,Arthrotomy hip w/drainage,,,145.71,14249.59,143
CPT,27033,Arthrt hip expl/rmv loose/fb,,,151.14,9254.47,143
CPT,27035,Denervation of hip joint,,,174.91,4266.34,143
CPT,27036,Capsulectomy/capsulotomy hip,,,158.15,14249.59,143
CPT,27040,Biopsy of soft tissues,,,154.26,2091.8,107
CPT,27040,HC BX PELV/HIP SFT TISS SUPERF,1539.27,1154.45,18.47,1385.34,119
CPT,27041,Biopsy of soft tissues,,,477.29,2091.8,107
CPT,27043,Exc hip pelvis les sc 3 cm/>,,,315.13,3236.54,107
CPT,27045,Exc hip/pelv tum deep 5 cm/>,,,114.54,3236.54,143
CPT,27047,Exc hip/pelvis les sc < 3 cm,,,241.93,3236.54,107
CPT,27048,Exc hip/pelv tum deep < 5 cm,,,95.28,3236.54,143
CPT,27049,Resect hip/pelv tum < 5 cm,,,208.02,4098.49,143
CPT,27050,Biopsy of sacroiliac joint,,,273.16,2387.17,107
CPT,27052,Biopsy of hip joint,,,90.34,2387.17,143
CPT,27054,Removal of hip joint lining,,,107.56,15039.8,143
CPT,27057,Buttock fasciotomy w/dbrdmt,,,676.28,3234.24,107
CPT,27059,Resect hip/pelv tum 5 cm/>,,,280.84,5217.0,143
CPT,27060,Removal of ischial bursa,,,314.2,11309.48,107
CPT,27062,Remove femur lesion/bursa,,,306.48,4266.34,107
CPT,27065,Remove hip bone les super,,,82.37,9254.47,143
CPT,27066,Remove hip bone les deep,,,127.8,4266.34,143
CPT,27067,Remove/graft hip bone lesion,,,161.07,12688.69,143
CPT,27070,Part remove hip bone super,,,137.76,14249.59,143
CPT,27071,Part removal hip bone deep,,,151.61,15039.8,143
CPT,27075,Resect hip tumor,,,322.43,19385.47,107
CPT,27076,Resect hip tum incl acetabul,,,389.76,23404.76,107
CPT,27077,Resect hip tum w/innom bone,,,434.61,26095.26,107
CPT,27078,Rsect hip tum incl femur,,,317.9,19119.08,143
CPT,27080,Removal of tail bone,,,79.69,4266.34,107
CPT,27086,HC RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27086,HC RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27086,Remove hip foreign body,,,130.5,3236.54,107
CPT,27087,HC REMOVAL FOREIGN BODY PELVIS/HIP DEEP BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27087,HC REMOVAL FOREIGN BODY PELVIS/HIP DEEP UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27087,Remove hip foreign body,,,95.95,4266.34,143
CPT,27090,Removal of hip prosthesis,,,129.53,14249.59,143
CPT,27091,Removal of hip prosthesis,,,246.99,14860.22,143
CPT,27093,HC HIP INJ ARTHOGRAPHY BILATERAL,1361.61,1021.21,16.34,1225.45,119
CPT,27093,HC HIP INJ ARTHOGRAPHY UNILATERAL,680.81,510.61,8.17,612.73,119
CPT,27093,Injection for hip x-ray,,,99.92,2020.34,52
CPT,27095,Injection for hip x-ray,,,119.34,2705.67,52
CPT,27096,HC SI JOINT INJECTION - ARTHROGRAM/ANESTHETIC BILATERAL,4293.55,3220.16,51.52,3864.2,119
CPT,27096,HC SI JOINT INJECTION - ARTHROGRAM/ANESTHETIC UNILATERAL,2146.78,1610.08,25.76,1932.1,119
CPT,27096,Inject sacroiliac joint,,,120.45,1494.85,53
CPT,27097,Revision of hip tendon,,,106.72,4266.34,143
CPT,27098,Transfer tendon to pelvis,,,108.55,5315.69,143
CPT,27100,Transfer of abdominal muscle,,,129.41,11585.33,143
CPT,27105,Transfer of spinal muscle,,,135.57,6034.02,143
CPT,27110,Transfer of iliopsoas muscle,,,151.06,12137.01,143
CPT,27111,Transfer of iliopsoas muscle,,,140.58,4266.34,143
CPT,27120,Reconstruction of hip socket,,,201.6,14249.59,143
CPT,27122,Reconstruction of hip socket,,,171.33,15039.8,143
CPT,27125,Partial hip replacement,,,175.68,15039.8,143
CPT,27130,Total hip arthroplasty,,,199.31,27280.55,143
CPT,27132,Total hip arthroplasty,,,258.99,23055.72,143
CPT,27134,Revise hip joint replacement,,,295.12,33651.11,143
CPT,27137,Revise hip joint replacement,,,227.11,25422.26,143
CPT,27138,Revise hip joint replacement,,,235.93,16249.91,143
CPT,27140,Transplant femur ridge,,,139.49,14249.59,143
CPT,27146,Incision of hip bone,,,196.94,14249.59,143
CPT,27147,Revision of hip bone,,,226.75,14249.59,143
CPT,27151,Incision of hip bones,,,245.2,14754.17,143
CPT,27156,Revision of hip bones,,,264.13,15893.35,143
CPT,27158,Revision of pelvis,,,217.01,14249.59,107
CPT,27161,Incision of neck of femur,,,189.4,14249.59,143
CPT,27165,Incision/fixation of femur,,,213.35,14249.59,143
CPT,27170,Repair/graft femur head/neck,,,181.96,14249.59,143
CPT,27175,Treat slipped epiphysis,,,448.29,15039.8,107
CPT,27176,Treat slipped epiphysis,,,143.55,14249.59,143
CPT,27177,Treat slipped epiphysis,,,173.38,15039.8,143
CPT,27178,Treat slipped epiphysis,,,143.55,15039.8,143
CPT,27179,Revise head/neck of femur,,,152.28,9254.47,143
CPT,27181,Treat slipped epiphysis,,,173.96,15039.8,143
CPT,27185,Revision of femur epiphysis,,,483.55,14249.59,107
CPT,27187,Reinforce hip bones,,,154.89,14249.59,143
CPT,27197,Clsd tx pelvic ring fx,,,129.36,441.34,71
CPT,27197,HC CLSD TX PELVIC RING FX,643.27,482.45,7.72,578.94,119
CPT,27198,Clsd tx pelvic ring fx,,,189.98,910.11,71
CPT,27198,HC CLSD TX PELVIC RING FX,643.27,482.45,7.72,578.94,119
CPT,27200,HC TREAT TAIL BONE FRACTURE,643.27,482.45,7.72,578.94,119
CPT,27200,Treat tail bone fracture,,,126.64,560.16,71
CPT,27202,Treat tail bone fracture,,,82.37,4266.34,107
CPT,27215,Treat pelvic fracture(s),,,1454.23,12954.18,17
CPT,27216,Treat pelvic ring fracture,,,2152.46,8341.13,17
CPT,27217,Treat pelvic ring fracture,,,2021.44,12954.18,17
CPT,27218,Treat pelvic ring fracture,,,2777.35,12954.18,17
CPT,27220,HC CLTX ACETABULUM HIP/SOCKT FX W/O MANJ BILAT,643.27,482.45,7.72,578.94,119
CPT,27220,HC CLTX ACETABULUM HIP/SOCKT FX W/O MANJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,27220,Treat hip socket fracture,,,229.97,1216.29,107
CPT,27222,HC CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27222,HC CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27222,Treat hip socket fracture,,,249.76,15039.8,107
CPT,27226,Treat hip wall fracture,,,164.11,15039.8,179
CPT,27227,Treat hip fracture(s),,,255.78,15406.1,179
CPT,27228,Treat hip fracture(s),,,291.02,17493.65,179
CPT,27230,HC CLTX FEM FX PROX END NCK W/O MANJ BILAT,643.27,482.45,7.72,578.94,119
CPT,27230,HC CLTX FEM FX PROX END NCK W/O MANJ UNILAT,643.27,482.45,7.72,578.94,119
CPT,27230,Treat thigh fracture,,,229.97,1418.88,107
CPT,27232,HC CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ BILAT,583.94,437.96,7.01,525.55,119
CPT,27232,HC CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ UNILAT,583.94,437.96,7.01,525.55,119
CPT,27232,Treat thigh fracture,,,489.15,14249.59,107
CPT,27235,Treat thigh fracture,,,607.77,9254.47,107
CPT,27236,Treat thigh fracture,,,185.15,14249.59,143
CPT,27238,HC CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27238,HC CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27238,Treat thigh fracture,,,315.78,2387.17,107
CPT,27240,HC CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27240,HC CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27240,Treat thigh fracture,,,642.0,14249.59,107
CPT,27244,Treat thigh fracture,,,190.51,14249.59,143
CPT,27245,Treat thigh fracture,,,190.31,14249.59,179
CPT,27246,HC CLSD TX TROCHANTRIC FX W/O MAN,643.27,482.45,7.72,578.94,119
CPT,27246,Treat thigh fracture,,,229.97,1143.25,107
CPT,27248,Treat thigh fracture,,,116.03,14249.59,143
CPT,27250,HC CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA BILAT,643.27,482.45,7.72,578.94,119
CPT,27250,HC CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA UNILAT,643.27,482.45,7.72,578.94,119
CPT,27250,Treat hip dislocation,,,229.97,518.5,71
CPT,27252,HC CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27252,HC CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27252,Treat hip dislocation,,,506.75,2387.17,107
CPT,27253,Treat hip dislocation,,,146.24,15039.8,143
CPT,27254,Treat hip dislocation,,,197.38,15039.8,143
CPT,27256,Treat hip dislocation,,,188.34,916.21,107
CPT,27257,Treat hip dislocation,,,280.63,2387.17,107
CPT,27258,Treat hip dislocation,,,172.71,14249.59,143
CPT,27259,Treat hip dislocation,,,239.24,14411.8,143
CPT,27265,HC CLTX POST HIP ARTHRP DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CPT,27265,HC CLTX POST HIP ARTHRP DISLC W/O ANES UNILAT,643.27,482.45,7.72,578.94,119
CPT,27265,Treat hip dislocation,,,229.97,1225.57,107
CPT,27266,HC CLTX POST HIP ARTHRP DISLC REQ ANES BILAT,583.94,437.96,7.01,525.55,119
CPT,27266,HC CLTX POST HIP ARTHRP DISLC REQ ANES UNILAT,583.94,437.96,7.01,525.55,119
CPT,27266,Treat hip dislocation,,,393.84,2387.17,107
CPT,27267,Cltx thigh fx,,,69.03,4266.34,143
CPT,27267,HC CLTX THIGH FX BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27267,HC CLTX THIGH FX UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27268,Cltx thigh fx w/mnpj,,,85.17,14249.59,143
CPT,27268,HC CLTX THIGH FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27268,HC CLTX THIGH FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27269,Optx thigh fx,,,192.55,15039.8,143
CPT,27275,Manipulation of hip joint,,,143.0,2387.17,71
CPT,27278,Arthrd si jt plmt iartic dev,,,1.0,108715.69,34
CPT,27279,Arthrd si jt plmt tartclr dv,,,126.53,31193.03,143
CPT,27280,Arthr si jt opn b1grf instrm,,,211.35,17753.44,143
CPT,27282,Arthrodesis symphysis pubis,,,133.95,15039.8,107
CPT,27284,Arthrodesis hip joint,,,248.53,15039.8,143
CPT,27286,Arthrd hip jt sbtrchc osteot,,,254.68,15317.7,143
CPT,27290,Amputation of leg at hip,,,251.87,17753.44,107
CPT,27295,Amputation of leg at hip,,,195.4,17753.44,143
CPT,27299,Unlisted px pelvis/hip joint,,,229.97,815.99,27
CPT,27301,Drain thigh/knee lesion,,,341.03,3236.54,107
CPT,27301,HC I/D DEEP ABSC BURSA THIGH/KNEE,9275.55,6956.66,111.31,8347.99,119
CPT,27303,Drainage of bone lesion,,,99.43,15039.8,143
CPT,27305,Incise thigh tendon & fascia,,,75.63,4266.34,143
CPT,27306,Incision of thigh tendon,,,52.5,4266.34,143
CPT,27307,Incision of thigh tendons,,,276.31,4266.34,107
CPT,27310,Exploration of knee joint,,,114.26,4266.34,143
CPT,27323,Biopsy thigh soft tissues,,,135.66,2091.8,107
CPT,27324,Biopsy thigh soft tissues,,,275.81,3236.54,107
CPT,27325,Neurectomy hamstring,,,88.26,2618.2,143
CPT,27326,Neurectomy popliteal,,,81.69,2618.2,143
CPT,27327,Exc thigh/knee les sc < 3 cm,,,211.15,2091.8,107
CPT,27328,Exc thigh/knee tum deep <5cm,,,418.97,3236.54,107
CPT,27329,Resect thigh/knee tum < 5 cm,,,161.66,3236.54,143
CPT,27330,Biopsy knee joint lining,,,284.95,4266.34,107
CPT,27331,Explore/treat knee joint,,,74.62,4266.34,143
CPT,27332,Removal of knee cartilage,,,100.79,4266.34,143
CPT,27333,Removal of knee cartilage,,,92.09,4266.34,143
CPT,27334,Remove knee joint lining,,,107.26,4266.34,143
CPT,27335,Remove knee joint lining,,,119.37,9254.47,143
CPT,27337,Exc thigh/knee les sc 3 cm/>,,,65.24,3236.54,143
CPT,27339,Exc thigh/knee tum dep 5cm/>,,,117.17,3236.54,143
CPT,27340,Removal of kneecap bursa,,,252.66,4266.34,107
CPT,27345,Removal of knee cyst,,,75.95,4266.34,143
CPT,27347,Remove knee cyst,,,82.49,4266.34,143
CPT,27350,Removal of kneecap,,,102.22,9254.47,143
CPT,27355,Remove femur lesion,,,95.01,4266.34,143
CPT,27356,Remove femur lesion/graft,,,115.49,21699.51,143
CPT,27357,Remove femur lesion/graft,,,127.64,11309.48,143
CPT,27358,Remove femur lesion/fixation,,,42.45,2539.02,52
CPT,27360,Partial removal leg bone(s),,,140.66,4266.34,143
CPT,27364,Resect thigh/knee tum 5 cm/>,,,242.69,4497.55,143
CPT,27365,Resect femur/knee tumor,,,317.79,19127.95,143
CPT,27369,HC INJ CONT KNEE OR ENHANCED CT/MRI ARTHRO,740.31,555.23,8.88,666.28,119
CPT,27369,Njx cntrst kne arthg/ct/mri,,,59.07,1548.07,52
CPT,27372,Removal of foreign body,,,269.27,3236.54,107
CPT,27380,Repair of kneecap tendon,,,97.34,9254.47,143
CPT,27381,Repair/graft kneecap tendon,,,127.94,11309.48,143
CPT,27385,Repair of thigh muscle,,,94.67,9254.47,143
CPT,27386,Repair/graft of thigh muscle,,,133.34,9254.47,143
CPT,27390,Incision of thigh tendon,,,70.43,4266.34,143
CPT,27391,Incision of thigh tendons,,,391.02,4266.34,71
CPT,27392,Incision of thigh tendons,,,111.32,4266.34,107
CPT,27393,Lengthening of thigh tendon,,,78.54,9254.47,143
CPT,27394,Lengthening of thigh tendons,,,102.15,9254.47,107
CPT,27395,Lengthening of thigh tendons,,,137.4,4266.34,107
CPT,27396,Transplant of thigh tendon,,,96.61,9254.47,143
CPT,27397,Transplants of thigh tendons,,,142.36,13240.37,143
CPT,27400,Revise thigh muscles/tendons,,,108.61,9254.47,143
CPT,27403,Repair of knee cartilage,,,100.65,13240.37,143
CPT,27405,Repair of knee ligament,,,105.48,9254.47,143
CPT,27407,Repair of knee ligament,,,124.19,12688.69,143
CPT,27409,Repair of knee ligaments,,,150.54,9254.47,143
CPT,27412,Autochondrocyte implant knee,,,255.5,9254.47,143
CPT,27415,Osteochondral knee allograft,,,212.99,25768.16,143
CPT,27416,Osteochondral knee autograft,,,657.85,9254.47,107
CPT,27418,Repair degenerated kneecap,,,129.28,9254.47,143
CPT,27420,Revision of unstable kneecap,,,116.41,9254.47,143
CPT,27422,Revision of unstable kneecap,,,115.75,9254.47,143
CPT,27424,Revision/removal of kneecap,,,116.84,9254.47,143
CPT,27425,Lat retinacular release open,,,306.18,4266.34,107
CPT,27427,Reconstruction knee,,,110.8,11861.17,143
CPT,27428,Reconstruction knee,,,173.61,21699.51,143
CPT,27429,Reconstruction knee,,,195.6,23055.72,143
CPT,27430,Revision of thigh muscles,,,115.77,9254.47,143
CPT,27435,Incision of knee joint,,,126.26,4266.34,143
CPT,27437,Revise kneecap,,,445.1,9254.47,107
CPT,27438,Revise kneecap with implant,,,130.92,16550.47,143
CPT,27440,Revision of knee joint,,,124.36,21699.51,143
CPT,27441,Revision of knee joint,,,128.42,16550.47,143
CPT,27442,Revision of knee joint,,,135.74,21699.51,143
CPT,27443,Revision of knee joint,,,127.18,24411.94,143
CPT,27445,Revision of knee joint,,,194.68,15039.8,134
CPT,27446,Revision of knee joint,,,178.11,22418.02,143
CPT,27447,Total knee arthroplasty,,,199.11,27280.55,143
CPT,27448,Incision of thigh,,,129.0,15039.8,143
CPT,27450,Incision of thigh,,,157.94,14249.59,143
CPT,27454,Realignment of thigh bone,,,200.86,14249.59,143
CPT,27455,Realignment of knee,,,149.57,14249.59,143
CPT,27457,Realignment of knee,,,149.44,14249.59,143
CPT,27458,Osteot femur imed lngth dev,,,7347.11,7347.11,9
CPT,27465,Shortening of thigh bone,,,193.79,15039.8,143
CPT,27466,Lengthening of thigh bone,,,184.02,15039.8,143
CPT,27468,Shorten/lengthen thighs,,,208.12,15039.8,134
CPT,27470,Repair of thigh,,,183.37,15039.8,143
CPT,27472,Repair/graft of thigh,,,196.41,15039.8,143
CPT,27475,Surgery to stop leg growth,,,446.59,9254.47,107
CPT,27477,Surgery to stop leg growth,,,493.58,12137.01,107
CPT,27479,Surgery to stop leg growth,,,142.98,9254.47,143
CPT,27485,Surgery to stop leg growth,,,452.7,9254.47,107
CPT,27486,Revise/replace knee joint,,,217.75,15039.8,143
CPT,27487,Revise/replace knee joint,,,271.61,28007.42,143
CPT,27488,Removal of knee prosthesis,,,186.34,15039.8,143
CPT,27495,Reinforce thigh,,,175.59,15039.8,143
CPT,27496,Decompression of thigh/knee,,,369.24,4266.34,107
CPT,27497,Decompression of thigh/knee,,,351.36,4266.34,143
CPT,27498,Decompression of thigh/knee,,,102.56,2387.17,179
CPT,27499,Decompression of thigh/knee,,,109.59,9254.47,179
CPT,27500,HC CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27500,Treatment of thigh fracture,,,229.97,1522.8,107
CPT,27501,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27501,Treatment of thigh fracture,,,229.97,1469.76,107
CPT,27502,HC CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27502,HC CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27502,Treatment of thigh fracture,,,508.97,2387.17,107
CPT,27503,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27503,HC CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27503,Treatment of thigh fracture,,,539.14,2387.17,107
CPT,27506,Treatment of thigh fracture,,,207.66,15039.8,143
CPT,27507,Treatment of thigh fracture,,,150.4,15039.8,179
CPT,27508,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27508,Treatment of thigh fracture,,,229.97,1537.74,107
CPT,27509,Treatment of thigh fracture,,,455.01,12137.01,107
CPT,27510,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27510,HC CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27510,Treatment of thigh fracture,,,459.74,2387.17,107
CPT,27511,Treatment of thigh fracture,,,154.78,15039.8,179
CPT,27513,Treatment of thigh fracture,,,191.91,15039.8,179
CPT,27514,Treatment of thigh fracture,,,150.05,15039.8,143
CPT,27516,HC CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27516,Treat thigh fx growth plate,,,229.97,1520.93,107
CPT,27517,HC TREAT THIGH FX GROWTH PLATE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27517,HC TREAT THIGH FX GROWTH PLATE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27517,Treat thigh fx growth plate,,,465.02,2387.17,107
CPT,27519,Treat thigh fx growth plate,,,138.49,15039.8,143
CPT,27520,HC CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27520,Treat kneecap fracture,,,205.13,964.91,107
CPT,27524,Treat kneecap fracture,,,117.45,9254.47,143
CPT,27530,HC CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27530,Treat knee fracture,,,196.56,910.17,107
CPT,27532,HC TREAT KNEE FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27532,HC TREAT KNEE FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27532,Treat knee fracture,,,390.9,4266.34,107
CPT,27535,Treat knee fracture,,,139.4,15039.8,179
CPT,27536,Treat knee fracture,,,184.31,15039.8,143
CPT,27538,HC CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,643.27,482.45,7.72,578.94,119
CPT,27538,Treat knee fracture(s),,,229.97,1417.84,107
CPT,27540,Treat knee fracture,,,126.99,15039.8,143
CPT,27550,HC CLOSED RX KNEE DISLOCATN BILAT,643.27,482.45,7.72,578.94,119
CPT,27550,HC CLOSED RX KNEE DISLOCATN UNILAT,643.27,482.45,7.72,578.94,119
CPT,27550,Treat knee dislocation,,,229.97,1501.47,107
CPT,27552,HC CLOSED RX KNEE DISLOC+ANESTH BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27552,HC CLOSED RX KNEE DISLOC+ANESTH UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27552,Treat knee dislocation,,,426.7,2387.17,107
CPT,27556,Treat knee dislocation,,,136.29,15039.8,143
CPT,27557,Treat knee dislocation,,,162.22,15039.8,143
CPT,27558,Treat knee dislocation,,,184.59,15039.8,179
CPT,27560,HC CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,643.27,482.45,7.72,578.94,119
CPT,27560,Treat kneecap dislocation,,,229.97,1101.12,107
CPT,27562,HC TREAT KNEECAP DISLOCATION BILAT,643.27,482.45,7.72,578.94,119
CPT,27562,HC TREAT KNEECAP DISLOCATION UNILAT,643.27,482.45,7.72,578.94,119
CPT,27562,Treat kneecap dislocation,,,229.97,1437.39,107
CPT,27566,Treat kneecap dislocation,,,138.91,9254.47,143
CPT,27570,Fixation of knee joint,,,119.22,2387.17,107
CPT,27580,Fusion of knee,,,228.89,15039.8,143
CPT,27590,Amputate leg at thigh,,,121.44,15039.8,143
CPT,27591,Amputate leg at thigh,,,150.01,15039.8,143
CPT,27592,Amputate leg at thigh,,,103.82,15039.8,143
CPT,27594,Amputation follow-up surgery,,,336.09,4266.34,107
CPT,27596,Amputation follow-up surgery,,,476.84,15039.8,107
CPT,27598,Amputate lower leg at knee,,,107.84,15039.8,143
CPT,27599,Unlisted px femur/knee,,,229.97,3886.61,27
CPT,27600,Decompression of lower leg,,,269.4,4266.34,107
CPT,27601,Decompression of lower leg,,,296.12,4266.34,107
CPT,27602,Decompression of lower leg,,,73.98,4266.34,143
CPT,27603,Drain lower leg lesion,,,262.51,3236.54,107
CPT,27603,HC DRAIN LOWER LEG LESION,6199.2,4649.4,74.39,5579.28,119
CPT,27604,Drain lower leg bursa,,,216.33,4266.34,107
CPT,27605,Incision of achilles tendon,,,142.48,2387.17,107
CPT,27606,Incision of achilles tendon,,,210.92,4266.34,107
CPT,27607,Treat lower leg bone lesion,,,401.35,4266.34,107
CPT,27610,Explore/treat ankle joint,,,433.4,4266.34,107
CPT,27612,Exploration of ankle joint,,,88.28,4266.34,143
CPT,27613,Biopsy lower leg soft tissue,,,124.46,1803.33,107
CPT,27614,Biopsy lower leg soft tissue,,,279.52,3236.54,107
CPT,27615,Resect leg/ankle tum < 5 cm,,,686.85,3236.54,107
CPT,27616,Resect leg/ankle tum 5 cm/>,,,849.02,3587.75,107
CPT,27618,Exc leg/ankle tum < 3 cm,,,205.21,2091.8,107
CPT,27619,Exc leg/ankle tum deep <5 cm,,,314.74,3236.54,107
CPT,27620,Explore/treat ankle joint,,,69.24,4266.34,143
CPT,27625,Remove ankle joint lining,,,89.2,4266.34,143
CPT,27626,Remove ankle joint lining,,,95.14,4266.34,143
CPT,27630,Removal of tendon lesion,,,238.62,4266.34,107
CPT,27632,Exc leg/ankle les sc 3 cm/>,,,63.87,3236.54,143
CPT,27634,Exc leg/ankle tum dep 5 cm/>,,,105.34,3236.54,143
CPT,27635,Remove lower leg bone lesion,,,389.55,4266.34,107
CPT,27637,Remove/graft leg bone lesion,,,115.41,11309.48,143
CPT,27638,Remove/graft leg bone lesion,,,116.51,9254.47,143
CPT,27640,Partial removal of tibia,,,558.31,4266.34,107
CPT,27641,Partial removal of fibula,,,438.73,4266.34,107
CPT,27645,Resect tibia tumor,,,273.79,16476.19,143
CPT,27646,Resect fibula tumor,,,237.87,15039.8,143
CPT,27647,Resect talus/calcaneus tum,,,155.52,4266.34,143
CPT,27648,HC INJECTION ANKLE ARTHROGRAM BILATERAL,1838.76,1379.07,22.07,1654.88,119
CPT,27648,HC INJECTION ANKLE ARTHROGRAM UNILATERAL,919.38,689.54,11.03,827.44,119
CPT,27648,Injection for ankle x-ray,,,74.31,1843.53,52
CPT,27650,Repair achilles tendon,,,102.5,11309.48,143
CPT,27652,Repair/graft achilles tendon,,,446.35,11861.17,107
CPT,27654,Repair of achilles tendon,,,111.36,11309.48,143
CPT,27656,Repair leg fascia defect,,,53.94,4266.34,143
CPT,27658,Repair of leg tendon each,,,57.59,4266.34,107
CPT,27659,Repair of leg tendon each,,,73.39,9254.47,107
CPT,27664,Repair of leg tendon each,,,244.2,9254.47,71
CPT,27665,Repair of leg tendon each,,,65.56,11861.17,107
CPT,27675,Repair lower leg tendons,,,77.62,4266.34,143
CPT,27676,Repair lower leg tendons,,,94.47,9254.47,143
CPT,27680,Release of lower leg tendon,,,281.11,4266.34,71
CPT,27681,Release of lower leg tendons,,,339.51,4266.34,107
CPT,27685,Revision of lower leg tendon,,,72.58,4266.34,143
CPT,27686,Revise lower leg tendons,,,354.32,4266.34,107
CPT,27687,Revision of calf tendon,,,70.7,4266.34,143
CPT,27690,Revise lower leg tendon,,,99.39,9254.47,143
CPT,27691,Revise lower leg tendon,,,115.7,9254.47,143
CPT,27692,Revise additional leg tendon,,,15.56,952.71,52
CPT,27695,Repair of ankle ligament,,,325.6,12412.85,107
CPT,27696,Repair of ankle ligaments,,,369.45,12964.53,107
CPT,27698,Repair of ankle ligament,,,99.81,12137.01,143
CPT,27700,Revision of ankle joint,,,95.44,12137.01,143
CPT,27702,Reconstruct ankle joint,,,149.54,31193.03,143
CPT,27703,Reconstruction ankle joint,,,172.82,31193.03,143
CPT,27704,Removal of ankle implant,,,381.63,4266.34,107
CPT,27705,Osteotomy tibia,,,117.48,12688.69,143
CPT,27707,Osteotomy fibula,,,272.29,4266.34,107
CPT,27709,Osteotomy tibia & fibula,,,176.42,21699.51,143
CPT,27712,Osteot mlt relignmt imed rod,,,171.15,15039.8,143
CPT,27713,Osteot tibia imed lngth dev,,,7347.11,7347.11,9
CPT,27715,Ostpl tibfib lngth/shrt,,,166.65,23055.72,143
CPT,27720,Repair of tibia,,,135.87,11861.17,143
CPT,27722,Repair/graft of tibia,,,139.18,11309.48,143
CPT,27724,Repair/graft of tibia,,,194.95,15039.8,143
CPT,27725,Repair of lower leg,,,188.69,15039.8,143
CPT,27726,Repair fibula nonunion,,,642.79,11585.33,107
CPT,27727,Repair of lower leg,,,161.56,15039.8,143
CPT,27730,Repair of tibia epiphysis,,,396.3,5315.69,107
CPT,27732,Repair of fibula epiphysis,,,306.23,4266.34,107
CPT,27734,Repair lower leg epiphyses,,,442.98,4266.34,107
CPT,27740,Repair of leg epiphyses,,,110.51,4266.34,143
CPT,27742,Repair of leg epiphyses,,,121.14,4266.34,143
CPT,27745,Reinforce tibia,,,117.66,11861.17,143
CPT,27750,HC CLTX TIBIAL SHAFT FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27750,Treatment of tibia fracture,,,219.69,1027.51,107
CPT,27752,HC CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,1701.62,1276.21,20.42,1531.46,119
CPT,27752,Treatment of tibia fracture,,,332.75,2387.17,107
CPT,27756,Treatment of tibia fracture,,,90.17,13240.37,143
CPT,27758,Treatment of tibia fracture,,,139.47,21699.51,143
CPT,27759,Treatment of tibia fracture,,,155.02,21699.51,179
CPT,27760,Cltx medial ankle fx,,,208.51,988.01,107
CPT,27760,HC CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27762,Cltx med ankle fx w/mnpj,,,297.0,2387.17,107
CPT,27762,HC CLTX MED ANKLE FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27762,HC CLTX MED ANKLE FX W/MNPJ UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27766,Optx medial ankle fx,,,408.2,9254.47,107
CPT,27767,Cltx post ankle fx,,,197.0,861.59,107
CPT,27767,HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,27768,Cltx post ankle fx w/mnpj,,,303.19,2387.17,107
CPT,27768,HC CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,27769,Optx post ankle fx,,,488.53,11309.48,107
CPT,27780,HC CLTX PROX FIBULA/SHFT FX W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27780,Treatment of fibula fracture,,,194.01,916.84,107
CPT,27781,HC TREATMENT OF FIBULA FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27781,HC TREATMENT OF FIBULA FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27781,Treatment of fibula fracture,,,274.05,2387.17,107
CPT,27784,Treatment of fibula fracture,,,477.65,9254.47,107
CPT,27786,HC CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27786,Treatment of ankle fracture,,,195.64,923.58,107
CPT,27788,HC CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,643.27,482.45,7.72,578.94,119
CPT,27788,Treatment of ankle fracture,,,229.97,1251.0,107
CPT,27792,Treatment of ankle fracture,,,433.99,11585.33,107
CPT,27808,HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27808,Treatment of ankle fracture,,,207.97,993.25,107
CPT,27810,HC CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,1701.62,1276.21,20.42,1531.46,119
CPT,27810,Treatment of ankle fracture,,,290.68,2387.17,107
CPT,27814,Treatment of ankle fracture,,,119.17,11861.17,143
CPT,27816,HC CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,27816,Treatment of ankle fracture,,,199.78,978.84,107
CPT,27818,HC CLTX MED ANKLE FX W/MNPJ BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27818,HC TREATMENT OF ANKLE FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27818,HC TREATMENT OF ANKLE FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27818,Treatment of ankle fracture,,,299.02,2387.17,107
CPT,27822,Treatment of ankle fracture,,,136.06,11585.33,143
CPT,27823,Treatment of ankle fracture,,,153.22,11861.17,143
CPT,27824,HC CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,27824,Treat lower leg fracture,,,207.97,932.81,107
CPT,27825,HC TREAT LOWER LEG FRACTURE BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27825,HC TREAT LOWER LEG FRACTURE UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27825,Treat lower leg fracture,,,333.85,2387.17,107
CPT,27826,Treat lower leg fracture,,,133.02,11309.48,179
CPT,27827,Treat lower leg fracture,,,174.29,21699.51,179
CPT,27828,Treat lower leg fracture,,,206.39,23055.72,179
CPT,27829,Treat lower leg joint,,,110.14,11861.17,179
CPT,27830,HC CLTX PROX TIBFIB JT DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CPT,27830,HC CLTX PROX TIBFIB JT DISLC W/O ANES UNILAT,643.27,482.45,7.72,578.94,119
CPT,27830,Treat lower leg dislocation,,,229.97,1150.41,107
CPT,27831,HC CLTX PROX TIBFIB JT DISLC REQ ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27831,HC CLTX PROX TIBFIB JT DISLC REQ ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27831,Treat lower leg dislocation,,,276.83,4266.34,107
CPT,27832,Treat lower leg dislocation,,,118.08,12137.01,143
CPT,27840,HC CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,643.27,482.45,7.72,578.94,119
CPT,27840,Treat ankle dislocation,,,229.97,1138.27,107
CPT,27842,HC TREAT ANKLE DISLOCATION BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27842,HC TREAT ANKLE DISLOCATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,27842,Treat ankle dislocation,,,331.86,2387.17,107
CPT,27846,Treat ankle dislocation,,,112.07,13516.22,143
CPT,27848,Treat ankle dislocation,,,122.4,9254.47,143
CPT,27860,Fixation of ankle joint,,,127.99,4266.34,107
CPT,27870,Fusion of ankle joint open,,,157.14,23055.72,143
CPT,27871,Fusion of tibiofibular joint,,,107.72,23055.72,143
CPT,27880,Amputation of lower leg,,,139.29,15039.8,143
CPT,27881,Amputation of lower leg,,,132.03,15039.8,143
CPT,27882,Amputation of lower leg,,,394.49,15039.8,107
CPT,27884,Amputation follow-up surgery,,,386.0,4266.34,107
CPT,27886,Amputation follow-up surgery,,,432.6,15039.8,107
CPT,27888,Amputation of foot at ankle,,,99.72,15039.8,143
CPT,27889,Ankle disarticulation,,,425.19,9254.47,107
CPT,27892,Decompression of leg,,,359.23,4266.34,107
CPT,27893,Decompression of leg,,,413.04,9254.47,107
CPT,27894,Decompression of leg,,,126.44,4266.34,143
CPT,27899,Unlisted px leg/ankle,,,229.97,266.99,19
CPT,28001,Drainage of bursa of foot,,,94.07,1803.33,71
CPT,28001,HC DRAINAGE OF BURSA OF FOOT,726.31,544.73,8.72,653.68,119
CPT,28002,Treatment of foot infection,,,136.7,2387.17,71
CPT,28003,Treatment of foot infection,,,254.25,4266.34,71
CPT,28005,Treat foot bone lesion,,,383.38,4266.34,71
CPT,28008,Incision of foot fascia,,,197.46,4266.34,107
CPT,28010,Incision of toe tendon,,,138.81,1781.27,71
CPT,28011,Incision of toe tendons,,,186.59,2387.17,71
CPT,28020,Exploration of foot joint,,,246.96,4266.34,71
CPT,28022,Exploration of foot joint,,,218.89,4266.34,71
CPT,28024,Exploration of toe joint,,,205.09,2387.17,71
CPT,28035,Decompression of tibia nerve,,,240.44,2618.2,107
CPT,28039,Exc foot/toe tum sc 1.5 cm/>,,,53.12,3236.54,143
CPT,28041,Exc foot/toe tum dep 1.5cm/>,,,302.17,3236.54,107
CPT,28043,Exc foot/toe tum sc < 1.5 cm,,,174.56,2091.8,107
CPT,28045,Exc foot/toe tum deep <1.5cm,,,233.21,3236.54,107
CPT,28046,Resect foot/toe tumor < 3 cm,,,477.38,3236.54,107
CPT,28047,Resect foot/toe tumor 3 cm/>,,,160.31,3236.54,143
CPT,28050,Biopsy of foot joint lining,,,186.59,4266.34,107
CPT,28052,Biopsy of foot joint lining,,,170.72,4266.34,107
CPT,28054,Biopsy of toe joint lining,,,156.27,4266.34,107
CPT,28055,Neurectomy foot,,,257.72,2618.2,107
CPT,28060,Partial removal foot fascia,,,240.44,4266.34,107
CPT,28062,Removal of foot fascia,,,271.19,4266.34,107
CPT,28070,Removal of foot joint lining,,,230.0,9254.47,71
CPT,28072,Removal of foot joint lining,,,217.42,4266.34,71
CPT,28080,Removal of foot lesion,,,251.91,2387.17,71
CPT,28086,Excise foot tendon sheath,,,54.93,4266.34,143
CPT,28088,Excise foot tendon sheath,,,194.82,4266.34,107
CPT,28090,Removal of foot lesion,,,206.41,2387.17,107
CPT,28092,Removal of toe lesions,,,181.17,2387.17,71
CPT,28100,Removal of ankle/heel lesion,,,65.02,4266.34,143
CPT,28102,Remove/graft foot lesion,,,95.33,12964.53,143
CPT,28103,Remove/graft foot lesion,,,60.3,12137.01,143
CPT,28104,Removal of foot lesion,,,54.83,4266.34,107
CPT,28106,Remove/graft foot lesion,,,66.18,11309.48,107
CPT,28107,Remove/graft foot lesion,,,53.82,9254.47,107
CPT,28108,Removal of toe lesions,,,192.67,2387.17,71
CPT,28110,Part removal of metatarsal,,,195.06,4266.34,107
CPT,28111,Part removal of metatarsal,,,214.5,4266.34,107
CPT,28112,Part removal of metatarsal,,,209.95,4266.34,107
CPT,28113,Part removal of metatarsal,,,284.93,4266.34,107
CPT,28114,Removal of metatarsal heads,,,129.85,4266.34,143
CPT,28116,Revision of foot,,,395.93,4266.34,107
CPT,28118,Removal of heel bone,,,65.31,4266.34,143
CPT,28119,Removal of heel spur,,,243.53,4266.34,107
CPT,28120,Part removal of ankle/heel,,,332.61,4266.34,107
CPT,28122,Partial removal of foot bone,,,68.04,4266.34,143
CPT,28124,Partial removal of toe,,,223.03,3611.26,107
CPT,28126,Partial removal of toe,,,166.21,4266.34,71
CPT,28130,Removal of ankle bone,,,94.41,12137.01,143
CPT,28140,Removal of metatarsal,,,286.69,4266.34,71
CPT,28150,Removal of toe,,,186.46,4266.34,71
CPT,28153,Partial removal of toe,,,176.26,4266.34,71
CPT,28160,Partial removal of toe,,,177.9,4266.34,71
CPT,28171,Resect tarsal tumor,,,171.83,4266.34,107
CPT,28173,Resect metatarsal tumor,,,488.0,4266.34,71
CPT,28175,Resect phalanx of toe tumor,,,314.81,2387.17,71
CPT,28190,HC REMOVAL FOREIGN BODY FOOT SQ,2026.89,1520.17,24.32,1824.2,119
CPT,28190,Removal of foot foreign body,,,102.38,783.1,107
CPT,28192,HC REMOVAL FOREIGN BODY FOOT DEEP,1701.62,1276.21,20.42,1531.46,119
CPT,28192,Removal of foot foreign body,,,207.49,2091.8,107
CPT,28193,HC REMOVAL OF FOOT FOREIGN BODY BILAT,583.94,437.96,7.01,525.55,119
CPT,28193,HC REMOVAL OF FOOT FOREIGN BODY UNILAT,583.94,437.96,7.01,525.55,119
CPT,28193,Removal of foot foreign body,,,245.27,2091.8,107
CPT,28200,Repair of foot tendon,,,218.97,4266.34,71
CPT,28202,Repair/graft of foot tendon,,,66.93,12137.01,107
CPT,28208,Repair of foot tendon,,,215.74,4266.34,71
CPT,28210,Repair/graft of foot tendon,,,66.18,11861.17,107
CPT,28220,Release of foot tendon,,,204.07,1781.27,107
CPT,28222,Release of foot tendons,,,244.28,4266.34,107
CPT,28225,Release of foot tendon,,,176.58,4266.34,107
CPT,28226,Release of foot tendons,,,267.86,4266.34,107
CPT,28230,Incision of foot tendon(s),,,190.99,1781.27,107
CPT,28232,Incision of toe tendon,,,160.67,1781.27,71
CPT,28234,Incision of foot tendon,,,179.06,2387.17,71
CPT,28238,Revision of foot tendon,,,76.5,9254.47,143
CPT,28240,Release of big toe,,,196.58,4266.34,107
CPT,28250,Revision of foot fascia,,,63.87,4266.34,143
CPT,28260,Release of midfoot joint,,,82.99,4266.34,143
CPT,28261,Revision of foot tendon,,,628.64,3079.32,107
CPT,28262,Revision of foot and ankle,,,175.0,11309.48,143
CPT,28264,Release of midfoot joint,,,105.0,2538.54,143
CPT,28270,Release of foot contracture,,,223.48,4266.34,107
CPT,28272,Release of toe joint each,,,167.66,1781.27,107
CPT,28280,Fusion of toes,,,232.96,4266.34,107
CPT,28285,Repair of hammertoe,,,257.46,4266.34,107
CPT,28286,Repair of hammertoe,,,198.34,4266.34,107
CPT,28288,Partial removal of foot bone,,,290.1,4266.34,71
CPT,28289,Corrj halux rigdus w/o implt,,,71.54,4266.34,143
CPT,28291,Corrj halux rigdus w/implt,,,75.47,12137.01,143
CPT,28292,Cor hlx vlgs rsc prx phlx bs,,,75.0,4266.34,143
CPT,28295,Cor hlx vlgs prx mtar osteot,,,94.62,4266.34,143
CPT,28296,Cor hlx vlgs dstl mtar osteo,,,79.63,4266.34,143
CPT,28297,Cor hlx vlgs jt arthrd,,,93.63,24411.94,143
CPT,28298,Cor hlx vlgs prx phlx osteot,,,78.42,11309.48,143
CPT,28299,Cor hlx vlgs double osteot,,,91.91,11585.33,143
CPT,28300,Incision of heel bone,,,101.35,11309.48,143
CPT,28302,Incision of ankle bone,,,111.66,15171.26,143
CPT,28304,Incision of midfoot bones,,,95.67,11309.48,143
CPT,28305,Incise/graft midfoot bones,,,104.48,15171.26,143
CPT,28306,Incision of metatarsal,,,63.0,9254.47,143
CPT,28307,Incision of metatarsal,,,347.38,9254.47,107
CPT,28308,Incision of metatarsal,,,59.92,4266.34,143
CPT,28309,Incision of metatarsals,,,604.07,9254.47,107
CPT,28310,Revision of big toe,,,242.19,11309.48,107
CPT,28312,Revision of toe,,,226.19,4266.34,71
CPT,28313,Repair deformity of toe,,,241.38,4266.34,71
CPT,28315,Removal of sesamoid bone,,,219.03,4266.34,107
CPT,28320,Repair of foot bones,,,95.3,23055.72,143
CPT,28322,Repair of metatarsals,,,90.06,11309.48,107
CPT,28340,Resect enlarged toe tissue,,,274.23,4266.34,71
CPT,28341,Resect enlarged toe,,,326.35,4266.34,71
CPT,28344,Repair extra toe(s),,,186.82,4266.34,107
CPT,28345,Repair webbed toe(s),,,242.64,2387.17,71
CPT,28360,Reconstruct cleft foot,,,170.83,9254.47,143
CPT,28400,Cltx calcaneal fx w/o mnpj,,,155.26,725.73,107
CPT,28400,HC CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,28405,Cltx calcaneal fx w/mnpj,,,229.97,1326.72,107
CPT,28405,HC TREATMENT OF HEEL FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CPT,28405,HC TREATMENT OF HEEL FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CPT,28406,Prq skel fix clcnl fx w/mnpj,,,379.04,9254.47,107
CPT,28415,Optx calcaneal fracture,,,175.02,11861.17,143
CPT,28420,Optx calcaneal fx w/bone grf,,,201.57,21699.51,143
CPT,28430,Cltx talus fracture w/o mnpj,,,142.56,703.15,107
CPT,28430,HC CLOSED TX TALUS FRACTURE W/O MANIPULATION BILAT,643.27,482.45,7.72,578.94,119
CPT,28430,HC CLOSED TX TALUS FRACTURE W/O MANIPULATION UNILAT,643.27,482.45,7.72,578.94,119
CPT,28435,Cltx talus fracture w/mnpj,,,222.27,2387.17,107
CPT,28435,HC CLOSED TX TALUS FRACTURE W/MANIPULATION BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28435,HC CLOSED TX TALUS FRACTURE W/MANIPULATION UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28436,Prq skel fix talus fx w/mnpj,,,333.59,12688.69,107
CPT,28445,Optx talus fracture,,,161.75,11861.17,143
CPT,28446,Opn osteochondrl agrft talus,,,190.19,12137.01,143
CPT,28450,HC TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,28450,Tx tarsal b1 fx w/o mnpj ea,,,128.71,619.52,71
CPT,28455,HC TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,643.27,482.45,7.72,578.94,119
CPT,28455,Tx tarsal b1 fx w/mnpj each,,,176.56,1781.27,71
CPT,28456,Prq skel fix tarsl fx w/mnpj,,,248.79,11585.33,71
CPT,28465,Optx tarsal bone fx each,,,426.2,11585.33,71
CPT,28470,Cltx metatarsal fx wo mnp ea,,,138.02,636.91,71
CPT,28470,HC CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,643.27,482.45,7.72,578.94,119
CPT,28475,Cltx metatarsal fx w/mnpj ea,,,153.68,762.38,71
CPT,28475,HC CLTX METAR FX W/MANJ,643.27,482.45,7.72,578.94,119
CPT,28476,Prq skel fix metar fx w/mnpj,,,260.5,4266.34,71
CPT,28485,Optx metatarsal fx each,,,377.0,11585.33,71
CPT,28490,HC CLTX FX GRT TOE PHLX/PHLG W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,28490,Treat big toe fracture,,,84.06,416.09,107
CPT,28495,HC CLTX FX GRT TOE PHLX/PHLG W/MANJ,643.27,482.45,7.72,578.94,119
CPT,28495,Treat big toe fracture,,,100.07,527.49,107
CPT,28496,Treat big toe fracture,,,165.89,4266.34,107
CPT,28505,Treat big toe fracture,,,332.26,4266.34,107
CPT,28510,HC CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,643.27,482.45,7.72,578.94,119
CPT,28510,Treatment of toe fracture,,,80.85,355.65,71
CPT,28515,HC CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,643.27,482.45,7.72,578.94,119
CPT,28515,Treatment of toe fracture,,,96.41,479.08,71
CPT,28525,Treat toe fracture,,,271.63,4266.34,71
CPT,28530,HC TREAT SESAMOID BONE FRACTURE,643.27,482.45,7.72,578.94,119
CPT,28530,HC TREAT SESAMOID BONE FRACTURE BILAT,643.27,482.45,7.72,578.94,119
CPT,28530,Treat sesamoid bone fracture,,,67.59,346.11,107
CPT,28531,Treat sesamoid bone fracture,,,108.62,11309.48,143
CPT,28540,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CPT,28540,HC TREAT SESAMOID BONE FRACTURE UNILAT,643.27,482.45,7.72,578.94,119
CPT,28540,Treat foot dislocation,,,118.07,572.06,107
CPT,28545,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28545,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28545,Treat foot dislocation,,,183.24,4266.34,107
CPT,28546,Treat foot dislocation,,,235.95,3157.23,107
CPT,28555,Repair foot dislocation,,,103.44,12964.53,143
CPT,28570,HC CLOSED TX TALOTARSAL JOINT DISLC W/O ANES BILAT,643.27,482.45,7.72,578.94,119
CPT,28570,HC CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES UNILAT,643.27,482.45,7.72,578.94,119
CPT,28570,Treat foot dislocation,,,132.89,695.57,107
CPT,28575,HC CLOSED TX TALOTARSAL JOINT DISLC W/O ANES UNILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28575,HC CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES BILAT,1701.62,1276.21,20.42,1531.46,119
CPT,28575,Treat foot dislocation,,,229.56,4266.34,107
CPT,28576,Treat foot dislocation,,,260.42,9254.47,107
CPT,28585,Repair foot dislocation,,,108.76,12412.85,143
CPT,28600,HC CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CPT,28600,Treat foot dislocation,,,125.46,640.52,71
CPT,28605,HC CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES UNILAT,643.27,482.45,7.72,578.94,119
CPT,28605,Treat foot dislocation,,,205.97,1006.06,71
CPT,28606,Treat foot dislocation,,,259.22,4266.34,71
CPT,28615,Repair foot dislocation,,,128.48,11309.48,107
CPT,28630,HC CLTX METATARSOPHLNGL JT DISLC W/O ANES,643.27,482.45,7.72,578.94,119
CPT,28630,Treat toe dislocation,,,86.42,445.53,71
CPT,28635,HC CLTX METATARSOPHLNGL JT DISLC REQ ANES,1701.62,1276.21,20.42,1531.46,119
CPT,28635,Treat toe dislocation,,,104.47,2387.17,71
CPT,28636,Treat toe dislocation,,,119.55,4266.34,107
CPT,28645,Repair toe dislocation,,,324.99,4266.34,71
CPT,28660,HC CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,643.27,482.45,7.72,578.94,119
CPT,28660,Treat toe dislocation,,,72.5,364.59,71
CPT,28665,HC CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,643.27,482.45,7.72,578.94,119
CPT,28665,Treat toe dislocation,,,97.04,514.91,71
CPT,28666,Treat toe dislocation,,,106.41,4266.34,107
CPT,28675,Repair of toe dislocation,,,276.33,4266.34,71
CPT,28705,Arthrodesis pantalar,,,190.01,31193.03,143
CPT,28715,Arthrodesis triple,,,146.07,23055.72,143
CPT,28725,Arthrodesis subtalar,,,120.89,23055.72,143
CPT,28730,Fusion of foot bones,,,113.27,24411.94,143
CPT,28735,Fusion of foot bones,,,121.46,24411.94,143
CPT,28737,Revision of foot bones,,,106.85,24411.94,143
CPT,28740,Fusion of foot bones,,,95.99,12688.69,143
CPT,28750,Fusion of big toe joint,,,386.93,12688.69,107
CPT,28755,Fusion of big toe joint,,,223.53,9254.47,107
CPT,28760,Fusion of big toe joint,,,87.95,11585.33,143
CPT,28800,Amputation of midfoot,,,82.03,15039.8,143
CPT,28805,Amputation thru metatarsal,,,474.83,4266.34,107
CPT,28810,Amputation toe & metatarsal,,,282.69,4266.34,71
CPT,28820,Amputation of toe,,,173.62,4266.34,71
CPT,28820,HC AMPUTATION TOE METATARSOPHALANGEAL JOINT,9347.0,7010.25,112.16,8412.3,119
CPT,28825,HC PARTIAL AMPUTATION OF TOE,7027.83,5270.87,84.33,6325.05,119
CPT,28825,Partial amputation of toe,,,168.12,4266.34,71
CPT,28890,Hi enrgy eswt plantar fascia,,,147.4,1781.27,107
CPT,28899,Unlisted px foot/toes,,,229.97,3848.05,27
CPT,29000,Appl halo type body cast,,,189.84,1048.45,71
CPT,29010,Appl risser jacket body only,,,154.29,811.06,71
CPT,29015,Appl rissr jacket bdy w/head,,,173.85,869.23,71
CPT,29035,Appl body cast sho to hips,,,138.0,764.3,71
CPT,29040,Appl bdy cst sho to hip head,,,166.26,871.63,71
CPT,29044,Appl bdy cst sho to hip 1thi,,,151.27,853.61,71
CPT,29046,Appl bdy cst sho to hip b th,,,180.76,933.32,71
CPT,29049,Appl cast figure-of-eight,,,66.82,295.59,71
CPT,29055,Appl cast shoulder spica,,,132.38,661.79,71
CPT,29058,Appl cast plaster velpeau,,,90.3,362.02,71
CPT,29065,Appl cst sho to hand lng arm,,,98.73,295.59,71
CPT,29065,HC APPLY LONG ARM CAST,836.83,627.62,10.04,753.15,119
CPT,29065,HC OT APPLY LONG ARM CAST,669.48,502.11,8.03,602.53,119
CPT,29075,Appl cst elbw fngr short arm,,,90.86,295.59,71
CPT,29075,HC APPLY FOREARM CAST,726.31,544.73,8.72,653.68,119
CPT,29085,Appl cast hand&lwr forearm,,,97.35,281.33,71
CPT,29085,HC APPLY CAST HAND & LOWER FOREARM,643.27,482.45,7.72,578.94,119
CPT,29085,HC OT APPLY CAST HAND & LOWER FOREARM,445.31,333.98,5.34,400.78,119
CPT,29086,Application cast finger,,,71.31,224.76,71
CPT,29086,HC APPLY CAST FINGER,643.27,482.45,7.72,578.94,119
CPT,29105,Application long arm splint,,,61.79,240.58,71
CPT,29105,HC APPLY LONG ARM SPLINT,644.47,483.35,7.73,580.02,119
CPT,29105,PBB APPLICATION LONG ARM SPLINT SHOULDER HAND,484.56,363.42,5.81,436.1,119
CPT,29125,Appl short arm splint static,,,58.53,629.26,71
CPT,29125,HC APPLY FOREARM SPLINT STATIC,578.95,434.21,6.95,521.06,119
CPT,29125,PBB APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,578.95,434.21,6.95,521.06,119
CPT,29126,Appl short arm splint dyn,,,71.45,743.09,71
CPT,29126,HC APPLY SPLINT FOREARM TO HAND (SHORT ARM-DYNAMIC),225.66,169.24,2.71,203.09,119
CPT,29130,Appl finger splint static,,,42.99,397.27,71
CPT,29130,HC APPLY FINGER SPLINT STATIC,238.03,178.52,2.86,214.23,119
CPT,29131,Appl finger splint dynamic,,,50.72,514.35,71
CPT,29131,HC APPLY SPLINT FINGER (DYNAMIC),162.71,122.03,1.95,146.44,119
CPT,29200,HC APPLY STRAPPING THORAX,347.34,260.5,4.17,312.61,119
CPT,29200,Strapping thorax,,,18.2,175.62,71
CPT,29240,HC APPLY STRAPPING SHOULDER,643.27,482.45,7.72,578.94,119
CPT,29240,Strapping of shoulder,,,26.82,270.04,71
CPT,29260,HC STRAPPING ELBOW TO WRIST,643.27,482.45,7.72,578.94,119
CPT,29260,Strapping of elbow or wrist,,,28.17,267.08,71
CPT,29280,HC STRAPPING; HAND OR FINGER,643.27,482.45,7.72,578.94,119
CPT,29280,Strapping of hand or finger,,,29.12,272.99,71
CPT,29305,Appl hip spica cast 1 leg,,,152.35,731.19,71
CPT,29325,Appl hip spica cast1&1/2,,,170.55,808.17,71
CPT,29345,Application of long leg cast,,,144.23,393.76,71
CPT,29345,HC APPLY CAST THIGH TO TOES (LONG LEG),643.27,482.45,7.72,578.94,119
CPT,29355,Appl long leg cast walker,,,154.07,411.09,71
CPT,29355,HC APPLICATION OF LONG LEG CAST BILAT,643.27,482.45,7.72,578.94,119
CPT,29355,HC APPLICATION OF LONG LEG CAST UNILAT,643.27,482.45,7.72,578.94,119
CPT,29358,Appl long leg cast brace,,,148.98,472.71,71
CPT,29365,Appl cylinder cast,,,126.11,361.2,71
CPT,29405,Appl short leg cast,,,84.54,295.59,71
CPT,29405,HC APPLY CAST BELOW KNEE TO TOES (SHORT LEG),670.71,503.03,8.05,603.64,119
CPT,29405,HC OT APPLY CAST BELOW KNEE TO TOES (SHORT LEG),495.44,371.58,5.95,445.9,119
CPT,29405,HC PT APPLY CAST BELOW KNEE TO TOES (SHORT LEG),495.44,371.58,5.95,445.9,119
CPT,29425,Appl short leg cast walking,,,78.48,295.59,71
CPT,29425,HC APPLY WLKR SH LEG CAST,643.27,482.45,7.72,578.94,119
CPT,29435,Appl patllr tdn bearing cast,,,117.26,361.2,71
CPT,29440,Adding walker to prev cast,,,40.62,175.62,71
CPT,29445,Appl rigid tot cntc leg cast,,,143.09,367.9,71
CPT,29445,HC APPLICATION RIGID TOTAL CONTACT LEG CAST,1027.71,770.78,12.33,924.94,119
CPT,29445,HC APPLY RIGID CONTACT TOTAL LEG CAST BILATERAL,2091.23,1568.42,25.09,1882.11,119
CPT,29445,HC APPLY RIGID CONTACT TOTAL LEG CAST UNILATERAL,1045.61,784.21,12.55,941.05,119
CPT,29445,HC PT APPLICATION OF TOTAL CONTACT CAST UNILATERAL,1045.61,784.21,12.55,941.05,119
CPT,29450,Application clubfoot cast,,,151.27,417.49,71
CPT,29505,Application long leg splint,,,75.18,294.23,71
CPT,29505,HC APPLY LONG LEG SPLINT,292.09,219.07,3.51,262.88,119
CPT,29515,Application short leg splint,,,71.6,211.74,71
CPT,29515,HC APPLY LOWER LEG SPLINT,499.21,374.41,5.99,449.29,119
CPT,29515,PBB APPLICATION SHORT LEG SPLINT CALF FOOT,499.21,374.41,5.99,449.29,119
CPT,29520,HC STRAPPING OF HIP BILAT,643.27,482.45,7.72,578.94,119
CPT,29520,HC STRAPPING OF HIP UNILAT,643.27,482.45,7.72,578.94,119
CPT,29520,Strapping of hip,,,26.82,314.68,71
CPT,29530,HC APPLY STRAPPING KNEE,643.27,482.45,7.72,578.94,119
CPT,29530,Strapping of knee,,,26.82,270.04,71
CPT,29540,HC APPLY STRAPPING ANKLE AND/OR FOOT,377.76,283.32,4.53,339.98,119
CPT,29540,Strapping ankle &/foot,,,25.82,175.62,71
CPT,29550,HC STRAPPING OF TOES,643.27,482.45,7.72,578.94,119
CPT,29550,Strapping of toes,,,16.41,180.84,71
CPT,29580,HC PT UNNA BOOT STRAPPING BILATERAL,820.34,615.26,9.84,738.31,119
CPT,29580,HC PT UNNABOOT STRAPPING UNILATERAL,226.39,169.79,2.72,203.75,119
CPT,29580,HC STRAPPING; UNNA BOOT,154.4,115.8,1.85,138.96,119
CPT,29580,Strapping unna boot,,,38.57,176.67,71
CPT,29581,Appl multlayer cmprn sys leg,,,39.41,242.97,71
CPT,29581,HC COMPRESSION WRAP LWR LEG BILATERAL,847.07,635.3,10.16,762.36,119
CPT,29581,HC COMPRESSION WRAP LWR LEG UNILATERAL,425.9,319.42,5.11,383.31,119
CPT,29584,Appl mltlay cmprn sys up arm,,,23.42,220.68,71
CPT,29584,HC APPL MULTLAY COMPRS ARM/HAND BIL,828.65,621.49,9.94,745.78,238
CPT,29584,HC PT APPLY MULTLAY COMPRS UPR ARM FOREARM HAND AND FINGERS,828.65,621.49,9.94,745.78,119
CPT,29700,Rmvl/bivlv gauntlet boot/cst,,,31.97,295.59,71
CPT,29705,Rmvl/bivlv full arm/leg cast,,,65.09,295.59,71
CPT,29710,Rmvl/bivlv sho/hip spica,,,119.52,358.55,71
CPT,29720,Repair spica body cst/jacket,,,42.21,257.45,71
CPT,29730,Windowing of cast,,,43.05,186.23,71
CPT,29740,Wedging of cast,,,66.68,295.59,71
CPT,29750,Wedging of clubfoot cast,,,111.75,310.43,71
CPT,29799,HC OT CAST CONSTRAINT INDUCED,203.74,152.8,2.44,183.37,119
CPT,29799,HC OT CAST SERIAL 1 JOINTS,223.08,167.31,2.68,200.77,119
CPT,29799,HC OT CAST SERIAL 2 JOINTS,377.1,282.82,4.53,339.39,119
CPT,29799,HC PT CAST SERIAL 1 JOINT,223.08,167.31,2.68,200.77,119
CPT,29799,HC PT CAST SERIAL 2 JOINTS,301.67,226.25,3.62,271.5,119
CPT,29799,HC PT STRAPPING LOW BACK,258.33,193.75,3.1,232.5,119
CPT,29799,Unlisted px casting/strpg,,,151.27,175.62,19
CPT,29800,Jaw arthroscopy/surgery,,,356.54,4266.34,107
CPT,29804,Jaw arthroscopy/surgery,,,92.64,4266.34,143
CPT,29805,Sho arthrs dx +- synovial bx,,,315.6,4266.34,107
CPT,29806,Sho arthrs srg capsulorraphy,,,709.02,9729.0,120
CPT,29807,Sho arthrs srg rpr slap les,,,693.59,9729.0,120
CPT,29819,Sho arthrs srg rmvl loose/fb,,,394.56,9729.0,120
CPT,29820,Sho arthrs srg prtl synvct,,,83.23,9729.0,156
CPT,29821,Sho arthrs srg compl synvct,,,92.58,4266.34,143
CPT,29822,Sho arthrs srg lmtd dbrdmt,,,84.36,9729.0,156
CPT,29823,Sho arthrs srg xtnsv dbrdmt,,,92.46,9729.0,156
CPT,29824,Sho arthrs srg dstl claviclc,,,105.55,9729.0,156
CPT,29825,Sho arthrs srg lss&rescj ads,,,91.49,9729.0,156
CPT,29826,Sho arthrs srg decompression,,,26.67,9729.0,101
CPT,29827,Sho arthrs srg rt8tr cuf rpr,,,166.17,15125.0,156
CPT,29828,Sho arthrs srg bicp tenodsis,,,142.47,9254.47,143
CPT,29830,Elbow arthroscopy,,,305.78,4266.34,107
CPT,29834,Elbow arthroscopy/surgery,,,76.88,4266.34,143
CPT,29835,Elbow arthroscopy/surgery,,,79.49,4266.34,143
CPT,29836,Elbow arthroscopy/surgery,,,91.32,9254.47,143
CPT,29837,Elbow arthroscopy/surgery,,,82.36,4266.34,143
CPT,29838,Elbow arthroscopy/surgery,,,399.9,4266.34,107
CPT,29840,Wrist arthroscopy,,,304.35,4266.34,107
CPT,29843,Wrist arthroscopy/surgery,,,75.96,4266.34,143
CPT,29844,Wrist arthroscopy/surgery,,,78.13,4266.34,143
CPT,29845,Wrist arthroscopy/surgery,,,91.56,4266.34,143
CPT,29846,Wrist arthroscopy/surgery,,,352.41,4266.34,107
CPT,29847,Wrist arthroscopy/surgery,,,84.96,9254.47,143
CPT,29848,Wrist endoscopy/surgery,,,344.53,2387.17,107
CPT,29850,Knee arthroscopy/surgery,,,377.06,2387.17,143
CPT,29851,Knee arthroscopy/surgery,,,144.57,2688.17,179
CPT,29855,Tibial arthroscopy/surgery,,,121.56,12137.01,179
CPT,29856,Tibial arthroscopy/surgery,,,154.3,24411.94,179
CPT,29860,Hip arthroscopy dx,,,100.43,9254.47,143
CPT,29861,Hip arthro w/fb removal,,,110.81,9254.47,143
CPT,29862,Hip arthr0 w/debridement,,,126.38,9254.47,143
CPT,29863,Hip arthr0 w/synovectomy,,,126.18,4266.34,143
CPT,29866,Autgrft implnt knee w/scope,,,705.17,9254.47,107
CPT,29867,Allgrft implnt knee w/scope,,,856.03,21699.51,107
CPT,29868,Meniscal trnspl knee w/scpe,,,1116.19,9254.47,107
CPT,29870,Arthrs knee dx w/wo syn bx,,,273.5,4266.34,107
CPT,29871,Arthrs knee surg for infctj,,,346.81,4266.34,107
CPT,29873,Arthrs knee surg w/lat rls,,,360.05,4266.34,107
CPT,29874,Arthrs knee surg rmv loos/fb,,,360.38,4266.34,107
CPT,29875,Arthrs knee surg synvct lmtd,,,333.93,4266.34,107
CPT,29876,Arthrs knee surg synvct maj,,,438.34,4266.34,107
CPT,29877,Arthrs knee surg dbrdmt/shvg,,,417.36,6225.0,120
CPT,29879,Arthrs kne srg abrasj arthrp,,,444.34,4266.34,107
CPT,29880,Arthrs kne srg mnisectmy m&l,,,377.93,6225.0,120
CPT,29881,Arthrs kne srg mnisectmy m/l,,,363.8,6225.0,120
CPT,29882,Arthrs kne srg mnisc rpr m/l,,,463.25,6225.0,120
CPT,29883,Arthrs kne srg mnisc rpr m&l,,,566.1,4266.34,107
CPT,29884,Arthrs knee surg lysis ads,,,96.52,4266.34,143
CPT,29885,Arthrs kne srg drlg ost diss,,,117.74,12137.01,143
CPT,29886,Arthrs knee surg drlg od les,,,427.97,4266.34,107
CPT,29887,Arthrs knee srg drlg od fixj,,,117.27,12964.53,143
CPT,29888,Arthrs aid acl rpr/agmntj,,,151.65,19288.0,156
CPT,29889,Arthrs aid pcl rpr/agmntj,,,190.14,24411.94,143
CPT,29891,Arthr ank ostchn df tal&/tib,,,104.34,4266.34,143
CPT,29892,Arthrs aid rpr od les/tib fx,,,100.2,9254.47,143
CPT,29893,Endoscopic plantr fasciotomy,,,291.44,4266.34,107
CPT,29894,Ankle arthroscopy/surgery,,,77.38,4266.34,143
CPT,29895,Ankle arthroscopy/surgery,,,72.37,4266.34,143
CPT,29897,Ankle arthroscopy/surgery,,,77.67,4266.34,143
CPT,29898,Ankle arthroscopy/surgery,,,87.49,4266.34,143
CPT,29899,Ankle arthroscopy/surgery,,,156.52,12412.85,143
CPT,29900,Mcp joint arthroscopy dx,,,339.1,4266.34,107
CPT,29901,Mcp joint arthroscopy surg,,,363.75,4266.34,107
CPT,29902,Mcp joint arthroscopy surg,,,385.77,2387.17,107
CPT,29904,Subtalar arthro w/fb rmvl,,,99.64,4266.34,143
CPT,29905,Subtalar arthro w/exc,,,80.11,9254.47,143
CPT,29906,Subtalar arthro w/deb,,,100.23,4266.34,143
CPT,29907,Subtalar arthro w/fusion,,,136.47,24411.94,143
CPT,29914,Hip arthro w/femoroplasty,,,154.59,9254.47,143
CPT,29915,Hip arthro acetabuloplasty,,,158.15,9254.47,143
CPT,29916,Hip arthro w/labral repair,,,158.3,9254.47,143
CPT,29999,Unlisted px arthroscopy,,,229.97,266.99,19
CPT,30000,Drainage of nose lesion,,,94.23,734.04,71
CPT,30000,HC DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,643.27,482.45,7.72,578.94,119
CPT,30020,Drainage of nose lesion,,,94.98,734.99,71
CPT,30020,HC DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,726.31,544.73,8.72,653.68,119
CPT,30100,Intranasal biopsy,,,65.5,1648.68,71
CPT,30110,Removal of nose polyp(s),,,102.9,1648.68,107
CPT,30115,Removal of nose polyp(s),,,346.09,3825.0,107
CPT,30117,Removal of intranasal lesion,,,245.17,3825.0,71
CPT,30118,Removal of intranasal lesion,,,589.8,3825.0,71
CPT,30120,Revision of nose,,,309.3,3825.0,71
CPT,30124,Removal of nose lesion,,,225.05,1850.43,71
CPT,30125,Removal of nose lesion,,,102.39,7571.84,107
CPT,30130,Excise inferior turbinate,,,308.01,3825.0,107
CPT,30140,Resect inferior turbinate,,,260.36,3825.0,71
CPT,30150,Rhinectomy partial,,,596.58,7571.84,71
CPT,30160,Rhinectomy total,,,127.46,7571.84,107
CPT,30200,Injection treatment of nose,,,57.58,566.8,71
CPT,30210,Nasal sinus therapy,,,79.81,1648.68,71
CPT,30220,Insert nasal septal button,,,99.22,1850.43,71
CPT,30300,HC REM FOREIGN BODY INTRANASAL,643.27,482.45,7.72,578.94,119
CPT,30300,Remove nasal foreign body,,,96.05,1867.19,71
CPT,30310,Remove nasal foreign body,,,161.74,3825.0,71
CPT,30320,Remove nasal foreign body,,,361.71,1850.43,71
CPT,30400,Reconstruction of nose,,,906.69,7571.84,71
CPT,30410,Reconstruction of nose,,,219.82,9815.35,107
CPT,30420,Reconstruction of nose,,,1077.66,7571.84,71
CPT,30430,Revision of nose,,,166.74,7571.84,107
CPT,30435,Revision of nose,,,208.09,7571.84,107
CPT,30450,Revision of nose,,,272.21,7571.84,107
CPT,30460,Revision of nose,,,129.14,7571.84,143
CPT,30462,Revision of nose,,,248.28,7571.84,143
CPT,30465,Repair nasal stenosis,,,762.45,7571.84,71
CPT,30468,Rpr nsl vlv collapse w/implt,,,246.99,10656.66,71
CPT,30469,Rpr nsl vlv collapse w/rmdlg,,,145.98,10376.22,71
CPT,30520,Repair of nasal septum,,,499.73,3825.0,71
CPT,30540,Rpr choanal atresia ntranasl,,,115.47,7571.84,107
CPT,30545,Rpr choanal atresia trsnpltn,,,156.84,7571.84,107
CPT,30560,Lysis intranasal synechia,,,116.54,896.48,71
CPT,30580,Repair upper jaw fistula,,,340.15,7571.84,71
CPT,30600,Repair mouth/nose fistula,,,284.13,7571.84,71
CPT,30620,Intranasal reconstruction,,,500.2,7571.84,71
CPT,30630,Repair nasal septum defect,,,498.02,3825.0,71
CPT,30801,Ablate inf turbinate superf,,,117.98,1850.43,71
CPT,30802,Ablate inf turbinate submuc,,,157.83,1850.43,71
CPT,30901,Control of nosebleed,,,83.1,1412.26,71
CPT,30901,HC CONTROL NASAL HEMORRHAGE,417.76,313.32,5.01,375.98,119
CPT,30903,Control of nosebleed,,,113.72,671.27,71
CPT,30903,"HC CONTROL NASAL HEMORRHAGE, ANTERIOR, COMPLEX",643.27,482.45,7.72,578.94,119
CPT,30905,Control of nosebleed,,,103.38,961.6,71
CPT,30905,HC CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,1701.62,1276.21,20.42,1531.46,119
CPT,30906,HC CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,643.27,482.45,7.72,578.94,119
CPT,30906,Repeat control of nosebleed,,,129.94,1048.99,71
CPT,30915,Ligation nasal sinus artery,,,448.23,4266.34,71
CPT,30920,Ligation upper jaw artery,,,648.81,4266.34,71
CPT,30930,Ther fx nasal inf turbinate,,,91.43,3825.0,71
CPT,30999,Unlisted procedure nose,,,222.62,258.46,19
CPT,31000,Irrigation maxillary sinus,,,85.46,516.11,107
CPT,31002,Irrigation sphenoid sinus,,,148.66,1850.43,107
CPT,31020,Exploration maxillary sinus,,,260.7,3825.0,107
CPT,31030,Exploration maxillary sinus,,,377.43,7571.84,107
CPT,31032,Explore sinus remove polyps,,,441.1,7571.84,107
CPT,31040,Exploration behind upper jaw,,,597.63,7571.84,107
CPT,31050,Exploration sphenoid sinus,,,383.24,7571.84,107
CPT,31051,Sphenoid sinus surgery,,,514.69,7571.84,107
CPT,31070,Exploration of frontal sinus,,,352.71,7571.84,107
CPT,31075,Exploration of frontal sinus,,,129.34,7571.84,143
CPT,31080,Removal of frontal sinus,,,170.3,7571.84,143
CPT,31081,Removal of frontal sinus,,,182.56,7571.84,143
CPT,31084,Removal of frontal sinus,,,188.91,9534.91,143
CPT,31085,Removal of frontal sinus,,,194.92,9815.35,143
CPT,31086,Removal of frontal sinus,,,184.03,7571.84,143
CPT,31087,Removal of frontal sinus,,,175.31,10656.66,143
CPT,31090,Exploration of sinuses,,,820.1,7571.84,107
CPT,31200,Removal of ethmoid sinus,,,458.17,7571.84,107
CPT,31201,Removal of ethmoid sinus,,,589.59,2198.22,107
CPT,31205,Removal of ethmoid sinus,,,145.52,3825.0,143
CPT,31225,Removal of upper jaw,,,281.09,16648.46,143
CPT,31230,Removal of upper jaw,,,313.77,18588.77,143
CPT,31231,Nasal endoscopy dx,,,62.97,528.28,71
CPT,31233,Nsl/sins ndsc dx max sinusc,,,196.49,756.04,71
CPT,31235,Nsl/sins ndsc dx sphn sinusc,,,231.51,2310.17,71
CPT,31237,Nsl/sins ndsc surg bx polypc,,,232.68,2310.17,71
CPT,31238,Nsl/sins ndsc srg nsl hemrrg,,,243.06,2310.17,71
CPT,31239,Nsl/sinus endoscopy surg dcr,,,470.42,4413.46,107
CPT,31240,Nsl/sns ndsc cnch bull rescj,,,231.32,2310.17,71
CPT,31241,Nsl/sns ndsc lig sphnptn art,,,648.38,2310.17,71
CPT,31242,Nsl/sinus ndsc rf abltj pnn,,,5494.86,10656.66,35
CPT,31243,Nsl/sinus ndsc cryoabltj pnn,,,5335.99,10376.22,35
CPT,31253,Nsl/sins ndsc total,,,729.81,7704.73,71
CPT,31254,Nsl/sins ndsc w/prtl ethmdct,,,354.54,7704.73,71
CPT,31255,Nsl/sins ndsc w/tot ethmdct,,,471.9,7704.73,71
CPT,31256,Exploration maxillary sinus,,,262.62,4413.46,71
CPT,31257,Nsl/sins ndsc tot w/sphendt,,,650.25,7704.73,71
CPT,31259,Nsl/sins ndsc sphn tiss rmvl,,,688.1,7704.73,71
CPT,31267,Endoscopy maxillary sinus,,,386.94,7704.73,71
CPT,31276,Nsl/sins ndsc frnt tiss rmvl,,,551.0,7704.73,71
CPT,31287,Nasal/sinus endoscopy surg,,,294.03,7704.73,71
CPT,31288,Nasal/sinus endoscopy surg,,,341.67,7704.73,71
CPT,31290,Nasal/sinus endoscopy surg,,,892.8,15039.8,107
CPT,31291,Nasal/sinus endoscopy surg,,,948.79,15039.8,107
CPT,31292,Nsl/sins ndsc med/inf dcmprn,,,775.65,7704.73,107
CPT,31293,Nsl/sins ndsc med&inf dcmprn,,,839.54,7704.73,107
CPT,31294,Nsl/sins ndsc surg on dcmprn,,,959.3,7704.73,107
CPT,31295,Nsl/sins ndsc surg max sins,,,24.51,7704.73,107
CPT,31296,Nsl/sins ndsc surg frnt sins,,,27.91,7704.73,107
CPT,31297,Nsl/sins ndsc surg sphn sins,,,209.55,7704.73,71
CPT,31298,Nsl/sins ndsc surg frnt&sphn,,,373.58,8118.59,71
CPT,31299,Unlisted px accessory sinus,,,222.62,258.46,19
CPT,31300,Removal of larynx lesion,,,194.81,3825.0,107
CPT,31360,Removal of larynx,,,320.15,18970.96,107
CPT,31365,Removal of larynx,,,395.5,23460.64,107
CPT,31367,Partial removal of larynx,,,338.63,20037.89,107
CPT,31368,Partial removal of larynx,,,374.5,22143.18,107
CPT,31370,Partial removal of larynx,,,317.63,18772.67,107
CPT,31375,Partial removal of larynx,,,301.89,17851.5,107
CPT,31380,Partial removal of larynx,,,297.64,17599.99,107
CPT,31382,Partial removal of larynx,,,326.02,19275.69,107
CPT,31390,Removal of larynx & pharynx,,,436.35,25811.52,107
CPT,31395,Reconstruct larynx & pharynx,,,457.84,27037.52,107
CPT,31400,Revision of larynx,,,157.39,7571.84,107
CPT,31420,Epiglottidectomy,,,129.82,7571.84,107
CPT,31500,HC FIBROSCOPY INTUBATION ASSIST,752.61,564.46,9.03,677.35,119
CPT,31500,HC INTUBATION ET EMERGENT,599.36,449.52,7.19,539.42,119
CPT,31500,Insert emergency airway,,,137.49,441.34,71
CPT,31502,Change of windpipe airway,,,34.06,441.34,71
CPT,31502,HC TRACH TUBE CHANGE - SCOOP,1701.62,1276.21,20.42,1531.46,119
CPT,31505,Diagnostic laryngoscopy,,,47.49,245.76,71
CPT,31505,HC LARYNGOSCOPY INDIRECT DIAGNOSTIC (MIRROR),436.75,327.56,5.24,393.08,119
CPT,31510,Laryngoscopy with biopsy,,,117.54,4413.46,71
CPT,31511,Remove foreign body larynx,,,130.0,588.33,71
CPT,31512,Removal of larynx lesion,,,125.4,4413.46,71
CPT,31513,Injection into vocal cord,,,126.73,655.12,71
CPT,31515,Laryngoscopy for aspiration,,,108.18,655.12,71
CPT,31520,Dx laryngoscopy newborn,,,151.28,655.12,71
CPT,31525,Dx laryngoscopy excl nb,,,154.57,2310.17,71
CPT,31526,Dx laryngoscopy w/oper scope,,,151.91,2310.17,71
CPT,31527,Laryngoscopy for treatment,,,188.94,4413.46,71
CPT,31528,Laryngoscopy and dilation,,,139.84,4413.46,71
CPT,31529,Laryngoscopy and dilation,,,155.64,4413.46,71
CPT,31530,HC LARYNGOSCOPY W/FOREIGN BODY REMOVAL,125.29,93.97,1.5,112.76,119
CPT,31530,Laryngoscopy w/fb removal,,,192.87,2310.17,71
CPT,31531,Laryngoscopy w/fb & op scope,,,205.3,4413.46,71
CPT,31535,Laryngoscopy w/biopsy,,,182.74,4413.46,71
CPT,31536,Laryngoscopy w/bx & op scope,,,203.97,4413.46,71
CPT,31540,Laryngoscopy w/exc of tumor,,,234.1,4413.46,71
CPT,31541,Larynscop w/tumr exc + scope,,,255.38,4413.46,71
CPT,31545,Remove vc lesion w/scope,,,525.5,4413.46,71
CPT,31546,Remove vc lesion scope/graft,,,796.76,7704.73,71
CPT,31551,Laryngoplasty laryngeal sten,,,1142.52,7571.84,71
CPT,31552,Laryngoplasty laryngeal sten,,,1103.15,7571.84,71
CPT,31553,Laryngoplasty laryngeal sten,,,1244.48,7571.84,71
CPT,31554,Laryngoplasty laryngeal sten,,,1245.19,7571.84,71
CPT,31560,Laryngoscop w/arytenoidectom,,,302.63,7704.73,71
CPT,31561,Larynscop remve cart + scop,,,330.82,7704.73,71
CPT,31570,Laryngoscope w/vc inj,,,221.84,4413.46,71
CPT,31571,Laryngoscop w/vc inj + scope,,,240.73,4413.46,71
CPT,31572,Largsc w/laser dstrj les,,,262.76,4413.46,71
CPT,31573,Largsc w/ther injection,,,216.57,1919.35,71
CPT,31574,Largsc w/njx augmentation,,,217.05,2476.6,71
CPT,31575,Diagnostic laryngoscopy,,,65.77,356.88,71
CPT,31575,HC ST LARYNGOSCOPY FLEX FIBEROPTIC DIAGNOSTIC,1106.34,829.76,13.28,995.71,119
CPT,31576,Laryngoscopy with biopsy,,,115.29,2310.17,71
CPT,31577,HC LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),125.29,93.97,1.5,112.76,119
CPT,31577,Largsc w/rmvl foreign bdy(s),,,129.99,754.26,71
CPT,31578,Largsc w/removal lesion,,,144.7,4413.46,71
CPT,31579,HC ST VIDEOSTROBOSCOPY,1105.37,829.03,13.26,994.83,119
CPT,31579,Laryngoscopy telescopic,,,115.91,551.7,71
CPT,31580,Laryngoplasty laryngeal web,,,948.21,7571.84,71
CPT,31584,Laryngoplasty fx rdctj fixj,,,1045.08,7571.84,71
CPT,31587,Laryngoplasty cricoid split,,,892.84,7571.84,71
CPT,31590,Reinnervate larynx,,,143.05,7571.84,107
CPT,31591,Laryngoplasty medialization,,,814.32,7571.84,107
CPT,31592,Cricotracheal resection,,,1284.3,7571.84,71
CPT,31599,Unlisted procedure larynx,,,222.62,258.46,19
CPT,31600,Planned tracheostomy,,,296.05,3825.0,71
CPT,31601,Planned tracheostomy<2 yrs,,,69.96,7571.84,71
CPT,31603,Emer tracheostomy ttrach,,,311.19,1850.43,71
CPT,31605,Emer tracheostomy cthyr mem,,,222.62,945.91,71
CPT,31610,Tracheostomy fenest skin flp,,,708.53,7571.84,71
CPT,31611,Constj trachesophgl fstl,,,83.31,3825.0,107
CPT,31612,Perq trchl pnxr ttrach aspir,,,47.43,3825.0,71
CPT,31613,Tracheostoma revj simple,,,313.26,3825.0,71
CPT,31614,Tracheostoma revj complex,,,527.88,7571.84,71
CPT,31615,Trcheobrnchsc est trachs inc,,,111.42,896.48,71
CPT,31622,Dx bronchoscope/wash,,,126.56,2310.17,71
CPT,31622,HC BRONCH DIAGNOSTIC,125.29,93.97,1.5,112.76,119
CPT,31622,HC BRONCH DIAGNOSTIC ADDTL PROCEDURE,1701.62,1276.21,20.42,1531.46,119
CPT,31623,Dx bronchoscope/brush,,,126.64,2310.17,71
CPT,31624,Dx bronchoscope/lavage,,,128.77,2310.17,71
CPT,31625,Bronchoscopy w/biopsy(s),,,149.66,2310.17,71
CPT,31626,Bronchoscopy w/markers,,,188.7,7704.73,71
CPT,31627,HC BRONCHOSCOPY W/FLUORO & 3D NAVIGATION,4283.85,3212.89,51.41,3855.47,119
CPT,31627,Navigational bronchoscopy,,,92.46,9036.72,52
CPT,31628,Bronchoscopy/lung bx each,,,168.95,4413.46,71
CPT,31629,Bronchoscopy/needle bx each,,,179.07,4413.46,71
CPT,31630,Bronchoscopy dilate/fx repr,,,190.6,4413.46,71
CPT,31631,Bronchoscopy dilate w/stent,,,217.55,7704.73,71
CPT,31632,Bronchoscopy/lung bx addl,,,47.56,592.99,52
CPT,31633,Bronchoscopy/needle bx addl,,,60.49,744.86,52
CPT,31634,Bronch w/balloon occlusion,,,29.05,7704.73,71
CPT,31635,Bronchoscopy w/fb removal,,,167.87,2310.17,71
CPT,31635,HC BRONCHOSCOPY W/FB REMOVAL,1701.62,1276.21,20.42,1531.46,119
CPT,31635,HC NJH BRONCH W/FOREIG BODY REM ADDTL PROCEDURE,3735.2,2801.4,44.82,3361.68,119
CPT,31636,Bronchoscopy bronch stents,,,207.88,8693.6,71
CPT,31637,Bronchoscopy stent add-on,,,74.21,696.87,52
CPT,31638,Bronchoscopy revise stent,,,237.43,7704.73,71
CPT,31640,Bronchoscopy w/tumor excise,,,238.81,4413.46,71
CPT,31641,Bronchoscopy treat blockage,,,244.64,4413.46,71
CPT,31643,Diag bronchoscope/catheter,,,163.21,2310.17,71
CPT,31645,Brnchsc w/ther aspir 1st,,,140.97,2310.17,71
CPT,31646,Brnchsc w/ther aspir sbsq,,,136.03,655.12,71
CPT,31647,Bronchial valve init insert,,,197.29,7704.73,71
CPT,31648,Bronchial valve remov init,,,188.95,4413.46,71
CPT,31649,Bronchial valve remov addl,,,64.57,2310.17,71
CPT,31651,Bronchial valve addl insert,,,73.9,693.91,52
CPT,31652,Bronch ebus samplng 1/2 node,,,212.09,4413.46,71
CPT,31652,HC BRONCH INCL FLUOR GUIDE; EBUS SAMPLING 1/2 NODES,14139.44,10604.58,169.67,12725.5,119
CPT,31653,Bronch ebus samplng 3/> node,,,235.2,4413.46,71
CPT,31653,HC BRONCH INCL FLUOR GUIDE; EBUS SAMPLING 3 OR MORE NODES,15775.67,11831.75,189.31,14198.1,119
CPT,31654,Bronch ebus ivntj perph les,,,64.14,1091.57,52
CPT,31660,Bronch thermoplsty 1 lobe,,,190.35,10095.79,70
CPT,31661,Bronch thermoplsty 2/> lobes,,,193.21,8413.15,70
CPT,31717,Bronchial brush biopsy,,,102.53,781.33,71
CPT,31720,Clearance of airways,,,47.37,495.43,71
CPT,31720,HC NASOTRACH CATH ASPIRATION,129.93,97.45,1.56,116.94,119
CPT,31725,Clearance of airways,,,76.21,15039.8,71
CPT,31730,HC TRANSTRACHEAL STENT INSERTION,7472.7,5604.52,89.67,6725.43,119
CPT,31730,Intro windpipe wire/tube,,,144.0,2820.87,71
CPT,31750,Tracheoplasty cervical,,,210.44,7571.84,107
CPT,31755,Trachplsty trchphryngl fstlj,,,268.4,7571.84,107
CPT,31760,Tracheoplasty intrathoracic,,,211.14,15039.8,107
CPT,31766,Carinal reconstruction,,,272.27,16310.62,107
CPT,31770,Repair/graft of bronchus,,,203.78,15039.8,107
CPT,31775,Reconstruct bronchus,,,214.56,15039.8,107
CPT,31780,Reconstruct windpipe,,,187.12,15039.8,107
CPT,31781,Reconstruct windpipe,,,224.59,15039.8,107
CPT,31785,Remove windpipe lesion,,,167.81,7571.84,107
CPT,31786,Remove windpipe lesion,,,221.11,15039.8,107
CPT,31800,Repair of windpipe injury,,,523.87,15039.8,71
CPT,31805,Repair of windpipe injury,,,125.72,15039.8,107
CPT,31820,Closure of windpipe lesion,,,245.74,3825.0,71
CPT,31825,Repair of windpipe defect,,,360.23,3825.0,71
CPT,31830,Revise windpipe scar,,,272.25,3825.0,71
CPT,31899,HC NBAL,1216.43,912.32,14.6,1094.79,119
CPT,31899,Unlisted px trachea bronchi,,,186.11,216.08,19
CPT,32035,Thoracostomy w/rib resection,,,112.88,15039.8,143
CPT,32036,Thoracostomy w/flap drainage,,,121.76,15039.8,143
CPT,32096,Open wedge/bx lung infiltr,,,122.73,15039.8,107
CPT,32097,Open wedge/bx lung nodule,,,123.04,15039.8,107
CPT,32098,Open biopsy of lung pleura,,,116.73,15039.8,107
CPT,32100,Exploration of chest,,,124.25,15039.8,107
CPT,32110,Explore/repair chest,,,226.28,15039.8,107
CPT,32120,Re-exploration of chest,,,133.98,15039.8,107
CPT,32124,Explore chest free adhesions,,,141.68,15039.8,107
CPT,32140,Removal of lung lesion(s),,,152.02,15039.8,107
CPT,32141,Remove/treat lung lesions,,,233.71,15039.8,107
CPT,32150,Removal of lung lesion(s),,,155.36,15039.8,107
CPT,32151,Remove lung foreign body,,,154.27,15039.8,107
CPT,32160,Open chest heart massage,,,122.69,15039.8,107
CPT,32200,Drain open lung lesion,,,174.95,15039.8,107
CPT,32215,Treat chest lining,,,123.29,15039.8,143
CPT,32220,Release of lung,,,245.18,15039.8,143
CPT,32225,Partial release of lung,,,153.12,15039.8,143
CPT,32310,Removal of chest lining,,,141.09,15039.8,107
CPT,32320,Free/remove chest lining,,,246.52,15039.8,107
CPT,32400,HC BX PLEURA PERCUT NEEDLE,1731.07,1298.3,20.77,1557.96,119
CPT,32400,Needle biopsy chest lining,,,81.86,2091.8,71
CPT,32408,Core ndl bx lng/med perq,,,147.62,2264.52,71
CPT,32408,HC CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,1845.85,1384.39,22.15,1661.26,119
CPT,32440,Remove lung pneumonectomy,,,240.45,15039.8,107
CPT,32442,Sleeve pneumonectomy,,,467.72,27967.17,107
CPT,32445,Removal of lung extrapleural,,,540.53,32361.26,107
CPT,32480,Partial removal of lung,,,226.94,15039.8,107
CPT,32482,Bilobectomy,,,242.47,15039.8,107
CPT,32484,Segmentectomy,,,219.81,15039.8,107
CPT,32486,Sleeve lobectomy,,,358.66,21454.99,107
CPT,32488,Completion pneumonectomy,,,366.33,21939.08,107
CPT,32491,Lung volume reduction,,,225.87,15039.8,143
CPT,32501,Repair bronchus add-on,,,37.2,15039.8,71
CPT,32503,Resect apical lung tumor,,,275.15,16484.66,107
CPT,32504,Resect apical lung tum/chest,,,313.3,18763.21,107
CPT,32505,Wedge resect of lung initial,,,143.0,15039.8,107
CPT,32506,Wedge resect of lung add-on,,,23.96,15039.8,71
CPT,32507,Wedge resect of lung diag,,,23.96,15039.8,71
CPT,32540,Removal of lung lesion,,,264.79,15872.35,107
CPT,32550,HC INSERT PLEURAL CATH W/CUFF,5739.84,4304.88,68.88,5165.86,119
CPT,32550,Insert pleural cath,,,196.99,5746.69,71
CPT,32551,HC TUBE THORACOSTOMY W/WATER,4475.12,3356.34,53.7,4027.61,119
CPT,32551,Insertion of chest tube,,,225.38,1850.43,71
CPT,32552,HC PLEURAL CATH W/CUFF REMOVAL,632.58,474.44,7.59,569.32,119
CPT,32552,Remove lung catheter,,,120.96,1034.41,71
CPT,32553,Ins mark thor for rt perq,,,27.16,2172.25,71
CPT,32554,Aspirate pleura w/o imaging,,,128.61,1034.41,71
CPT,32554,HC THORACENTES/ASPIRTN W/O IMAGING BILATERAL,3005.58,2254.18,36.07,2705.02,119
CPT,32554,HC THORACENTESIS/ASPIRATION W/O IMAGING UNILATERAL,1502.79,1127.09,18.03,1352.51,119
CPT,32554,PBB THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,1781.07,1335.8,21.37,1602.96,119
CPT,32555,Aspirate pleura w/ imaging,,,159.02,1034.41,71
CPT,32555,HC THORACENTES/ASPIRTN W/O IMAGING BILAT,1337.72,1003.29,16.05,1203.95,119
CPT,32555,HC THORACENTESIS/ASPIRATION WITH IMAGING BILATERAL,5058.56,3793.92,60.7,4552.7,119
CPT,32555,HC THORACENTESIS/ASPIRATION WITH IMAGING UNILATERAL,2529.28,1896.96,30.35,2276.35,119
CPT,32556,HC PLEURAL DRAIN W CATHETER W/O IMAGING BILATERAL,8217.76,6163.32,98.61,7395.98,119
CPT,32556,HC PLEURAL DRAINAGE W CATHETER W/O IMAGING UNILATERAL,4108.88,3081.66,49.31,3697.99,119
CPT,32556,Insert cath pleura w/o image,,,180.12,2464.18,71
CPT,32557,HC PLEURAL DRAINAGE W CATHETER W IMAGING BILATERAL,8347.27,6260.45,100.17,7512.54,119
CPT,32557,HC PLEURAL DRAINAGE W CATHETER W IMAGING UNILATERAL,4173.63,3130.22,50.08,3756.27,119
CPT,32557,Insert cath pleura w/ image,,,216.98,1850.43,71
CPT,32560,Treat pleurodesis w/agent,,,73.36,1034.41,71
CPT,32561,Lyse chest fibrin init day,,,10.49,1034.41,71
CPT,32562,Lyse chest fibrin subq day,,,9.34,1034.41,71
CPT,32601,Thoracoscopy diagnostic,,,294.8,7571.84,71
CPT,32604,Thoracoscopy wbx sac,,,458.22,12412.85,71
CPT,32606,Thoracoscopy w/bx med space,,,441.47,7571.84,71
CPT,32607,Thoracoscopy w/bx infiltrate,,,294.78,12412.85,71
CPT,32608,Thoracoscopy w/bx nodule,,,362.12,12412.85,71
CPT,32609,Thoracoscopy w/bx pleura,,,245.14,7571.84,71
CPT,32650,Thoracoscopy w/pleurodesis,,,102.53,15039.8,143
CPT,32651,Thoracoscopy remove cortex,,,167.97,15039.8,143
CPT,32652,Thoracoscopy rem totl cortex,,,254.96,15278.57,143
CPT,32653,Thoracoscopy remov fb/fibrin,,,162.49,15039.8,107
CPT,32654,Thoracoscopy contrl bleeding,,,180.83,15039.8,143
CPT,32655,Thoracoscopy resect bullae,,,146.94,15039.8,143
CPT,32656,Thoracoscopy w/pleurectomy,,,123.41,15039.8,143
CPT,32658,Thoracoscopy w/sac fb remove,,,109.8,15039.8,107
CPT,32659,Thoracoscopy w/sac drainage,,,112.65,15039.8,107
CPT,32661,Thoracoscopy w/pericard exc,,,122.62,15039.8,107
CPT,32662,Thoracoscopy w/mediast exc,,,137.18,15039.8,107
CPT,32663,Thoracoscopy w/lobectomy,,,214.39,15039.8,107
CPT,32664,Thoracoscopy w/ th nrv exc,,,130.16,15039.8,143
CPT,32665,Thoracoscop w/esoph musc exc,,,188.87,15039.8,107
CPT,32666,Thoracoscopy w/wedge resect,,,133.5,15039.8,143
CPT,32667,Thoracoscopy w/w resect addl,,,23.96,15039.8,71
CPT,32668,Thoracoscopy w/w resect diag,,,23.96,15039.8,71
CPT,32669,Thoracoscopy remove segment,,,205.74,15039.8,107
CPT,32670,Thoracoscopy bilobectomy,,,245.97,15039.8,107
CPT,32671,Thoracoscopy pneumonectomy,,,271.69,16262.43,107
CPT,32672,Thoracoscopy for lvrs,,,232.07,15039.8,107
CPT,32673,Thoracoscopy w/thymus resect,,,186.29,15039.8,107
CPT,32674,Thoracoscopy lymph node exc,,,32.81,15039.8,71
CPT,32701,Thorax stereo rad targetw/tx,,,202.75,1917.74,52
CPT,32800,Repair lung hernia,,,145.6,15039.8,107
CPT,32810,Close chest after drainage,,,138.36,15039.8,107
CPT,32815,Close bronchial fistula,,,430.28,25701.54,107
CPT,32820,Reconstruct injured chest,,,204.45,15039.8,107
CPT,32850,Donor pneumonectomy,,,12954.18,15039.8,19
CPT,32851,Lung transplant single,,,501.21,30047.82,143
CPT,32852,Lung transplant with bypass,,,541.7,32376.43,143
CPT,32853,Lung transplant double,,,700.07,42059.27,143
CPT,32854,Lung transplant with bypass,,,741.81,44469.08,143
CPT,32855,Prepare donor lung single,,,487.12,15039.8,35
CPT,32856,Prepare donor lung double,,,497.78,15039.8,35
CPT,32900,Removal of rib(s),,,219.54,15039.8,107
CPT,32905,Revise & repair chest wall,,,204.66,15039.8,107
CPT,32906,Revise & repair chest wall,,,252.52,15130.35,107
CPT,32940,Revision of lung,,,189.21,15039.8,107
CPT,32960,Therapeutic pneumothorax,,,88.36,1034.41,71
CPT,32994,Ablate pulm tumor perq crybl,,,67.59,17929.67,106
CPT,32994,HC LUNG ABLATION CRYO UNILATERAL INC IMAGE GUIDE,9591.08,7193.31,115.09,8631.97,119
CPT,32997,Total lung lavage,,,490.34,15039.8,71
CPT,32998,Ablate pulm tumor perq rf,,,67.77,8126.3,107
CPT,32998,HC ABLATE PULM TUMOR PERQ RF,14181.51,10636.13,170.18,12763.36,119
CPT,32998,HC CT LUNG RF ABLATION BILATERAL INC IMAGE GUIDE,28363.01,21272.26,340.36,25526.71,119
CPT,32998,HC CT LUNG RF ABLATION UNILATERAL INC IMAGE GUIDE,13094.65,9820.99,157.14,11785.18,119
CPT,32999,Unlisted px lungs & pleura,,,592.7,688.13,19
CPT,33016,HC PERICARDIOCENTESIS W/IMAGING,3041.84,2281.38,36.5,2737.66,119
CPT,33016,Pericardiocentesis w/imaging,,,224.35,1850.43,71
CPT,33017,HC PERICARDIOCENTESIS W/IMAGING & INDWELLING CATH,3188.5,2391.38,38.26,2869.65,238
CPT,33017,Prcrd drg 6yr+ w/o cgen car,,,235.49,15039.8,71
CPT,33018,HC PERICARD DRAINAGE W/IMAGE -5 W CONGENTIAL ISSUE,4164.81,3123.61,49.98,3748.33,119
CPT,33018,Prcrd drg 0-5yr or w/anomly,,,276.2,15039.8,71
CPT,33019,Perq prcrd drg insj cath ct,,,204.53,15039.8,71
CPT,33020,Incision of heart sac,,,126.73,15039.8,107
CPT,33025,Incision of heart sac,,,118.14,15039.8,107
CPT,33030,Partial removal of heart sac,,,306.02,18353.43,107
CPT,33031,Partial removal of heart sac,,,378.57,22657.04,107
CPT,33050,Resect heart sac lesion,,,154.33,15039.8,107
CPT,33120,Exc icar tum resc w/card byp,,,319.85,19160.77,107
CPT,33130,Rescj external cardiac tumor,,,209.13,15039.8,107
CPT,33140,Heart revascularize (tmr),,,238.15,15039.8,107
CPT,33141,Heart tmr w/other procedure,,,20.15,15039.8,71
CPT,33202,Insert epicard eltrd open,,,621.31,15039.8,71
CPT,33203,Insert epicard eltrd endo,,,651.45,15039.8,71
CPT,33206,HC ATRIAL PACER INSERT/REPLACE,24477.97,18358.48,293.74,22030.17,119
CPT,33206,Insert heart pm atrial,,,271.15,17929.67,107
CPT,33207,HC VENTRIC PERM PACER INSRT/REPLACE W ELECTRODE,26832.64,20124.48,321.99,24149.38,119
CPT,33207,Insert heart pm ventricular,,,285.01,17929.67,107
CPT,33208,HC INSRT NEW/REPLACE PERM AV PACEMKR W ELECTRODE,29267.89,21950.92,351.21,26341.1,119
CPT,33208,Insrt heart pm atrial & vent,,,308.87,17929.67,107
CPT,33210,HC TEMP SINGLE PACER INSERT/REPLACE,24729.11,18546.83,296.75,22256.2,119
CPT,33210,Insert electrd/pm cath sngl,,,155.06,10656.66,71
CPT,33211,Insert card electrodes dual,,,161.21,17929.67,71
CPT,33212,HC PACER GENERATOR CHANGE/SINGLE,4295.3,3221.48,51.54,3865.77,119
CPT,33212,Insert pulse gen sngl lead,,,259.27,16550.47,71
CPT,33213,HC PACER GENERATOR CHANGE/DUAL,34662.22,25996.66,415.95,31196.0,119
CPT,33213,Insert pulse gen dual leads,,,271.35,17929.67,71
CPT,33214,HC PACEMAKER UPGRADE SGL TO DUAL,36741.94,27556.46,440.9,33067.75,119
CPT,33214,Upgrade of pacemaker system,,,285.75,17929.67,107
CPT,33215,HC RA/RV LEAD REPOSITN PREV IMPLANT,8510.54,6382.9,102.13,7659.49,119
CPT,33215,Reposition pacing-defib lead,,,250.41,4266.34,71
CPT,33216,HC INSERT SINGLE PACING LEAD,24262.49,18196.87,291.15,21836.24,119
CPT,33216,Insert 1 electrode pm-defib,,,300.41,15171.26,71
CPT,33217,HC INSERT DUAL PACING LEADS,24581.35,18436.01,294.98,22123.22,119
CPT,33217,Insert 2 electrode pm-defib,,,297.46,16550.47,71
CPT,33218,HC REPAIR 1 PACE-DEFIB LEAD ONLY,10809.86,8107.4,129.72,9728.87,119
CPT,33218,Repair lead pace-defib one,,,315.01,5315.69,71
CPT,33220,HC REPAIR 2 PACE-DEFIB LEADS ONLY,8900.91,6675.68,106.81,8010.82,119
CPT,33220,Repair lead pace-defib dual,,,303.77,6896.03,71
CPT,33221,HC INSERT PULSE GEN MULT LEADS,57852.67,43389.5,694.23,52067.4,119
CPT,33221,Insert pulse gen mult leads,,,290.04,31193.03,71
CPT,33222,HC POCKET REVISN/RELOCTN-PACMAKER,5632.215,4224.16,63.0,5413.24,238
CPT,33222,Relocation pocket pacemaker,,,276.67,3080.23,71
CPT,33223,HC POCKET RELOCATION IMPLANTABLE  DEFIB,5577.06,4182.8,66.92,5019.35,119
CPT,33223,Relocate pocket for defib,,,330.59,3080.23,71
CPT,33224,HC LV LEAD INSERT PREV PM AND DEFIB,38496.68,28872.51,461.96,34647.01,119
CPT,33224,Insert pacing lead & connect,,,492.66,17929.67,71
CPT,33225,HC LEFT VENT LEAD INSERT OF IMPLANT DIFIB PMKR,7820.14,5865.1,93.84,7038.13,119
CPT,33225,L ventric pacing lead add-on,,,445.69,4209.2,52
CPT,33226,HC LEFT VENT LEAD REPOSITION,8896.87,6672.65,106.76,8007.18,119
CPT,33226,Reposition l ventric lead,,,469.04,5603.02,71
CPT,33227,HC REMOVE&REPLACE PM GEN SINGL,28353.39,21265.04,340.24,25518.05,238
CPT,33227,Remove&replace pm gen singl,,,273.67,16550.47,71
CPT,33228,HC REMV&REPLC PM GEN DUAL LEAD,33298.03,24973.52,399.58,29968.23,119
CPT,33228,Remv&replc pm gen dual lead,,,285.77,17929.67,71
CPT,33229,HC REMV&REPLC PM GEN MULT LEADS,67424.84,50568.63,809.1,60682.36,238
CPT,33229,Remv&replc pm gen mult leads,,,302.03,31193.03,71
CPT,33230,HC INSRT PULSE GEN W/DUAL LEADS,78914.91,59186.18,946.98,71023.42,119
CPT,33230,Insrt pulse gen w/dual leads,,,309.41,31193.03,71
CPT,33231,HC INSRT PULSE GEN W/MULT LEADS,5671.32,4253.49,68.06,5104.19,119
CPT,33231,Insrt pulse gen w/mult leads,,,322.53,35684.67,71
CPT,33233,HC PACEMAKER REMOVAL,27782.61,20836.96,333.39,25004.35,238
CPT,33233,Removal of pm generator,,,188.31,13792.06,71
CPT,33234,HC SINGLE LEAD REMOVAL PACEMAKER,10122.42,7591.82,113.22,9728.87,238
CPT,33234,Removal of pacemaker system,,,390.92,6752.36,71
CPT,33235,HC DUAL LEAD REMOVAL PACEMAKER,10302.535,7726.9,115.23,9901.99,238
CPT,33235,Removal pacemaker electrode,,,514.11,5315.69,71
CPT,33236,Remove electrode/thoracotomy,,,466.12,15039.8,107
CPT,33237,Remove electrode/thoracotomy,,,499.83,15039.8,107
CPT,33238,Remove electrode/thoracotomy,,,563.73,15039.8,107
CPT,33240,HC INSERT PULSE GEN WITH  SINGLE LEAD,9596.97,7197.73,115.16,8637.27,119
CPT,33240,Insrt pulse gen w/singl lead,,,295.43,31193.03,71
CPT,33241,HC REMOVAL ONLY IMPLANT DEFIB PULSE GEN,11016.93,8262.7,132.2,9915.24,238
CPT,33241,Remove pulse generator,,,173.15,5315.69,71
CPT,33243,Remove eltrd/thoracotomy,,,210.76,15039.8,107
CPT,33244,HC ICD LEAD EXTRACTION,11022.18,8266.64,132.27,9919.96,238
CPT,33244,Remove elctrd transvenously,,,698.08,5315.69,71
CPT,33249,HC IMPLANT/REPOS DEFIB  PULSE GEN W/LEADS SNG/DUAL,118743.74,89057.8,1424.92,106869.37,238
CPT,33249,Insj/rplcmt defib w/lead(s),,,737.37,35684.67,71
CPT,33250,Ablate heart dysrhythm focus,,,222.7,15039.8,107
CPT,33251,Ablate heart dysrhythm focus,,,249.45,15039.8,107
CPT,33254,Ablate atria lmtd,,,208.1,15039.8,107
CPT,33255,Ablate atria w/o bypass ext,,,248.54,15039.8,107
CPT,33256,Ablate atria w/bypass exten,,,294.68,17631.53,107
CPT,33257,Ablate atria lmtd add-on,,,89.27,15039.8,71
CPT,33258,Ablate atria x10sv add-on,,,99.49,15039.8,71
CPT,33259,Ablate atria w/bypass add-on,,,129.56,15039.8,71
CPT,33261,Ablate heart dysrhythm focus,,,246.43,15039.8,107
CPT,33262,HC REMOVE & REPL IMPLANT DEFIB PLS GEN SINGLE LEAD,76368.99,57276.74,916.43,68732.09,238
CPT,33262,Rmvl& replc pulse gen 1 lead,,,301.0,31193.03,71
CPT,33263,HC REMOVE & REPLAC DEFIB PULSE GEN DUAL LEADS,80305.93,60229.45,963.67,72275.34,238
CPT,33263,Rmvl & rplcmt dfb gen 2 lead,,,312.56,31193.03,71
CPT,33264,HC REMOVE & REPLAC DEFIB PULSE GEN MULT LEADS,114039.16,85529.37,1368.47,102635.24,238
CPT,33264,Rmvl & rplcmt dfb gen mlt ld,,,325.95,35684.67,71
CPT,33265,Ablate atria lmtd endo,,,208.55,15039.8,107
CPT,33266,Ablate atria x10sv endo,,,282.07,16890.01,107
CPT,33267,Excl laa open any method,,,159.87,15039.8,107
CPT,33268,Excl laa opn oth px any meth,,,20.0,15039.8,71
CPT,33269,Excl laa thrscp any method,,,126.32,15039.8,107
CPT,33270,HC INSERT/REPLMNT SUBQ IMPL DEFIB W SBQ ELECTRODE,98012.87,73509.65,1176.15,88211.58,119
CPT,33270,Ins/rep subq defibrillator,,,453.76,35684.67,71
CPT,33271,HC INSERT SUBQ DEFIB ELECTRODE,5520.39,4140.29,66.24,4968.35,119
CPT,33271,Insj subq impltbl dfb elctrd,,,364.49,17929.67,71
CPT,33272,HC RMVL SUBQ DEFIB ELECTRODE,3685.57,2764.18,44.23,3317.01,238
CPT,33272,Rmvl of subq defibrillator,,,279.75,5315.69,71
CPT,33273,HC REPOS SUBQ DEFIB ELECTRODE AND/OR PLS GEN,8595.34,6446.5,103.14,7735.81,119
CPT,33273,Repos prev impltbl subq dfb,,,321.9,5315.69,71
CPT,33274,HC TRANSCATH INSRT/REPLC PERM LEADLESS PCMKR RT VENT W/GUIDANCE,37247.09,27935.32,446.97,33522.38,119
CPT,33274,Tcat insj/rpl perm ldls pm,,,285.79,31193.03,106
CPT,33275,HC LEADLESS PM REMOVAL W/IMG,7532.21,5649.16,90.39,6778.99,119
CPT,33275,Tcat rmvl perm ldls pm w/img,,,404.57,6465.03,70
CPT,33276,Insj phrnc nrv stim sys,,,1368.9,50085.75,34
CPT,33277,HC INSJ PHRNC NRV STIM TRANSVNS,9329.89,6997.42,111.96,8396.9,119
CPT,33277,Insj phrnc nrv stim transvns,,,656.91,2545.62,16
CPT,33278,HC REMOVAL OF NEUROSTIMULATOR GENERATOR AND LEAD(S),23457.91,17593.43,281.49,21112.12,119
CPT,33278,Rmvl phrnc nrv stim sys,,,1359.19,5315.7,35
CPT,33279,HC RMVL PHRNC NRV STIMULATOR TRANSVNS STIMJ/SNSG LD,9127.17,6845.38,109.53,8214.45,119
CPT,33279,Rmvl phrnc nrv stim transvns,,,814.74,6752.36,35
CPT,33280,HC RMVL PHRENIC NRV STIMULATOR PULSE GENERATOR ONLY,26713.29,20034.97,320.56,24041.96,119
CPT,33280,Rmvl phrnc nrv stim pg only,,,491.78,5315.7,35
CPT,33281,HC REPOSG PHRNC NRV STIM TRNSVN,7933.05,5949.79,95.2,7139.74,119
CPT,33281,Reposg phrnc nrv stim trnsvn,,,867.97,5315.69,35
CPT,33285,HC INSERTION SUBCUTAN CARDIAC RHYTHM MONITOR INC PROGRAMMING,22565.89,16924.42,270.79,20309.3,119
CPT,33285,Insj subq car rhythm mntr,,,84.39,17929.67,71
CPT,33286,HC REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,1749.87,1312.4,21.0,1574.88,119
CPT,33286,Rmvl subq car rhythm mntr,,,83.08,1126.35,71
CPT,33287,HC RMV&RPLCMT PHRNC NRV STIM PG,3613.19,2709.89,43.36,3251.87,119
CPT,33287,Rmv&rplcmt phrnc nrv stim pg,,,919.49,33917.23,35
CPT,33288,HC RMVL&RPLCMT PHRNC NRV STIM TRNSVNS STIMJ/SNSG LD,9329.89,6997.42,111.96,8396.9,119
CPT,33288,Rmv&rplcmt phrnc nrv stim ld,,,1169.56,24411.94,35
CPT,33289,HC TRANSCATHETER IMPLANT PULMONARY ARTERY SENSOR,11145.23,8358.92,133.74,10030.71,119
CPT,33289,Tcat impl wrls p-art prs snr,,,318.58,31640.85,71
CPT,33300,Repair of heart wound,,,372.71,22415.49,107
CPT,33305,Repair of heart wound,,,624.92,37385.29,107
CPT,33310,Exploratory heart surgery,,,179.11,15039.8,107
CPT,33315,Exploratory heart surgery,,,293.4,17508.53,107
CPT,33320,Repair major blood vessel(s),,,164.06,15039.8,107
CPT,33321,Repair major vessel,,,181.87,15039.8,107
CPT,33322,Repair major blood vessel(s),,,212.46,15039.8,107
CPT,33330,Insert major vessel graft,,,217.93,15039.8,107
CPT,33335,Insert major vessel graft,,,285.71,17087.22,107
CPT,33340,"HC PERQ CLSR TCAT L ATR APNDG INC FLUOR, CAT PLC, ANGIO IF PER",20420.39,15315.29,228.4,19626.48,238
CPT,33340,Perq clsr tcat l atr apndge,,,464.47,15039.8,71
CPT,33361,HC EVASC AORTIC HRT VALVE (TAVR),61464.41,46098.31,737.57,55317.97,238
CPT,33361,Replace aortic valve perq,,,715.37,15039.8,71
CPT,33362,HC REPLACE AORTIC VALVE OPEN FEMORAL ART APPROACH,70480.54,52860.4,845.77,63432.49,238
CPT,33362,Replace aortic valve open,,,780.39,15039.8,71
CPT,33363,HC REPLACE AORTIC VALVE OPEN AXILLARY APPROACH,68392.57,51294.43,820.71,61553.31,119
CPT,33363,Replace aortic valve open,,,808.05,15039.8,71
CPT,33364,HC REPLACE AORTIC VALVE OPEN ILIAC APPROACH,71023.16,53267.37,852.28,63920.84,119
CPT,33364,Replace aortic valve open,,,808.76,15039.8,71
CPT,33365,HC REPLAC AORTIC VALVE OPEN TRANSAORTIC APP,72769.36,54577.02,873.23,65492.42,119
CPT,33365,Replace aortic valve open,,,843.76,15039.8,71
CPT,33366,HC TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,73445.59,55084.19,881.35,66101.03,119
CPT,33366,Trcath replace aortic valve,,,930.43,15039.8,71
CPT,33367,HC REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,15422.8,11567.1,185.07,13880.52,119
CPT,33367,Replace aortic valve w/byp,,,583.43,15039.8,71
CPT,33368,HC REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,17052.06,12789.04,204.62,15346.85,119
CPT,33368,Replace aortic valve w/byp,,,706.56,15039.8,71
CPT,33369,HC REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,19783.48,14837.61,237.4,17805.13,119
CPT,33369,Replace aortic valve w/byp,,,932.8,15039.8,71
CPT,33370,HC TRANSCATH PLACE/SUB REMOVE CEREBRAL EMBOLIC PRO DEVICE,4230.52,3172.89,50.77,3807.47,119
CPT,33370,HC TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,70026.74,52520.06,840.32,63024.07,119
CPT,33370,Tcat plmt&rmvl cepd perq,,,128.12,1221.76,52
CPT,33390,Valvuloplasty aortic valve,,,294.84,17642.47,107
CPT,33391,Valvuloplasty aortic valve,,,349.38,20908.71,107
CPT,33404,Prepare heart-aorta conduit,,,267.36,16004.42,107
CPT,33405,Replacement aortic valve opn,,,347.43,20794.78,107
CPT,33406,Replacement aortic valve opn,,,441.1,26402.94,107
CPT,33410,Replacement aortic valve opn,,,388.93,23317.34,107
CPT,33411,Replacement of aortic valve,,,512.75,30673.54,107
CPT,33412,Replacement of aortic valve,,,480.63,28699.62,107
CPT,33413,Replacement of aortic valve,,,492.27,29408.12,107
CPT,33414,Repair of aortic valve,,,328.72,19673.64,107
CPT,33415,Revision subvalvular tissue,,,310.29,18585.72,107
CPT,33416,Revise ventricle muscle,,,309.78,18546.79,107
CPT,33417,Repair of aortic valve,,,255.75,15336.23,107
CPT,33418,HC TMVR PERQ INITIAL,20833.15,15624.86,250.0,18749.84,238
CPT,33418,Repair tcat mitral valve,,,274.3,16424.55,107
CPT,33419,HC TMVR PERQ ADD PROSTHESIS(ES),10411.98,7808.98,124.94,9370.78,238
CPT,33419,Repair tcat mitral valve,,,64.6,3858.74,52
CPT,33420,Revision of mitral valve,,,1165.27,15039.8,71
CPT,33422,Revision of mitral valve,,,254.52,15241.02,107
CPT,33425,Repair of mitral valve,,,417.59,24959.93,107
CPT,33426,Repair of mitral valve,,,364.43,21835.5,107
CPT,33427,Repair of mitral valve,,,372.97,22329.55,107
CPT,33430,Replacement of mitral valve,,,428.62,25661.53,107
CPT,33440,Rplcmt a-valve tlcj autol pv,,,519.87,31042.03,107
CPT,33460,Revision of tricuspid valve,,,366.56,21895.62,107
CPT,33463,Valvuloplasty tricuspid,,,470.11,28135.6,107
CPT,33464,Valvuloplasty tricuspid,,,372.82,22316.24,107
CPT,33465,Replace tricuspid valve,,,421.24,25199.12,107
CPT,33468,Revision of tricuspid valve,,,375.15,22430.47,107
CPT,33471,Vlvt pv clsd hrt via p-art,,,203.24,12503.42,88
CPT,33474,Revision of pulmonary valve,,,333.84,19989.5,107
CPT,33475,Replacement pulmonary valve,,,355.35,21216.59,107
CPT,33476,Revision of heart chamber,,,233.67,15039.8,107
CPT,33477,HC PULMONARY VALVE IMPLATANTATION PERQ,68599.57,51449.68,823.19,61739.61,119
CPT,33477,Implant tcat pulm vlv perq,,,1289.92,15039.8,71
CPT,33478,Revision of heart chamber,,,241.42,15039.8,107
CPT,33496,Repair prosth valve clot,,,254.66,15243.39,107
CPT,33500,Repair heart vessel fistula,,,238.82,15039.8,107
CPT,33501,Repair heart vessel fistula,,,170.76,15039.8,143
CPT,33502,Coronary artery correction,,,196.11,15039.8,107
CPT,33503,Coronary artery graft,,,1069.93,15039.8,71
CPT,33504,Coronary artery graft,,,224.94,15039.8,107
CPT,33505,Repair artery w/tunnel,,,315.35,18835.15,107
CPT,33506,Repair artery translocation,,,314.07,18787.85,107
CPT,33507,Repair art intramural,,,263.54,15775.48,107
CPT,33508,Endoscopic vein harvest,,,2.46,146.35,52
CPT,33509,Ndsc hrv uxtr art 1 sgm cab,,,26.49,15039.8,71
CPT,33510,Cabg vein single,,,296.02,17719.24,107
CPT,33511,Cabg vein two,,,324.92,19464.12,107
CPT,33512,Cabg vein three,,,370.53,22150.67,107
CPT,33513,Cabg vein four,,,379.16,22641.17,107
CPT,33514,Cabg vein five,,,398.74,23828.93,107
CPT,33516,Cabg vein six or more,,,412.69,24664.56,107
CPT,33517,Cabg artery-vein single,,,28.54,15039.8,71
CPT,33518,Cabg artery-vein two,,,62.87,15039.8,71
CPT,33519,Cabg artery-vein three,,,83.08,15039.8,71
CPT,33521,Cabg artery-vein four,,,99.58,15039.8,71
CPT,33522,Cabg artery-vein five,,,111.88,15039.8,71
CPT,33523,Cabg art-vein six or more,,,126.31,15039.8,71
CPT,33530,Coronary artery bypass/reop,,,80.2,15039.8,71
CPT,33533,Cabg arterial single,,,286.57,17163.79,107
CPT,33534,Cabg arterial two,,,336.47,20166.51,107
CPT,33535,Cabg arterial three,,,374.27,22410.95,107
CPT,33536,Cabg arterial four or more,,,402.84,24145.39,107
CPT,33542,Removal of heart lesion,,,401.37,24087.04,107
CPT,33545,Repair of heart damage,,,468.55,27986.49,107
CPT,33548,Restore/remodel ventricle,,,450.78,26940.25,107
CPT,33572,Open coronary endarterectomy,,,35.27,15039.8,71
CPT,33600,Closure of valve,,,263.5,15797.16,107
CPT,33602,Closure of valve,,,255.8,15342.34,107
CPT,33606,Anastomosis/artery-aorta,,,272.57,16337.43,107
CPT,33608,Repair anomaly w/conduit,,,275.96,16550.01,107
CPT,33610,Repair by enlargement,,,272.23,16322.74,107
CPT,33611,Repair double ventricle,,,298.53,17865.29,107
CPT,33612,Repair double ventricle,,,306.48,18341.5,107
CPT,33615,Repair modified fontan,,,305.96,18330.07,107
CPT,33617,Repair single ventricle,,,331.44,19843.15,107
CPT,33619,Repair single ventricle,,,420.65,25180.98,107
CPT,33620,Apply r&l pulm art bands,,,252.4,15109.46,107
CPT,33621,Transthor cath for stent,,,142.43,15039.8,107
CPT,33622,Redo compl cardiac anomaly,,,524.67,31368.24,107
CPT,33641,Repair heart septum defect,,,250.86,15039.8,107
CPT,33645,Revision of heart veins,,,265.12,15874.52,107
CPT,33647,Repair heart septum defects,,,278.12,16648.07,107
CPT,33660,Repair of heart defects,,,268.76,16096.86,107
CPT,33665,Repair of heart defects,,,292.77,17528.83,107
CPT,33670,Repair of heart chambers,,,301.63,18024.56,107
CPT,33675,Close mult vsd,,,301.61,18048.8,107
CPT,33676,Close mult vsd w/resection,,,309.71,18527.96,107
CPT,33677,Cl mult vsd w/rem pul band,,,321.54,19243.75,107
CPT,33681,Closure 1 vsd w/wo patch,,,282.68,16949.44,107
CPT,33684,Clsr 1 vsd w/wo patch w/vlvt,,,289.05,17298.61,107
CPT,33688,Clsr 1vsd w/wo ptch rmvl bnd,,,288.12,17220.36,107
CPT,33690,Banding pulmonary artery,,,184.48,15039.8,107
CPT,33692,Comp rpr tof wo pulm atresia,,,299.17,17889.44,107
CPT,33694,Cmp rpr tof wo plm atrs ptch,,,298.53,17865.29,107
CPT,33697,Compl rpr tof w/pulm atresia,,,314.48,18820.67,107
CPT,33702,Repair of heart defects,,,237.25,15039.8,107
CPT,33710,Repair of heart defects,,,314.0,18786.47,107
CPT,33720,Repair of heart defect,,,237.36,15039.8,107
CPT,33724,Repair venous anomaly,,,235.43,15039.8,107
CPT,33726,Repair pul venous stenosis,,,310.88,18605.92,107
CPT,33730,Repair heart-vein defect(s),,,307.3,18406.74,107
CPT,33732,Repair heart-vein defect,,,252.77,15155.87,107
CPT,33735,Revision of heart chamber,,,199.03,15039.8,107
CPT,33736,Revision of heart chamber,,,215.93,15039.8,107
CPT,33737,Revision of heart chamber,,,199.27,12263.25,88
CPT,33741,HC TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,16112.56,12084.42,193.35,14501.3,119
CPT,33741,Tas congenital car anomal,,,114.72,15039.8,71
CPT,33745,HC TIS CREATION W/STENT CONGENITAL CARDIAC ANOMAL 1ST SHUNT,54229.86,40672.39,650.76,48806.87,119
CPT,33745,Tis cgen car anomal 1st shnt,,,163.83,15039.8,71
CPT,33746,HC TIS CREATION W/STENT CONGENITAL CARDIAC EA ADDL SHNT,11598.18,8698.64,139.18,10438.36,119
CPT,33746,Tis cgen car anomal ea addl,,,65.48,15039.8,71
CPT,33750,Shunt subclavian to pulm art,,,193.67,15039.8,107
CPT,33755,Shunt as-aort to pulm art,,,202.22,15039.8,107
CPT,33762,Shunt desc aorta to pulm art,,,196.65,15039.8,107
CPT,33764,Shunt central w/prostc graft,,,202.22,15039.8,107
CPT,33766,Shunt supr v/c p-art 1 lung,,,204.44,15039.8,107
CPT,33767,Shunt supr v/c p-art bth lng,,,218.1,15039.8,107
CPT,33768,Anast cavopulm sec sup v/c,,,63.62,15039.8,107
CPT,33770,Rpr tga w/o surg enlgmnt vsd,,,323.8,19360.93,107
CPT,33771,Rpr tga w/surg enlgmnt vsd,,,333.08,19899.53,107
CPT,33774,Rpr tga atrial baffle px,,,276.0,16549.81,107
CPT,33775,Rpr tga atr bfl rmvl plm bnd,,,284.24,17031.54,107
CPT,33776,Rpr tga atr bfl clsr vsd,,,300.37,18011.55,107
CPT,33777,Rpr tga bfl rpr sbpulm obstr,,,289.75,17341.98,107
CPT,33778,Rpr tga aortic pulm art rcns,,,359.88,21538.46,107
CPT,33779,Rpr tga rcnstj rmvl plm bnd,,,355.52,21245.27,107
CPT,33780,Rpr tga rcnstj clsr vsd,,,362.21,21657.91,107
CPT,33781,Rpr tga rcnstj rpr sbpl obst,,,353.6,21119.91,107
CPT,33782,Nikaidoh proc,,,493.48,29497.9,107
CPT,33783,Nikaidoh proc w/ostia implt,,,533.3,31875.79,107
CPT,33786,Repair arterial trunk,,,348.55,20835.78,107
CPT,33788,Revision of pulmonary artery,,,234.96,15039.8,107
CPT,33800,Aortic suspension,,,151.16,15039.8,143
CPT,33802,Division aberrant vessel,,,166.63,15039.8,107
CPT,33803,Div aberrant vsl w/reanast,,,176.58,15039.8,107
CPT,33813,Repair septal defect,,,190.48,11718.84,88
CPT,33814,Obltrj a-pulm sep def w/byp,,,233.82,15039.8,107
CPT,33820,Repair pda by ligation,,,148.46,15039.8,107
CPT,33822,Repair pda div<18 years,,,156.52,15039.8,107
CPT,33824,Repair pda div 18 yrs&older,,,181.38,15039.8,107
CPT,33840,Exc coa w/direct anastomosis,,,190.32,15039.8,107
CPT,33845,Excision coa w/graft,,,204.84,15039.8,107
CPT,33851,Exc coa rpr l subcl art/prst,,,195.4,15039.8,107
CPT,33852,Rpr hypopl a-arch wo byp,,,214.75,15039.8,107
CPT,33853,Rpr hypopl a-arch w/byp,,,280.98,16842.9,107
CPT,33858,As-aort grf f/aortic dsj,,,519.01,31019.85,107
CPT,33859,As-aort grf f/ds oth/thn dsj,,,372.67,22293.97,107
CPT,33863,Ascending aortic graft,,,480.82,28745.35,107
CPT,33864,Ascending aortic graft,,,491.46,29382.2,107
CPT,33866,Aortic hemiarch graft,,,880.04,8399.57,52
CPT,33871,Transvrs a-arch grf hypthrm,,,497.76,29732.26,107
CPT,33875,Thoracic aortic graft,,,419.15,25056.21,143
CPT,33877,Thoracoabdominal graft,,,551.0,32946.96,143
CPT,33880,Evasc rpr ta ndgft cov lsa,,,273.47,16280.07,143
CPT,33880,HC EVASC RPR TA DPLMNT AORT-ARTC TUBE NDGFT COV LSA,6685.08,5013.81,80.22,6016.57,119
CPT,33881,Evasc rpr ta ndgft xcov lsa,,,234.31,15039.8,143
CPT,33881,HC EVASC RPR TA DPLMNT AORT-ARTC TUB NDGFT XCOV LSA,13845.9,10384.42,166.15,12461.31,119
CPT,33882,Evasc rpr ta dplmt mltpc sys,,,14101.68,14101.68,9
CPT,33883,Delayed plmt prox xtn prosth,,,169.82,15039.8,143
CPT,33883,HC PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,7781.37,5836.03,93.38,7003.23,119
CPT,33884,Endovasc prosth taa add-on,,,60.27,15039.8,98
CPT,33884,HCD PROXIMAL THORAC EXT ADDL,5536.16,4152.12,66.43,4982.54,119
CPT,33886,Delayed plmt dstl xtn prosth,,,146.87,15039.8,143
CPT,33889,Artery transpose/endovas taa,,,121.3,15039.8,134
CPT,33891,Car-car bp grft/endovas taa,,,147.0,15039.8,134
CPT,33894,Evasc st rpr thrc/aa acrs br,,,935.67,15039.8,71
CPT,33894,HC ENDOVASC STENT RPR THOR/ABD AORTA - MAJOR SIDE BNCHS,43483.92,32612.94,521.81,39135.53,119
CPT,33895,Evasc st rpr thrc/aa x crsg,,,744.21,15039.8,71
CPT,33895,HC ENDOVASC STENT RPR THOR/ABD AORTA - NOT X MAJR BNCHS,43483.92,32612.94,521.81,39135.53,119
CPT,33897,HC PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECURRNT AORTA,21037.7,15778.28,252.45,18933.93,119
CPT,33897,Perq trluml angp nt/recr coa,,,553.63,15039.8,71
CPT,33900,HC PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,35171.83,26378.87,422.06,31654.65,119
CPT,33900,Perq p-art revsc 1 nm nt uni,,,560.35,17929.67,71
CPT,33901,HC PULMON ART REVASC W/ STENT INITIAL NATIVE BILAT,50221.01,37665.76,602.65,45198.91,119
CPT,33901,Perq p-art revsc 1 nm nt bi,,,736.47,13240.37,71
CPT,33902,HC PULMON ART REVASC W/STENT INITIAL ABNORM UNILAT,34497.58,25873.18,413.97,31047.82,119
CPT,33902,Perq p-art revsc 1 abnor uni,,,711.53,28480.59,71
CPT,33903,Perq p-art revsc 1 abnor bi,,,838.54,20343.28,71
CPT,33904,HC PULMON ART REVASC W/ STENT EA ADDL NATIVE/ABNORM,12129.92,9097.44,145.56,10916.93,119
CPT,33904,Perq p-art revsc each addl,,,281.44,2704.49,52
CPT,33910,Remove lung artery emboli,,,403.7,23873.38,107
CPT,33915,Remove lung artery emboli,,,210.54,15039.8,107
CPT,33916,Surgery of great vessel,,,638.18,38166.13,107
CPT,33917,Repair pulmonary artery,,,223.73,15039.8,107
CPT,33920,Repair pulmonary atresia,,,277.33,16594.95,107
CPT,33922,Transect pulmonary artery,,,213.14,15039.8,107
CPT,33924,Remove pulmonary shunt,,,43.64,15039.8,71
CPT,33925,Rpr pul art unifocal w/o cpb,,,262.81,15725.81,107
CPT,33926,Repr pul art unifocal w/cpb,,,369.5,22103.76,107
CPT,33927,Impltj tot rplcmt hrt sys,,,389.65,23243.92,71
CPT,33928,Rmvl & rplcmt tot hrt sys,,,12954.18,15039.8,19
CPT,33929,Rmvl rplcmt hrt sys f/trnspl,,,12954.18,15039.8,19
CPT,33930,Removal of donor heart/lung,,,12954.18,15039.8,19
CPT,33933,Prepare donor heart/lung,,,12954.18,15039.8,19
CPT,33935,Transplantation heart/lung,,,752.97,44974.76,143
CPT,33940,HC HEART TRANSPLANT ACQUISITION,239549.33,179662.0,2874.59,215594.4,119
CPT,33940,Removal of donor heart,,,12954.18,15039.8,19
CPT,33944,Prepare donor heart,,,519.09,15039.8,35
CPT,33945,Transplantation of heart,,,744.12,44485.64,143
CPT,33946,Ecmo/ecls initiation venous,,,296.47,15039.8,71
CPT,33946,HC ECMO-ECLS INITIATION VENO-VENOUS,4368.15,3276.11,52.42,3931.33,119
CPT,33947,Ecmo/ecls initiation artery,,,327.86,15039.8,71
CPT,33947,HC ECMO INITIATION VENO-ARTERIAL,4656.11,3492.08,55.87,4190.5,119
CPT,33948,Ecmo/ecls daily mgmt-venous,,,228.63,15039.8,71
CPT,33948,HC ECMO DAILY MGMT  VENOUS,5102.2,3826.65,61.23,4591.98,119
CPT,33949,Ecmo/ecls daily mgmt artery,,,221.8,15039.8,71
CPT,33949,HC ECMO DAILY MGMT ARTERY,5102.2,3826.65,61.23,4591.98,119
CPT,33951,Ecmo/ecls insj prph cannula,,,404.15,15039.8,71
CPT,33951,HC ECMO INSERT ART AND/OR VENOUS <6 YRS,1431.62,1073.71,17.18,1288.46,119
CPT,33952,Ecmo/ecls insj prph cannula,,,408.35,15039.8,71
CPT,33952,HC ECMO INSERT ART AND/OR VENOUS =>6 YRS,1431.62,1073.71,17.18,1288.46,119
CPT,33953,Ecmo/ecls insj prph cannula,,,450.7,15039.8,71
CPT,33954,Ecmo/ecls insj prph cannula,,,454.09,15039.8,71
CPT,33955,Ecmo/ecls insj ctr cannula,,,788.63,15039.8,71
CPT,33956,Ecmo/ecls insj ctr cannula,,,798.03,15039.8,71
CPT,33957,Ecmo/ecls repos perph cnula,,,175.68,15039.8,71
CPT,33958,Ecmo/ecls repos perph cnula,,,175.68,15039.8,71
CPT,33958,HC ECMO/ECLS CANNULA REPOSITION 6 OR OLDER PERQ,1601.65,1201.24,19.22,1441.48,119
CPT,33959,Ecmo/ecls repos perph cnula,,,222.52,15039.8,71
CPT,33962,Ecmo/ecls repos perph cnula,,,222.52,15039.8,71
CPT,33963,Ecmo/ecls repos perph cnula,,,445.16,15039.8,71
CPT,33964,Ecmo/ecls repos perph cnula,,,470.01,15039.8,71
CPT,33965,Ecmo/ecls rmvl perph cannula,,,175.68,15039.8,71
CPT,33966,Ecmo/ecls rmvl prph cannula,,,225.48,15039.8,71
CPT,33966,HC ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,7516.4,5637.3,90.2,6764.76,119
CPT,33967,HC BALLOON PUMP INSERT,12073.415,9055.060000000001,136.46,11497.91,238
CPT,33967,Insert i-aort percut device,,,246.23,15039.8,71
CPT,33968,HC REMOVE INTRA AORTIC BALLN PUMP,2210.21,1657.66,26.52,1989.19,119
CPT,33968,Remove aortic assist device,,,32.38,15039.8,71
CPT,33969,Ecmo/ecls rmvl perph cannula,,,259.8,15039.8,71
CPT,33970,Aortic circulation assist,,,54.12,15039.8,71
CPT,33971,Aortic circulation assist,,,569.01,15039.8,71
CPT,33973,Insert balloon device,,,76.64,15039.8,71
CPT,33974,Remove intra-aortic balloon,,,716.64,15039.8,71
CPT,33975,Implant ventricular device,,,198.34,15039.8,71
CPT,33976,Implant ventricular device,,,241.56,15039.8,71
CPT,33977,Remove ventricular device,,,171.48,15039.8,71
CPT,33978,Remove ventricular device,,,202.97,15039.8,71
CPT,33979,Insert intracorporeal device,,,297.05,17724.95,71
CPT,33980,Remove intracorporeal device,,,271.88,16254.44,71
CPT,33981,HC RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP,27075.0,20306.25,324.9,24367.5,119
CPT,33981,Replace vad pump ext,,,126.56,15039.8,71
CPT,33982,Replace vad intra w/o bp,,,297.4,17723.87,71
CPT,33983,Replace vad intra w/bp,,,353.48,20848.3,71
CPT,33984,Ecmo/ecls rmvl prph cannula,,,271.18,15039.8,71
CPT,33984,HC ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,3468.56,2601.42,41.62,3121.7,119
CPT,33985,Ecmo/ecls rmvl ctr cannula,,,489.61,15039.8,71
CPT,33986,Ecmo/ecls rmvl ctr cannula,,,500.07,15039.8,71
CPT,33986,HC ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,27075.0,20306.25,324.9,24367.5,119
CPT,33987,Artery expos/graft artery,,,198.1,15039.8,71
CPT,33988,Insertion of left heart vent,,,739.83,15039.8,71
CPT,33989,Removal of left heart vent,,,470.01,15039.8,71
CPT,33990,HC PERCUTANEOUS INSERT VAD ARTERY ACCESS,18971.31,14228.48,227.66,17074.18,238
CPT,33990,Insj perq vad l hrt arterial,,,55.13,15039.8,71
CPT,33991,HC INSERT VAD ARTERY VENOUS ACCESS,24474.81,18356.11,293.7,22027.33,238
CPT,33991,Insj perq vad l hrt artl&ven,,,69.51,15039.8,71
CPT,33992,HC REMOVAL PERCUTANEOUS VAD AT  DIFFERENT SESSION,9828.69,7371.52,117.94,8845.82,238
CPT,33992,Rmvl perq left heart vad,,,28.63,15039.8,71
CPT,33993,HC REPOSITION PERCUTANEOUS VAD DIFF SESSION,8582.8,6437.1,102.99,7724.52,238
CPT,33993,Reposg perq r/l hrt vad,,,25.38,15039.8,71
CPT,33995,HC INSERTION PERQ VAD RT HRT VENOUS,14176.95,10632.71,170.12,12759.26,238
CPT,33995,Insj perq vad r hrt venous,,,54.49,15039.8,71
CPT,33997,HC REMOVAL PERQ RT HEART VAD,8352.64,6264.48,100.23,7517.38,119
CPT,33997,Rmvl perq right heart vad,,,24.18,15039.8,71
CPT,33999,HC CAROTID APPROACH TAVR,60151.34,45113.5,721.82,54136.21,119
CPT,33999,HC TRANSCATHETER BICAVAL VALVE SYSTEM IMPLANTATION,57211.93,42908.95,686.54,51490.74,119
CPT,33999,Unlisted px cardiac surgery,,,592.7,688.13,19
CPT,34001,Removal of artery clot,,,139.84,15039.8,143
CPT,34051,Removal of artery clot,,,152.21,15039.8,143
CPT,34101,Removal of artery clot,,,91.32,7852.28,143
CPT,34111,Removal of arm artery clot,,,91.63,7852.28,143
CPT,34151,Removal of artery clot,,,212.79,15039.8,143
CPT,34201,Removal of artery clot,,,156.03,10095.79,143
CPT,34203,Removal of leg artery clot,,,144.76,10095.79,143
CPT,34401,Removal of vein clot,,,227.1,15039.8,143
CPT,34421,Removal of vein clot,,,106.21,6465.03,143
CPT,34451,Removal of vein clot,,,219.43,15039.8,143
CPT,34471,Removal of vein clot,,,592.7,3043.09,107
CPT,34490,Removal of vein clot,,,522.06,4266.34,107
CPT,34501,Repair valve femoral vein,,,136.61,7852.28,143
CPT,34502,Reconstruct vena cava,,,235.26,15039.8,107
CPT,34510,Transposition of vein valve,,,156.11,7852.28,143
CPT,34520,Cross-over vein graft,,,151.35,7852.28,143
CPT,34530,Leg vein fusion,,,143.93,4266.34,143
CPT,34701,Evasc rpr a-ao ndgft,,,188.84,15039.8,143
CPT,34701,HC EVAS RPR DPLMNT AORTO-AORTIC NDGFT,14192.33,10644.25,170.31,12773.1,119
CPT,34702,Evasc rpr a-ao ndgft rpt,,,281.9,16393.11,143
CPT,34702,HC EVAS RPR DPLMNT AORTO-AORTIC NDGFT RPT,11848.46,8886.34,142.18,10663.61,119
CPT,34703,Evasc rpr a-unilac ndgft,,,209.99,15039.8,143
CPT,34703,HC EVAS RPR DPLMNT AORTO UN-ILIAC NDGFT,54112.95,40584.71,649.36,48701.66,119
CPT,34704,Evasc rpr a-unilac ndgft rpt,,,349.68,20801.09,143
CPT,34704,HC EVASC RPR DPLMNT AORTO UN-ILIAC NDGFT RPT,54112.95,40584.71,649.36,48701.66,119
CPT,34705,Evac rpr a-biiliac ndgft,,,232.99,15039.8,143
CPT,34705,HC EVASC RPR DPLMNT AORTO BI-ILIAC NDGFT,81825.48,61369.11,981.91,73642.93,119
CPT,34706,Evasc rpr a-biiliac rpt,,,347.39,20774.18,143
CPT,34706,HC EVASC RPR DPLMNT AORTO BI-ILIAC NDGFT RPT,55414.32,41560.74,664.97,49872.89,119
CPT,34707,Evasc rpr ilio-iliac ndgft,,,178.02,15039.8,179
CPT,34707,HC EVASC RPR DPLMNT ILIO-ILIAC NDGFT,10909.75,8182.31,130.92,9818.78,119
CPT,34708,Evasc rpr ilio-iliac rpt,,,277.56,16611.9,179
CPT,34708,HC EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,9925.87,7444.4,119.11,8933.28,119
CPT,34709,HC PLCMT XTN PROSTH FOR ENDOVASC RPR,13157.92,9868.44,157.9,11842.13,119
CPT,34709,Plmt xtn prosth evasc rpr,,,49.24,15039.8,107
CPT,34710,Dlyd plmt xtn prosth 1st vsl,,,121.29,15039.8,143
CPT,34710,HC DLYD PLCMT XTN PROSTH FOR EVASC RPR 1ST VESSEL,11269.2,8451.9,135.23,10142.28,119
CPT,34711,Dlyd plmt xtn prosth ea addl,,,44.92,15039.8,107
CPT,34711,HC DLYD PLCMT XTN PROSTH FOR EVASC RPR EACH ADDL,7760.08,5820.06,93.12,6984.07,119
CPT,34712,HC TRANSCATHER DLVR ENHNCD FIXATION DEVICES RS &I,3149.07,2361.8,37.79,2834.16,119
CPT,34712,Tcat dlvr enhncd fixj dev,,,100.14,15039.8,143
CPT,34713,HC PERQ ACCESS & CLOSURE FEM ART FOR DLVR NDGFT =>12 FR,560.98,420.74,6.73,504.88,119
CPT,34713,Perq access & clsr fem art,,,18.83,1123.6,124
CPT,34714,Opn fem art expos cndt crtj,,,41.11,2457.62,124
CPT,34715,Opn ax/subcla art expos,,,45.71,2717.3,124
CPT,34716,Opn ax/subcla art expos cndt,,,56.81,3399.78,124
CPT,34717,Evasc rpr a-iliac ndgft,,,67.58,15039.8,107
CPT,34718,Evasc rpr n/a a-iliac ndgft,,,188.46,15039.8,143
CPT,34808,Endovas iliac a device addon,,,30.9,15039.8,107
CPT,34812,HC BILATERAL FEM ART EXP FOR PROSTH,25678.9,19259.18,308.15,23111.01,119
CPT,34812,HC UNILATERAL FEM ART EXP FOR PROSTH,12839.45,9629.59,154.07,11555.5,119
CPT,34812,Opn fem art expos,,,31.41,15039.8,143
CPT,34813,Femoral endovas graft add-on,,,35.99,15039.8,107
CPT,34820,HC OPEN ILIAC PROSTH-ABD/RP/UNILATERAL,1587.59,1190.69,19.05,1428.83,119
CPT,34820,Opn iliac art expos,,,51.4,15039.8,143
CPT,34830,Open aortic tube prosth repr,,,269.27,16121.1,143
CPT,34831,Open aortoiliac prosth repr,,,294.26,17675.18,143
CPT,34832,Open aortofemor prosth repr,,,289.44,17336.16,143
CPT,34833,Opn ilac art expos cndt crtj,,,59.91,15039.8,143
CPT,34834,HC EXPOSE ENDOPROSTH BRACHIAL,11200.51,8400.38,134.41,10080.46,119
CPT,34834,Opn brach art expos,,,19.78,15039.8,143
CPT,34839,Plnning pt spec fenest graft,,,,,0
CPT,34841,Endovasc visc aorta 1 graft,,,3975.0,15403.74,35
CPT,34842,Endovasc visc aorta 2 graft,,,3975.0,15403.74,35
CPT,34843,Endovasc visc aorta 3 graft,,,4292.97,16635.94,35
CPT,34844,Endovasc visc aorta 4 graft,,,4770.0,18484.5,35
CPT,34845,Visc & infraren abd 1 prosth,,,3975.0,15403.74,35
CPT,34846,Visc & infraren abd 2 prosth,,,4133.98,16019.79,35
CPT,34847,Visc & infraren abd 3 prosth,,,4133.98,16019.79,35
CPT,34848,Visc & infraren abd 4+ prost,,,4292.97,16635.94,35
CPT,35001,Repair defect of artery,,,171.86,15039.8,143
CPT,35002,Repair artery rupture neck,,,173.93,15039.8,143
CPT,35005,Repair defect of artery,,,152.3,15039.8,143
CPT,35011,Repair defect of artery,,,154.42,7852.28,143
CPT,35013,Repair artery rupture arm,,,194.03,15039.8,143
CPT,35021,Repair defect of artery,,,192.96,15039.8,143
CPT,35022,Repair artery rupture chest,,,220.63,15039.8,143
CPT,35045,Repair defect of arm artery,,,148.55,7852.28,143
CPT,35081,Repair defect of artery,,,264.27,15778.93,107
CPT,35082,Repair artery rupture aorta,,,330.28,19772.69,107
CPT,35091,Repair defect of artery,,,271.99,16263.41,143
CPT,35092,Repair artery rupture aorta,,,394.65,23690.07,143
CPT,35102,Repair defect of artery,,,286.46,17144.97,143
CPT,35103,Repair artery rupture aorta,,,339.31,19810.93,143
CPT,35111,Repair defect of artery,,,203.13,15039.8,107
CPT,35112,Repair artery rupture spleen,,,249.69,15039.8,143
CPT,35121,Repair defect of artery,,,241.48,15039.8,143
CPT,35122,Repair artery rupture belly,,,288.71,17289.65,143
CPT,35131,Repair defect of artery,,,210.46,15039.8,143
CPT,35132,Repair artery rupture groin,,,249.69,15039.8,143
CPT,35141,Repair defect of artery,,,167.04,15039.8,143
CPT,35142,Repair artery rupture thigh,,,201.69,15039.8,143
CPT,35151,Repair defect of artery,,,189.21,15039.8,143
CPT,35152,Repair ruptd popliteal art,,,213.57,15039.8,143
CPT,35180,Rpr cgen av fistula head&nck,,,120.03,2216.42,107
CPT,35182,Rpr cgen av fistula thrx&abd,,,274.59,16460.22,107
CPT,35184,Rpr cgen av fistula xtr,,,147.48,4266.34,107
CPT,35188,Rpr acq av fistula head&neck,,,199.32,7852.28,107
CPT,35189,Rpr acq av fistula thrx&abd,,,230.54,15039.8,107
CPT,35190,Repair acq av fistula xtr,,,116.82,7852.28,107
CPT,35201,Repair blood vessel dir neck,,,143.24,7852.28,143
CPT,35206,Repair blood vessel dir uxtr,,,120.53,4266.34,143
CPT,35207,Rpr bld vsl dir hand finger,,,618.15,4266.34,107
CPT,35211,Rpr blvsl dir ntrathrc w/byp,,,212.66,15039.8,143
CPT,35216,Rpr blvsl dir ntrthrc wo byp,,,322.38,19106.96,143
CPT,35221,Rpr bld vsl dir intra-abdl,,,226.36,15039.8,143
CPT,35226,HC REPAIR BLD VESS LWR EXTREM,643.27,482.45,7.72,578.94,119
CPT,35226,Repair blood vessel dir lxtr,,,127.29,2333.13,143
CPT,35231,Repair blvsl vn grf neck,,,193.17,4266.34,143
CPT,35236,Repair blvsl vn grf uxtr,,,152.55,7852.28,143
CPT,35241,Rpr blvsl vn grf ntrthrc w/b,,,219.78,15039.8,143
CPT,35246,Rpr blvsl vn grf ntrthrc w/o,,,239.12,15039.8,143
CPT,35251,Rpr blvsl vn grf intra-abdl,,,268.57,15857.77,143
CPT,35256,Repair blvsl vn grf lxtr,,,156.07,7852.28,143
CPT,35261,Rpr blvsl grf oth/thn vn nck,,,149.78,4266.34,143
CPT,35266,Rpr blvsl grf oth/th vn uxtr,,,131.72,7852.28,143
CPT,35271,Rpr blvs gr ot/th vn ntrth w,,,212.2,15039.8,143
CPT,35276,Rpr blvs gr ot/t vn ntrth wo,,,223.18,15039.8,143
CPT,35281,Rpr blvsl gr ot/th vn ntr-ab,,,248.09,15039.8,143
CPT,35286,Rpr blvsl grf oth/th vn lxtr,,,142.09,7852.28,143
CPT,35301,Rechanneling of artery,,,172.5,15039.8,143
CPT,35302,Rechanneling of artery,,,170.94,15039.8,143
CPT,35303,Rechanneling of artery,,,188.93,15039.8,143
CPT,35304,Rechanneling of artery,,,194.17,15039.8,143
CPT,35305,Rechanneling of artery,,,186.83,15039.8,143
CPT,35306,Rechanneling of artery,,,68.08,15039.8,71
CPT,35311,Rechanneling of artery,,,237.88,15039.8,143
CPT,35321,Rechanneling of artery,,,136.88,7852.28,143
CPT,35331,Rechanneling of artery,,,223.09,15039.8,143
CPT,35341,Rechanneling of artery,,,211.05,15039.8,143
CPT,35351,Rechanneling of artery,,,196.09,15039.8,143
CPT,35355,Rechanneling of artery,,,157.05,15039.8,143
CPT,35361,Rechanneling of artery,,,232.58,15039.8,143
CPT,35363,Rechanneling of artery,,,247.97,15039.8,143
CPT,35371,HC ENDARTERECTOMY COMMON FEMORAL ARTERY,19620.88,14715.66,235.45,17658.79,119
CPT,35371,Rechanneling of artery,,,124.46,15039.8,143
CPT,35372,Rechanneling of artery,,,149.01,15039.8,143
CPT,35390,Reoperation carotid add-on,,,24.23,15039.8,71
CPT,35400,Angioscopy,,,140.65,15039.8,71
CPT,35500,Harvest vein for bypass,,,48.46,2899.13,52
CPT,35501,Art byp grft ipsilat carotid,,,222.87,15039.8,143
CPT,35506,Art byp grft subclav-carotid,,,194.6,15039.8,143
CPT,35508,Art byp grft carotid-vertbrl,,,202.93,15039.8,143
CPT,35509,Art byp grft contral carotid,,,215.57,15039.8,143
CPT,35510,Art byp grft carotid-brchial,,,187.82,15039.8,143
CPT,35511,Art byp grft subclav-subclav,,,171.1,15039.8,143
CPT,35512,Art byp grft subclav-brchial,,,184.05,15039.8,143
CPT,35515,Art byp grft subclav-vertbrl,,,202.93,15039.8,143
CPT,35516,Art byp grft subclav-axilary,,,186.36,15039.8,143
CPT,35518,Art byp grft axillary-axilry,,,174.51,15039.8,143
CPT,35521,Art byp grft axill-femoral,,,187.64,15039.8,143
CPT,35522,Art byp grft axill-brachial,,,178.64,15039.8,143
CPT,35523,Art byp grft brchl-ulnr-rdl,,,193.44,15039.8,143
CPT,35525,Art byp grft brachial-brchl,,,172.99,15039.8,143
CPT,35526,Art byp grft aor/carot/innom,,,264.56,15811.94,143
CPT,35531,Art byp grft aorcel/aormesen,,,297.83,17829.91,143
CPT,35533,Art byp grft axill/fem/fem,,,230.21,15039.8,143
CPT,35535,Art byp grft hepatorenal,,,290.64,17401.8,143
CPT,35536,Art byp grft splenorenal,,,258.25,15461.88,143
CPT,35537,Art byp grft aortoiliac,,,318.2,19054.34,107
CPT,35538,Art byp grft aortobi-iliac,,,356.66,21352.2,107
CPT,35539,Art byp grft aortofemoral,,,334.64,20035.43,143
CPT,35540,Art byp grft aortbifemoral,,,1958.57,22328.76,107
CPT,35556,Art byp grft fem-popliteal,,,212.74,15039.8,143
CPT,35558,Art byp grft fem-femoral,,,188.16,15039.8,143
CPT,35560,Art byp grft aortorenal,,,260.36,15596.01,143
CPT,35563,Art byp grft ilioiliac,,,202.24,15039.8,143
CPT,35565,Art byp grft iliofemoral,,,199.93,15039.8,143
CPT,35566,Art byp fem-ant-post tib/prl,,,253.75,15141.19,143
CPT,35570,Art byp tibial-tib/peroneal,,,225.0,15039.8,143
CPT,35571,Art byp pop-tibl-prl-other,,,202.04,15039.8,143
CPT,35572,Harvest femoropopliteal vein,,,52.36,3127.09,52
CPT,35583,Vein byp grft fem-popliteal,,,220.27,15039.8,143
CPT,35585,Vein byp fem-tibial peroneal,,,254.75,15224.47,143
CPT,35587,Vein byp pop-tibl peroneal,,,208.31,15039.8,143
CPT,35600,Open hrv uxtr art 1 sgm cab,,,28.38,15039.8,71
CPT,35601,Bpg com crtd-ipsi int crtd,,,214.2,15039.8,143
CPT,35602,Bpg crtd-clat crtd,,,14101.68,14101.68,9
CPT,35606,Bpg carotid-subclavian,,,179.19,15039.8,143
CPT,35612,Bpg subclavian-subclavian,,,159.76,15039.8,143
CPT,35616,Bpg subclavian-axillary,,,168.32,15039.8,143
CPT,35621,Bpg axillary-femoral,,,167.57,15039.8,143
CPT,35623,Bpg axillary-pop/-tibial,,,200.86,15039.8,143
CPT,35626,Bpg aor-subcla/innom/carotid,,,243.13,15039.8,143
CPT,35631,Bpg aor-celiac-msn-renal,,,282.15,16851.87,143
CPT,35632,Bpg ilio-celiac,,,275.84,16520.83,143
CPT,35633,Bpg ilio-mesenteric,,,302.69,18050.08,143
CPT,35634,Bpg iliorenal,,,270.01,16167.82,143
CPT,35636,Bpg splenorenal,,,243.7,15039.8,143
CPT,35637,Bpg aortoiliac,,,253.31,15173.81,107
CPT,35638,Bpg aortobi-iliac,,,264.89,15934.94,107
CPT,35642,Bpg carotid-vertebral,,,151.03,15039.8,143
CPT,35645,Bpg subclavian-vertebral,,,144.79,15039.8,143
CPT,35646,Bpg aortobifemoral,,,260.33,15523.38,107
CPT,35647,Bpg aortofemoral,,,236.79,15039.8,143
CPT,35650,Bpg axillary-axillary,,,156.14,15039.8,143
CPT,35654,Bpg axillary-femoral-femoral,,,208.12,15039.8,107
CPT,35656,Bpg femoral-popliteal,,,164.03,15039.8,143
CPT,35661,Bpg femoral-femoral,,,165.4,15039.8,143
CPT,35663,Bpg ilioiliac,,,186.12,15039.8,143
CPT,35665,Bpg iliofemoral,,,179.11,15039.8,143
CPT,35666,Bpg fem-ant tib pst tib/prnl,,,196.63,15039.8,143
CPT,35671,Bpg pop-tibl/-prnl artery,,,173.26,15039.8,143
CPT,35681,Composite byp grft pros&vein,,,12.16,15039.8,71
CPT,35682,Composite byp grft 2 veins,,,335.78,15039.8,71
CPT,35683,Composite byp grft 3/> segmt,,,390.43,15039.8,71
CPT,35685,Bypass graft patency/patch,,,30.22,1807.46,52
CPT,35686,Bypass graft/av fist patency,,,24.52,1468.44,52
CPT,35691,Art trnsposj vertbrl carotid,,,144.68,15039.8,143
CPT,35693,Art trnsposj subclavian,,,127.71,15039.8,143
CPT,35694,Art trnsposj subclav carotid,,,151.04,15039.8,143
CPT,35695,Art trnsposj carotid subclav,,,156.81,15039.8,143
CPT,35697,Reimplant artery each,,,22.4,15039.8,107
CPT,35700,Reoperation bypass graft,,,23.13,15039.8,71
CPT,35701,Expl n/flwd surg neck art,,,68.16,15039.8,143
CPT,35702,Expl n/flwd surg uxtr art,,,63.18,15039.8,143
CPT,35703,Expl n/flwd surg lxtr art,,,63.89,15039.8,143
CPT,35800,Explore neck vessels,,,113.2,15039.8,107
CPT,35820,Explore chest vessels,,,308.24,18473.46,107
CPT,35840,Explore abdominal vessels,,,187.3,15039.8,107
CPT,35860,Explore limb vessels,,,128.62,4266.34,107
CPT,35870,Repair vessel graft defect,,,190.76,15039.8,107
CPT,35875,Removal of clot in graft,,,474.92,7852.28,71
CPT,35876,Removal of clot in graft,,,143.92,7852.28,107
CPT,35879,Revise graft w/vein,,,140.8,7852.28,143
CPT,35881,Revise graft w/vein,,,156.29,10095.79,143
CPT,35883,Revj fem anast nonautog grf,,,182.86,7852.28,143
CPT,35884,Revj fem anast autog vn grf,,,189.31,7852.28,143
CPT,35901,Excision graft neck,,,72.78,15039.8,107
CPT,35903,Excision graft extremity,,,86.36,4266.34,107
CPT,35905,Excision graft thorax,,,256.68,15368.16,107
CPT,35907,Excision graft abdomen,,,290.36,17460.93,107
CPT,36000,HC INTRO NEEDLE/INTRACATH VEIN,299.89,224.92,3.6,269.9,119
CPT,36000,Place needle in vein,,,72.35,280.38,16
CPT,36002,HC THROMBIN INJ PSEUDOANEURYSM EXTREM BILATERAL,2406.32,1804.74,28.88,2165.69,119
CPT,36002,HC THROMBIN INJ PSEUDOANEURYSM EXTREM UNILATERAL,1203.16,902.37,14.44,1082.84,119
CPT,36002,Pseudoaneurysm injection trt,,,150.48,1034.41,71
CPT,36005,HC EXTREMITY VENOGRAM INJ BILATERAL,1627.49,1220.62,19.53,1464.74,119
CPT,36005,HC EXTREMITY VENOGRAM INJ UNILATERAL,813.74,610.3,9.76,732.37,119
CPT,36005,Injection ext venography,,,69.42,2167.57,52
CPT,36010,HC VENACAVA CATH PLACEMENT BILATERAL,5089.13,3816.85,61.07,4580.22,119
CPT,36010,HC VENACAVA CATH PLACEMENT UNILATERAL,2544.56,1908.42,30.53,2290.1,119
CPT,36010,Place catheter in vein,,,155.76,4567.04,52
CPT,36011,HC CATH PLCMNT 1ST ORDER VENOUS BILATERAL,2996.64,2247.48,35.96,2696.98,119
CPT,36011,HC CATH PLCMNT 1ST ORDER VENOUS UNILATERAL,1498.32,1123.74,17.98,1348.49,119
CPT,36011,Place catheter in vein,,,224.87,6874.66,52
CPT,36012,HC CATH PLCMNT 2ND ORDER VENOUS BILATERAL,2991.64,2243.73,35.9,2692.48,119
CPT,36012,HC CATH PLCMNT 2ND ORDER VENOUS UNILATERAL,1495.82,1121.86,17.95,1346.24,119
CPT,36012,Place catheter in vein,,,248.73,7173.97,52
CPT,36013,HC CATH PLCMNT MAIN PUL ARTERY,1434.62,1075.96,17.22,1291.16,119
CPT,36013,Place catheter in artery,,,120.15,6632.52,52
CPT,36014,HC CATH PLCMNT SELECT PUL ARTERY BILATERAL,2476.91,1857.68,29.72,2229.22,119
CPT,36014,HC CATH PLCMNT SELECT PUL ARTERY UNILATERAL,1238.45,928.84,14.86,1114.6,119
CPT,36014,Place catheter in artery,,,217.95,6714.51,52
CPT,36015,HC CATH PLACEMENT SEG PUL ART BILATERAL,3690.32,2767.74,44.28,3321.29,119
CPT,36015,HC CATH PLACEMENT SEG PUL ART UNILATERAL,1845.16,1383.87,22.14,1660.64,119
CPT,36015,Place catheter in artery,,,246.27,7212.7,52
CPT,36100,Establish access to artery,,,221.16,4745.33,52
CPT,36140,"HC NEEDLE/INTRACATH INTRO, UPR OR LWR EXTREM ARTERY",1462.88,1097.16,17.55,1316.59,119
CPT,36140,Intro ndl icath upr/lxtr art,,,85.28,4346.98,52
CPT,36160,Establish access to aorta,,,118.56,4833.14,52
CPT,36160,HC CATH PLACEMENT AORTA TRANSLUM,1350.2,1012.65,16.2,1215.18,119
CPT,36200,HC INTRODUCTION CATH AORTA,2518.64,1888.98,30.22,2266.78,119
CPT,36200,HC INTRODUCTION CATH AORTA BILATERAL ACCESS,2518.64,1888.98,30.22,2266.78,119
CPT,36200,Place catheter in aorta,,,199.22,5070.16,52
CPT,36215,HC CATH 1ST ORDER THORAC/BRACHIO,3859.56,2894.67,46.31,3473.6,119
CPT,36215,Place catheter in artery,,,203.81,8954.72,52
CPT,36216,HC CATH 2ND THORAC/BRACHIO,3519.89,2639.92,42.24,3167.9,119
CPT,36216,Place catheter in artery,,,259.03,9257.38,52
CPT,36217,HC CATH 3RD THORAC/BRACHIO,4093.55,3070.16,49.12,3684.2,119
CPT,36217,Place catheter in artery,,,316.07,16116.57,52
CPT,36218,HC CATH ADDL 3RD THOR/BRACHIO,2067.25,1550.44,24.81,1860.52,119
CPT,36218,Place catheter in artery,,,49.84,1844.62,52
CPT,36221,HC CATH AORTA ANGIO CERV/VERTEB/CEREB UNILATERAL OR BILATERAL,7436.71,5577.53,89.24,6693.04,119
CPT,36221,Place cath thoracic aorta,,,190.72,8440.57,71
CPT,36222,HC FIRST ORDER CATH CERVICAL CAROTID ANGIO UNILATERAL,9869.58,7402.18,118.43,8882.62,119
CPT,36222,HC FIRST ORDER CATHETER CERVICAL CAROTID ANGIO BILATERAL,19739.17,14804.38,236.87,17765.25,119
CPT,36222,Place cath carotid/inom art,,,408.99,10723.65,71
CPT,36223,HC FIRST ORDER CERV/CEREB CAROTID ANGIO BILATERAL,16570.5,12427.88,198.85,14913.45,119
CPT,36223,HC FIRST ORDER CERV/CEREB CAROTID ANGIO UNILATERAL,12926.73,9695.05,155.12,11634.06,119
CPT,36223,Place cath carotid/inom art,,,469.61,14846.81,71
CPT,36224,HC INTERN CAROTID CATH W CERV/CEREB ANGIO BILATERAL,35268.24,26451.18,423.22,31741.42,119
CPT,36224,HC INTERN CAROTID CATH W CERV/CEREB ANGIO UNILATERAL,17634.12,13225.59,211.61,15870.71,119
CPT,36224,Place cath carotd art,,,527.57,18072.35,71
CPT,36225,HC FIRST ORDER CATH W VERTEBRAL ANGIO BILATERAL,9522.59,7141.94,114.27,8570.33,119
CPT,36225,HC FIRST ORDER CATH W VERTEBRAL ANGIO UNILATERAL,14317.34,10738.0,171.81,12885.61,119
CPT,36225,Place cath subclavian art,,,465.39,14100.27,71
CPT,36226,HC VERTEBRAL CATH PLCMNT ANGIO BILATERAL,19504.25,14628.19,234.05,17553.82,119
CPT,36226,HC VERTEBRAL CATH PLCMT ANGIO UNILATERAL,9752.12,7314.09,117.03,8776.91,119
CPT,36226,Place cath vertebral art,,,524.4,17623.25,71
CPT,36227,HC EXTERNAL CAROTID CATHETER PLACEMNT ANGIO UNILATERAL,12774.03,9580.52,153.29,11496.63,119
CPT,36227,Place cath xtrnl carotid,,,172.65,2209.26,52
CPT,36228,HC CATH PLCMNT EACH ADDL INTRACRAN/VERT ANGIO-LIMIT 2,3718.69,2789.02,44.62,3346.82,119
CPT,36228,Place cath intracranial art,,,353.75,11585.0,52
CPT,36245,HC ABDOMEN 1ST ORDER CATH PLACE BILATERAL,4953.1,3714.82,59.44,4457.79,119
CPT,36245,HC ABDOMEN 1ST ORDER CATH PLACE UNILATERAL,2476.55,1857.41,29.72,2228.9,119
CPT,36245,Ins cath abd/l-ext art 1st,,,338.37,10618.49,52
CPT,36246,HC CATH PLACEMENT 2ND ORDER ABD BILATERAL,4934.98,3701.24,59.22,4441.48,119
CPT,36246,HC CATH PLACEMENT 2ND ORDER ABD UNILATERAL,2471.99,1853.99,29.66,2224.79,119
CPT,36246,Ins cath abd/l-ext art 2nd,,,360.86,7182.05,52
CPT,36247,HC CATH PLACEMENT 3RD ORDER ABD BILATERAL,5042.51,3781.88,60.51,4538.26,119
CPT,36247,HC CATH PLACEMENT 3RD ORDER ABD UNILATERAL,2521.26,1890.94,30.26,2269.13,119
CPT,36247,Ins cath abd/l-ext art 3rd,,,429.06,12170.8,52
CPT,36248,HC ABDOMEN ADD 2/3 ORDER CATH PLACE,1232.42,924.32,14.79,1109.18,119
CPT,36248,Ins cath abd/l-ext art addl,,,46.53,1029.68,52
CPT,36251,HC RENAL ANGIOGRAPHY UNILATERAL,6407.94,4805.96,76.9,5767.15,119
CPT,36251,Ins cath ren art 1st unilat,,,245.65,10981.96,71
CPT,36252,HC RENAL ANGIOGRAPHY BILATERAL,7340.34,5505.26,88.08,6606.31,119
CPT,36252,Ins cath ren art 1st bilat,,,340.25,11965.22,71
CPT,36253,HC RENAL ANGIO UNILATERAL-SUPERSELECT,7198.99,5399.24,86.39,6479.09,119
CPT,36253,Ins cath ren art 2nd+ unilat,,,339.42,17242.24,71
CPT,36254,HC RENAL ANGIO BILATERAL-SUPERSELECT,11133.85,8350.39,133.61,10020.46,119
CPT,36254,Ins cath ren art 2nd+ bilat,,,396.09,16754.5,71
CPT,36260,Insertion of infusion pump,,,534.26,7852.28,71
CPT,36261,Revision of infusion pump,,,63.65,7291.4,107
CPT,36262,Removal of infusion pump,,,255.44,5315.69,71
CPT,36299,HC PERC SCLERO VASC HIGH,2479.26,1859.44,29.75,2231.33,119
CPT,36299,HC PERC SCLERO VASC LOW,1282.26,961.7,15.39,1154.03,119
CPT,36299,HC PERC SCLERO VASC MODERATE,2479.78,1859.84,29.76,2231.8,119
CPT,36299,Unlisted px vascular njx,,,,,0
CPT,36400,Vnpnxr<3yrs phy/qhp fem/jug,,,18.44,252.0,52
CPT,36405,Vnpnxr<3yrs phy/qhp scalp vn,,,14.54,217.8,52
CPT,36406,Vnpnxr<3yrs phy/qhp other vn,,,8.59,161.43,52
CPT,36410,Vnpnxr 3yr/> phy/qhp dx/ther,,,8.88,164.39,52
CPT,36415,Coll venous bld venipuncture,,,4.5,27.58,66
CPT,36415,HC VENIPUNCTURE,32.49,24.37,0.39,29.24,119
CPT,36415,HC VENIPUNCTURE POC,196.91,147.68,2.36,177.22,119
CPT,36416,Collj capillary blood spec,,,4.71,9.74,11
CPT,36416,HC CAPILLARY BLOOD DRAW,23.11,17.33,0.28,20.8,119
CPT,36416,HC CAPILLARY BLOOD DRAW POC,23.46,17.6,0.28,21.11,119
CPT,36420,Venipuncture cutdown < 1 yr,,,46.32,437.77,71
CPT,36425,Venipuncture cutdown 1 yr/>,,,26.51,452.32,71
CPT,36430,HC ADMIN BLOOD TRANSFUSION DAILY,1107.34,830.5,13.29,996.61,119
CPT,36430,Transfusion bld/bld compnt,,,36.67,486.58,71
CPT,36440,Bld push tfuj 2 yr/<,,,48.88,758.56,71
CPT,36450,Bld exchange truj newborn,,,154.12,758.56,71
CPT,36455,Bld exchange truj oth thn nb,,,120.69,758.56,71
CPT,36456,Prtl exchange transfuse nb,,,94.79,896.14,71
CPT,36460,HC TRANSFUSION INTRAUTERINE FETAL,1999.79,1499.84,24.0,1799.81,119
CPT,36460,Intrauterine transfusion ftl,,,53.64,979.81,71
CPT,36465,Njx noncmpnd sclrsnt 1 vein,,,171.27,3365.26,71
CPT,36466,Njx noncmpnd sclrsnt mlt vn,,,220.83,3535.29,71
CPT,36468,Njx sclrsnt spider veins,,,383.01,444.68,19
CPT,36470,Njx sclrsnt 1 incmptnt vein,,,55.95,2581.45,71
CPT,36471,HC INJ SCLEROSING SOLN:MULTI SAME LEG OTR THAN TELANGIECTASIA,1732.8,1299.6,20.79,1559.52,119
CPT,36471,Njx sclrsnt mlt incmptnt vn,,,109.71,2581.45,71
CPT,36473,Endovenous mchnchem 1st vein,,,259.97,3503.18,71
CPT,36474,Endovenous mchnchem add-on,,,129.32,2217.15,52
CPT,36475,Endovenous rf 1st vein,,,399.17,4266.34,71
CPT,36476,Endovenous rf vein add-on,,,192.75,2497.92,52
CPT,36478,Endovenous laser 1st vein,,,398.85,4266.34,71
CPT,36478,HC IR ABLTN EXTM INCOMP VEIN INTL,6340.91,4755.68,76.09,5706.82,119
CPT,36479,Endovenous laser vein addon,,,194.69,2703.21,52
CPT,36481,HC PORTAL VEIN ACCESS,2999.03,2249.27,35.99,2699.13,119
CPT,36481,Insertion of catheter vein,,,314.44,14874.6,52
CPT,36482,Endoven ther chem adhes 1st,,,256.73,6016.57,71
CPT,36483,Endoven ther chem adhes sbsq,,,127.35,12466.37,52
CPT,36500,HC VENOUS CATH BLOOD SAMPLE,953.83,715.37,11.45,858.45,119
CPT,36500,Insertion of catheter vein,,,174.08,3328.91,52
CPT,36510,HC UMBILICAL VEIN CATH NEWB FOR DIAGN/THERAP,4571.38,3428.54,54.86,4114.24,119
CPT,36510,Insertion of catheter vein,,,51.83,1057.98,52
CPT,36511,Apheresis wbc,,,105.81,2310.17,71
CPT,36511,HC THERAPEUTIC APHERESIS WBC,7912.46,5934.34,94.95,7121.21,119
CPT,36512,Apheresis rbc,,,102.99,2310.17,71
CPT,36512,HC THERAPEUTIC APHERESIS RBC,8954.34,6715.76,107.45,8058.91,119
CPT,36513,Apheresis platelets,,,102.53,1936.08,71
CPT,36514,Apheresis plasma,,,90.23,2310.17,71
CPT,36514,HC PLASMAPHERESIS,10967.35,8225.51,131.61,9870.62,119
CPT,36516,Apheresis immunoads slctv,,,82.05,5879.43,71
CPT,36522,HC PHOTOPHERESIS,12098.31,9073.73,145.18,10888.48,238
CPT,36522,Photopheresis,,,92.94,6034.02,71
CPT,36555,HC CENTRAL VENOUS CATH INSERT <5YRS,3771.77,2828.83,45.26,3394.59,119
CPT,36555,Insert non-tunnel cv cath,,,82.62,4695.73,71
CPT,36556,HC CENTRAL VENOUS CATH INSERT >5YRS,1885.86,1414.4,22.63,1697.27,119
CPT,36556,Insert non-tunnel cv cath,,,81.75,5056.94,71
CPT,36557,HC INSRT TUNNL CVC NO PORT/PUMP,3150.22,2362.66,37.8,2835.2,119
CPT,36557,Insert tunneled cv cath,,,246.79,7852.28,107
CPT,36558,HC TUNNEL CATH INSERT W/O PORT>5YRS,3852.5,2889.38,46.23,3467.25,119
CPT,36558,Insert tunneled cv cath,,,200.18,4266.34,107
CPT,36560,HC INSRT TUNNEL CATH W/PORT <5YRS,3411.81,2558.86,40.94,3070.63,119
CPT,36560,Insert tunneled cv cath,,,296.27,6580.77,107
CPT,36561,HC PORT INSERTION W/SUBCUTAN PORT >5YRS,4968.15,3726.11,59.62,4471.34,119
CPT,36561,Insert tunneled cv cath,,,256.33,4266.34,107
CPT,36563,Insert tunneled cv cath,,,280.74,7852.28,71
CPT,36565,Insert tunneled cv cath,,,258.33,4266.34,107
CPT,36566,Insert tunneled cv cath,,,275.36,10671.55,107
CPT,36568,HC INS PICC W/O PORT W/O IMG GDN <5 YRS,3322.96,2492.22,39.88,2990.66,119
CPT,36568,Insj picc <5 yr w/o imaging,,,89.81,3575.5,71
CPT,36569,HC PERIPHERALLY INSERTED CENTRAL CATHETER > 5YRS,4475.12,3356.34,53.7,4027.61,119
CPT,36569,Insj picc 5 yr+ w/o imaging,,,90.52,6580.77,71
CPT,36570,HC INSERT PERIPH  CVAD W/PORT <5YRS,4485.39,3364.04,53.82,4036.85,119
CPT,36570,Insert picvad cath,,,256.41,4266.34,107
CPT,36571,HC INSERT PERIP CVC W PORT >5YRS,4485.14,3363.86,53.82,4036.63,119
CPT,36571,Insert picvad cath,,,240.48,4266.34,107
CPT,36572,HC PERIPHERALLY INSERTED CENTRAL CATHETER W/O PORT >5YRS,5011.74,3758.8,60.14,4510.57,119
CPT,36572,Insj picc rs&i <5 yr,,,78.79,3575.5,71
CPT,36573,HC PERIPHERALLY INSERTED CENTRAL CATHETER W/IMAGE >5YRS,4051.82,3038.86,48.62,3646.64,119
CPT,36573,Insj picc rs&i 5 yr+,,,81.4,3575.5,71
CPT,36575,HC REPAIR CV CATHETER W/O PORT,4290.66,3218.0,51.49,3861.59,119
CPT,36575,Repair tunneled cv cath,,,32.29,1034.41,71
CPT,36576,Repair tunneled cv cath,,,141.15,1850.43,71
CPT,36578,Replace tunneled cv cath,,,156.65,4266.34,71
CPT,36580,HC REPLACE NON-TUNNEL CVC W/O PORT,3253.13,2439.85,39.04,2927.82,119
CPT,36580,Replace cvad cath,,,63.48,2233.16,71
CPT,36581,HC REPLACE TUNNEL CATH W/O PORT,4788.89,3591.67,57.47,4310.0,119
CPT,36581,Replace tunneled cv cath,,,140.86,5172.02,71
CPT,36582,HC REPLACE TUNNEL CATH W/PORT,4781.81,3586.36,57.38,4303.63,119
CPT,36582,Replace tunneled cv cath,,,221.25,4266.34,71
CPT,36583,Replace tunneled cv cath,,,253.29,12688.69,71
CPT,36584,Compl rplcmt picc rs&i,,,56.73,3575.5,71
CPT,36584,HC COMPLETE REPLACEMENT PICC RS&I,3025.06,2268.8,36.3,2722.55,119
CPT,36585,Replace picvad cath,,,216.51,10634.03,71
CPT,36589,HC TUNNEL CATH REMOVAL W/O PORT,1833.61,1375.21,22.0,1650.25,119
CPT,36589,Removal tunneled cv cath,,,105.43,1550.8,71
CPT,36590,HC REMOVAL TUNNEL CATH W/PORT,2186.34,1639.76,26.24,1967.71,119
CPT,36590,Removal tunneled cv cath,,,146.41,3575.5,71
CPT,36591,Draw blood off venous device,,,25.08,866.91,71
CPT,36591,HC BLD COLLECT VENOUS ACCESS DEVICE POC,247.4,185.55,2.97,222.66,119
CPT,36591,HC BLOOD COLLECT VENOUS ACESS DEVICE,228.59,171.44,2.74,205.73,119
CPT,36592,Collect blood from picc,,,27.28,1550.8,71
CPT,36592,HC COLLECT BLOOD FROM PICC,238.3,178.72,2.86,214.47,119
CPT,36593,Declot vascular device,,,31.02,369.17,71
CPT,36593,HC THROMBOLYSIS VAD/CATHETER,693.02,519.76,8.32,623.72,119
CPT,36595,HC CATHETER STRIPPING,1725.84,1294.38,20.71,1553.26,119
CPT,36595,Mech remov tunneled cv cath,,,174.13,5172.02,71
CPT,36596,HC INTRALUMINAL CATHETER STRIPPING,1897.97,1423.48,22.78,1708.17,119
CPT,36596,Mech remov tunneled cv cath,,,42.47,1850.43,71
CPT,36597,HC REPOSITION CENTRAL VENOUS CATH,2107.95,1580.96,25.3,1897.16,119
CPT,36597,Reposition venous catheter,,,58.85,4334.52,71
CPT,36598,HC INJECTION CV CATHETER PATENCY,720.28,540.21,8.64,648.25,119
CPT,36598,Inj w/fluor eval cv device,,,51.99,1550.8,71
CPT,36600,HC ABG DRAW,1342.1,1006.58,16.11,1207.89,119
CPT,36600,Withdrawal of arterial blood,,,14.57,1550.8,71
CPT,36620,HC ARTERIAL CATHETERIZATION FOR MONITORING,44.63,33.47,0.54,40.17,119
CPT,36620,Insertion catheter artery,,,43.41,404.95,52
CPT,36625,HC INSERTION CATHETER ARTERY,1701.62,1276.21,20.42,1531.46,119
CPT,36625,Insertion catheter artery,,,102.16,966.8,52
CPT,36640,Insertion catheter artery,,,112.86,4266.34,71
CPT,36660,HC CATH UMBCL ARTRY NB DX/THER,439.7,329.78,5.28,395.73,119
CPT,36660,Insertion catheter artery,,,66.38,15039.8,71
CPT,36680,HC PLCMNT NEEDLE INTRAOSS INF,611.49,458.62,7.34,550.34,119
CPT,36680,Insert needle bone cavity,,,57.78,3575.5,71
CPT,36800,Insertion of cannula,,,116.89,7852.28,71
CPT,36810,Insertion of cannula,,,202.72,5315.69,71
CPT,36815,Insertion of cannula,,,129.8,7852.28,71
CPT,36818,Av fuse uppr arm cephalic,,,105.35,7852.28,107
CPT,36819,Av fuse uppr arm basilic,,,111.56,7852.28,107
CPT,36820,Av fusion/forearm vein,,,110.56,7852.28,143
CPT,36821,Av fusion direct any site,,,101.03,6580.77,107
CPT,36823,Insertion of cannula(s),,,1141.26,15039.8,71
CPT,36825,Artery-vein autograft,,,121.23,7852.28,107
CPT,36830,Artery-vein nonautograft,,,101.83,10953.35,107
CPT,36831,Open thrombect av fistula,,,94.16,7852.28,107
CPT,36832,Av fistula revision open,,,115.45,7852.28,107
CPT,36833,Av fistula revision,,,123.35,7852.28,107
CPT,36835,Insertion thomas shunt,,,390.15,6580.77,71
CPT,36836,HC FISTULA UPPR PERIPHERAL SINGLE ARTERY/VEIN ACCESS,40081.4,30061.05,480.98,36073.26,119
CPT,36836,Prq av fstl crtj uxtr 1 acs,,,341.14,28480.59,71
CPT,36837,HC FISTULA UPPR PERIPHERAL 2 SEPARATE ARTERY/VEIN ACCESS,40081.4,30061.05,480.98,36073.26,119
CPT,36837,Prq av fstl crt uxtr sep acs,,,444.91,27124.38,71
CPT,36838,Dist revas ligation hemo,,,174.4,23868.77,143
CPT,36860,External cannula declotting,,,106.6,22732.17,71
CPT,36861,Cannula declotting,,,133.95,7852.28,71
CPT,36901,HC AV FISTULAGRAM,8277.37,6208.03,99.33,7449.63,119
CPT,36901,Intro cath dialysis circuit,,,161.45,1872.74,71
CPT,36902,HC AV FIST W PERIPH PTA,19042.24,14281.68,228.51,17138.02,119
CPT,36902,Intro cath dialysis circuit,,,229.71,6896.03,71
CPT,36903,HC AV FIST W PERIPH STENT,30030.14,22522.6,360.36,27027.13,119
CPT,36903,Intro cath dialysis circuit,,,301.75,17929.67,71
CPT,36904,HC AV FIST W MECH/LYTIC THROMBECTOMY,14447.48,10835.61,173.37,13002.73,119
CPT,36904,Thrmbc/nfs dialysis circuit,,,353.28,8974.03,71
CPT,36905,HC AV FIST W MECH/LYTIC THROMB W PERIPH PTA,17963.69,13472.77,215.56,16167.32,119
CPT,36905,Thrmbc/nfs dialysis circuit,,,424.86,17929.67,71
CPT,36906,HC AV FIST W/MECH/LYTIC THROMB W PERIPH STENTING,38287.8,28715.85,459.45,34459.02,119
CPT,36906,Thrmbc/nfs dialysis circuit,,,489.68,29836.82,71
CPT,36907,Balo angiop ctr dialysis seg,,,140.29,15026.35,52
CPT,36907,HC DIALYSIS CENTRAL VN PTA,13127.94,9845.96,157.54,11815.15,119
CPT,36908,HC DIALYSIS CENTRAL VN STENT,24349.27,18261.95,292.19,21914.34,119
CPT,36908,Stent plmt ctr dialysis seg,,,197.86,25005.38,52
CPT,36909,Dialysis circuit embolj,,,192.87,15892.56,52
CPT,36909,HC DIALYSIS EMBO ANY VEIN(S),29111.1,21833.32,349.33,26199.99,119
CPT,37140,Revision of circulation,,,1885.87,21548.42,71
CPT,37145,Revision of circulation,,,333.31,19997.98,107
CPT,37160,Revision of circulation,,,342.31,20533.62,107
CPT,37180,Revision of circulation,,,328.93,19740.56,107
CPT,37181,Splice spleen/kidney veins,,,359.21,21548.42,107
CPT,37182,HC TIPS PROCEDURE,34614.59,25960.94,415.38,31153.13,119
CPT,37182,Insert hepatic shunt (tips),,,784.28,18561.26,71
CPT,37183,HC TIPS REVISION,25835.83,19376.87,310.03,23252.25,119
CPT,37183,Revision tips,,,360.13,18059.67,71
CPT,37184,HC THROMBECTOMY ARTERY NON INTRACRANIAL INITIAL W FLUORO BILATERAL,14999.46,11249.6,179.99,13499.51,119
CPT,37184,HC THROMBECTOMY ARTERY NON INTRACRANIAL INITIAL W FLUORO UNILATERAL,7663.71,5747.78,91.96,6897.34,119
CPT,37184,Prim art m-thrmbc 1st vsl,,,255.2,29836.82,107
CPT,37185,HC THROMBECTOMY ARTERY NON INTRACRANIAL ADDL VESSELS W FLUORO,4353.57,3265.18,52.24,3918.21,119
CPT,37185,Prim art m-thrmbc sbsq vsl,,,96.68,7520.88,52
CPT,37186,HC THROMBECTOMY 2ND ARTERY NON INTRACRANIAL W FLUORO,7737.81,5803.36,92.85,6964.03,119
CPT,37186,Sec art thrombectomy add-on,,,143.97,25005.38,52
CPT,37187,HC VENOUS MECH THROMBECTOMY W/INJ UNILATERAL,8653.88,6490.41,103.85,7788.49,119
CPT,37187,Venous mech thrombectomy,,,232.92,20343.28,106
CPT,37188,HC VENOUS MECH THROMBEC REPEAT BILATERAL,14710.74,11033.06,176.53,13239.67,119
CPT,37188,HC VENOUS MECH THROMBEC REPEAT UNILATERAL,7355.37,5516.53,88.26,6619.83,119
CPT,37188,Ven mechnl thrmbc repeat tx,,,166.47,8522.61,106
CPT,37191,HC IVC FILTER PLACEMENT,13049.73,9787.3,156.6,11744.76,119
CPT,37191,Ins endovas vena cava filtr,,,212.57,17049.12,71
CPT,37192,HC IVC FILTER REPOSITION,5957.55,4468.16,71.49,5361.8,119
CPT,37192,Redo endovas vena cava filtr,,,328.67,5779.37,71
CPT,37193,HC IVC FILTER REMOVAL,9729.21,7296.91,116.75,8756.29,119
CPT,37193,Rem endovas vena cava filter,,,332.36,8931.05,71
CPT,37195,HC THROMBOLYSIS CERBRL IV INFUS,1074.96,806.22,12.9,967.46,119
CPT,37195,Thrombolytic therapy stroke,,,317.98,3575.5,27
CPT,37197,HC REMOVAL INTRAVASC FOREIGN BODY,7977.39,5983.04,95.73,7179.65,119
CPT,37197,Remove intrvas foreign body,,,287.4,4266.34,71
CPT,37200,HC TRANSCATHETER BIOPSY,3106.22,2329.66,37.27,2795.6,119
CPT,37200,Transcatheter biopsy,,,206.58,7852.28,71
CPT,37211,HC THROMBOLYSIS ARTERIAL NON INTRACRANIAL INITIAL BILATERAL,15222.14,11416.6,182.67,13699.93,119
CPT,37211,HC THROMBOLYSIS ARTERIAL NON INTRACRANIAL INITIAL UNILATERAL,7514.57,5635.93,90.17,6763.11,119
CPT,37211,Thrombolytic art therapy,,,553.91,10656.66,71
CPT,37212,HC THROMBOLYSIS VENOUS INITIAL DAY BILATERAL,14234.95,10676.21,170.82,12811.46,119
CPT,37212,HC THROMBOLYSIS VENOUS INITIAL DAY UNILATERAL,7117.48,5338.11,85.41,6405.73,119
CPT,37212,Thrombolytic venous therapy,,,484.8,6580.77,71
CPT,37213,HC THROMBOLYSIS FOLLOW-UP ART/VEIN INCL CATH EXCH,9961.01,7470.76,119.53,8964.91,119
CPT,37213,Thromblytic art/ven therapy,,,221.15,8931.05,71
CPT,37214,Cessj therapy cath removal,,,117.07,4454.93,71
CPT,37214,HC THROMBOLYSIS CESSATION W CATH REMOVAL,10359.1,7769.32,124.31,9323.19,119
CPT,37215,HC CERV CAROTID STENT W/DEP UNILATERAL,14519.58,10889.68,174.23,13067.62,119
CPT,37215,Transcath stent cca w/eps,,,794.36,15039.8,107
CPT,37216,HC CERV CAROTID STENT OPEN/PERC INCL PTA W/O DEP,18141.73,13606.3,217.7,16327.56,119
CPT,37216,Transcath stent cca w/o eps,,,2345.95,9090.92,16
CPT,37217,Stent placemt retro carotid,,,867.8,15039.8,107
CPT,37218,Stent placemt ante carotid,,,661.14,15039.8,107
CPT,37220,HC REVASC ILIAC INITIAL W/PTA BILATERAL,13696.48,10272.36,164.36,12326.83,119
CPT,37220,HC REVASC ILIAC INITIAL W/PTA UNILATERAL,12921.37,9691.03,155.06,11629.23,119
CPT,37220,Iliac revasc,,,572.27,8287.7,62
CPT,37221,HCD REVASC ILIAC W/STENT PTA BILATERAL,30375.88,22781.91,364.51,27338.29,119
CPT,37221,HCD REVASC ILIAC W/STENT PTA UNILATERAL,30375.88,22781.91,364.51,27338.29,119
CPT,37221,Iliac revasc w/stent,,,704.51,17877.91,62
CPT,37222,HCD REVASC ILIAC EACH ADDL W/PTA BILATERAL,12383.38,9287.54,148.6,11145.04,119
CPT,37222,HCD REVASC ILIAC EACH ADDL W/PTA UNILATERAL,12384.07,9288.05,148.61,11145.66,119
CPT,37222,Iliac revasc add-on,,,265.26,6915.21,52
CPT,37223,HCD REVASC ILIAC EACH ADDL W/STENT PTA UNILATERAL,35958.37,26968.78,431.5,32362.53,119
CPT,37223,Iliac revasc w/stent add-on,,,302.52,14982.96,52
CPT,37224,Fem/popl revas w/tla,,,635.07,8801.43,62
CPT,37224,HC REVASC FEM-POP W/PTA UNILATERAL,17457.73,13093.3,209.49,15711.96,119
CPT,37225,Fem/popl revas w/ather,,,854.57,30254.92,62
CPT,37225,HC IR REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIO SM VESSEL UNILATERAL,44287.06,33215.3,531.44,39858.35,119
CPT,37226,Fem/popl revasc w/stent,,,741.72,20769.03,62
CPT,37226,HCD REVASC FEM-POP W/STENT PTA UNILATERAL,30542.99,22907.24,366.52,27488.69,119
CPT,37227,Fem/popl revasc stnt & ather,,,1025.63,28661.82,62
CPT,37227,HC REVAS FEM-POP W/ATHER W STNT/PTA UNILATERAL,62527.94,46895.96,750.34,56275.15,119
CPT,37228,HCD REVASC TIB-PERO INITIAL PTA UNILATERAL,33835.29,25376.47,406.02,30451.76,119
CPT,37228,Tib/per revasc w/tla,,,774.08,16502.68,62
CPT,37229,HC REVASC TIB PERO ARTHER PTA/INITIAL UNILATERAL,66279.61,49709.71,795.36,59651.65,119
CPT,37229,Tib/per revasc w/ather,,,992.75,22938.91,62
CPT,37230,HC REVASC TIB PERO W/STENT PTA INITIAL UNILATERAL,14975.63,11231.72,179.71,13478.07,119
CPT,37230,Tib/per revasc w/stent,,,989.93,22952.78,62
CPT,37231,HC REVASC TIB/PERO STNT ATHER BILATERAL,39487.36,29615.52,473.85,35538.62,119
CPT,37231,HC REVASC TIB/PERO STNT ATHER UNILATERAL,39487.36,29615.52,473.85,35538.62,119
CPT,37231,Tib/per revasc stent & ather,,,1051.76,30095.66,62
CPT,37232,HC REVASC TIB PER EA ADD W/PTA UNILATERAL,16708.29,12531.22,200.5,15037.46,119
CPT,37232,Tib/per revasc add-on,,,284.66,18036.42,52
CPT,37233,HC REVASC TIB/PER W/ATHR/PTA ADD BILATERAL,12111.0,9083.25,145.33,10899.9,119
CPT,37233,HC REVASC TIB/PER W/ATHR/PTA ADD UNILATERAL,25723.99,19292.99,308.69,23151.59,119
CPT,37233,Tibper revasc w/ather add-on,,,461.64,20450.44,52
CPT,37234,HC REVASC TIB-PER ADD W/STENT PTA UNILATERAL,24635.34,18476.5,295.62,22171.81,119
CPT,37234,Revsc opn/prq tib/pero stent,,,401.27,30308.1,52
CPT,37235,HC REVAS TIB-PER ADD W/ST/PTA/ATHER UNILATERAL,30718.05,23038.54,368.62,27646.24,119
CPT,37235,Tib/per revasc stnt & ather,,,533.46,33622.93,52
CPT,37236,HC STENT PLACEMT ARTERY W PTA INIT UNILATERAL,36252.85,27189.64,435.03,32627.56,119
CPT,37236,Open/perq place stent 1st,,,632.4,25401.14,71
CPT,37237,HC STENT PLACE ARTERY STENOSIS INC PTA EACH ADDL,13847.25,10385.44,166.17,12462.52,119
CPT,37237,Open/perq place stent ea add,,,300.77,28179.29,52
CPT,37238,HC STENT PLACEMT VEIN INC PTA 1ST VEIN UNILATERAL,24275.41,18206.56,291.3,21847.87,119
CPT,37238,Open/perq place stent same,,,438.11,17929.67,71
CPT,37239,HC STENT PLACEMT EA ADD VEIN INC PTA,7930.51,5947.88,95.17,7137.46,119
CPT,37239,Open/perq place stent ea add,,,215.07,14502.86,52
CPT,37241,HC VASC EMBOLIZE/OCCLUDE VENOUS,26604.41,19953.31,319.25,23943.97,119
CPT,37241,Vasc embolize/occlude venous,,,411.79,16550.47,71
CPT,37242,HC VASC EMBOLIZE/OCCLUDE ARTERY,37931.72,28448.79,455.18,34138.55,119
CPT,37242,Vasc embolize/occlude artery,,,456.69,27124.38,71
CPT,37243,HC VASC EMBOLIZE/OCCLUDE ORGAN,21081.23,15810.92,252.97,18973.11,119
CPT,37243,Vasc embolize/occlude organ,,,538.76,22276.51,71
CPT,37244,HC VASC EMBOLIZE/OCCLUDE BLEED,31013.39,23260.04,372.16,27912.05,119
CPT,37244,Vasc embolize/occlude bleed,,,636.17,22732.17,71
CPT,37246,HC TRULUML BALO ANGIOP 1ST ART,10830.63,8122.97,129.97,9747.57,119
CPT,37246,Trluml balo angiop 1st art,,,498.77,11096.38,71
CPT,37247,HC TRULUML BALO ANGIOP ADDL ART,8819.34,6614.5,105.83,7937.41,119
CPT,37247,Trluml balo angiop addl art,,,246.78,11096.38,52
CPT,37248,HC TRULUML BALO ANGIOP 1ST VEIN,13123.45,9842.59,157.48,11811.11,119
CPT,37248,Trluml balo angiop 1st vein,,,426.14,8693.6,71
CPT,37249,HC TRULUML BALO ANGIOP ADDL VEIN,13104.55,9828.41,157.25,11794.1,119
CPT,37249,Trluml balo angiop addl vein,,,208.7,4402.01,52
CPT,37252,HC INTRAVASC US NONCORONARY INITIAL,6514.55,4885.91,78.17,5863.1,119
CPT,37252,Intrvasc us noncoronary 1st,,,85.38,7949.68,52
CPT,37253,HC INTRAVASC US NONCORONARY ADDL,6017.92,4513.44,72.22,5416.13,119
CPT,37253,Intrvasc us noncoronary addl,,,67.72,3228.47,52
CPT,37254,Revsc evasc ivt angio sf 1st,,,5762.85,5762.85,9
CPT,37255,Revsc evasc ivt angio sf ea,,,,,0
CPT,37256,Revsc evasc ivt angio cplx 1,,,5762.85,5762.85,9
CPT,37257,Revsc evsc ivt angio cplx ea,,,,,0
CPT,37258,Revsc evasc ivt stent sf 1st,,,11688.79,11688.79,9
CPT,37259,Revsc evasc ivt stent sf ea,,,,,0
CPT,37260,Revsc evasc ivt st cplx 1st,,,11688.79,11688.79,9
CPT,37261,Revsc evasc ivt st cplx ea,,,,,0
CPT,37262,Iv lithotrp ivt w/in sm art,,,,,0
CPT,37263,Revsc evasc fpvt angio sf 1,,,5762.85,5762.85,9
CPT,37264,Revsc evasc fpvt angio sf ea,,,,,0
CPT,37265,Revsc evsc fpvt angio cplx 1,,,5762.85,5762.85,9
CPT,37266,Rvsc evsc fpvt angio cplx ea,,,,,0
CPT,37267,Revsc evsc fpvt stent sf 1st,,,11688.79,11688.79,9
CPT,37268,Revsc evasc fpvt stent sf ea,,,,,0
CPT,37269,Revsc evasc fpvt st cplx 1st,,,11688.79,11688.79,9
CPT,37270,Revsc evasc fpvt st cplx ea,,,,,0
CPT,37271,Revsc evsc fpvt athrc sf 1st,,,18561.26,18561.26,9
CPT,37272,Revsc evsc fpvt athrc sf ea,,,,,0
CPT,37273,Revsc evsc fpvt athrc cplx 1,,,18561.26,18561.26,9
CPT,37274,Rvsc evsc fpvt athrc cplx ea,,,,,0
CPT,37275,Rvsc evsc fpvt st athrc sf 1,,,18561.26,18561.26,9
CPT,37276,Rvsc evsc fpvt st athr sf ea,,,,,0
CPT,37277,Rvsc evsc fpvt st athr cpx 1,,,18561.26,18561.26,9
CPT,37278,Rvsc evsc fpvt st ath cpx ea,,,,,0
CPT,37279,Iv lithotrp fpvt w/in sm art,,,,,0
CPT,37280,Revsc evsc tpvt angio sf 1st,,,11688.79,11688.79,9
CPT,37281,Revsc evsc tpvt angio sf ea,,,,,0
CPT,37282,Rvsc evsc tpvt angio cplx 1,,,11688.79,11688.79,9
CPT,37283,Rvsc evsc tpvt angio cplx ea,,,,,0
CPT,37284,Revsc evasc tpvt st sf 1st,,,18561.26,18561.26,9
CPT,37285,Revsc evasc tpvt st sf ea,,,,,0
CPT,37286,Revsc evasc tpvt st cplx 1st,,,18561.26,18561.26,9
CPT,37287,Revsc evasc tpvt st cplx ea,,,,,0
CPT,37288,Revsc evsc tpvt athrc sf 1st,,,18561.26,18561.26,9
CPT,37289,Revsc evsc tpvt athrc sf ea,,,,,0
CPT,37290,Revsc evsc tpvt athrc cplx 1,,,18561.26,18561.26,9
CPT,37291,Revsc evsc tpvt athr cplx ea,,,,,0
CPT,37292,Rvsc evsc tpvt st athrc sf 1,,,18561.26,18561.26,9
CPT,37293,Rvsc evsc tpvt st athr sf ea,,,,,0
CPT,37294,Rvsc evsc tpvt st athr cpx 1,,,18561.26,18561.26,9
CPT,37295,Rvsc evsc tpvt st ath cpx ea,,,,,0
CPT,37296,Revsc evasc imvt angio sf 1,,,11688.79,11688.79,9
CPT,37297,Revsc evasc imvt angio sf ea,,,,,0
CPT,37298,Revsc evsc imvt angio cplx 1,,,11688.79,11688.79,9
CPT,37299,Revsc evsc imvt angio cpx ea,,,,,0
CPT,37500,Endoscopy ligate perf veins,,,506.51,7426.21,98
CPT,37501,Unlisted vasc endoscopy px,,,592.7,688.13,19
CPT,37565,Ligation int jugular vein,,,591.23,4266.34,107
CPT,37600,Ligation xtrnl carotid art,,,115.45,6223.69,107
CPT,37605,Ligation int/com carotid art,,,112.98,4266.34,107
CPT,37606,Lig int/com carotid art occl,,,113.36,4266.34,107
CPT,37607,Lig/banding angioacs av fstl,,,300.85,4266.34,71
CPT,37609,Ligation/bx temporal artery,,,158.18,3575.5,107
CPT,37615,Ligation major artery neck,,,79.73,4266.34,107
CPT,37616,Ligation major artery chest,,,170.36,15039.8,107
CPT,37617,Ligation major artery abd,,,203.27,15039.8,107
CPT,37618,Ligation major artery xtr,,,60.05,15039.8,107
CPT,37619,Ligation of inf vena cava,,,267.41,10240.29,107
CPT,37650,Ligation of femoral vein,,,369.61,4266.34,107
CPT,37660,Ligation common iliac vein,,,203.66,15039.8,143
CPT,37700,Ligation&div long saph vein,,,197.31,4266.34,107
CPT,37718,Lig div&strpg short saph vn,,,316.46,10245.5,107
CPT,37722,Lig div&strpg long saph vein,,,374.58,4266.34,107
CPT,37735,Lig&div&compl strpg saph vn,,,468.3,4266.34,107
CPT,37760,Lig prfratr vn radical 1 leg,,,463.86,4266.34,107
CPT,37761,Ligate leg veins open,,,82.93,4266.34,143
CPT,37765,Stab phleb veins xtr 10-20,,,207.7,3575.5,107
CPT,37766,Phleb veins - extrem 20+,,,254.42,3575.5,107
CPT,37780,Revision of leg vein,,,189.56,4266.34,107
CPT,37785,Ligate/divide/excise vein,,,204.9,4266.34,107
CPT,37788,Revascularization penis,,,194.76,15039.8,107
CPT,37790,Penile venous occlusion,,,389.05,4560.57,71
CPT,37799,HC LAP BAND INJECTION/EVALUATION,17804.08,13353.06,213.65,16023.67,119
CPT,37799,HC VASCULAR SURGERY PROCEDURE,395.41,296.56,4.74,355.87,119
CPT,37799,Unlisted px vascular surgery,,,592.7,688.13,19
CPT,38100,Removal of spleen total,,,178.63,15039.8,107
CPT,38101,Removal of spleen partial,,,180.64,15039.8,107
CPT,38102,Removal of spleen total,,,40.57,15039.8,71
CPT,38115,Repair of ruptured spleen,,,200.36,15039.8,107
CPT,38120,Laparoscopy splenectomy,,,164.23,12412.85,107
CPT,38129,Unlisted laps px spleen,,,5593.17,6493.67,19
CPT,38200,HC INJECTION PROC SPLENOPORTOGRAPHY,3016.65,2262.49,36.2,2714.98,119
CPT,38200,Injection for spleen x-ray,,,126.33,10083.85,52
CPT,38204,Bl donor search management,,,241.23,10402.86,16
CPT,38205,HC BLOOD CELL HARVEST TRANSPLANT ALLO,9767.13,7325.35,117.21,8790.42,119
CPT,38205,Harvest allogeneic stem cell,,,81.38,1214.86,53
CPT,38206,HC HARVEST AUTO STEM CELLS,10485.03,7863.77,125.82,9436.53,119
CPT,38206,Harvest auto stem cells,,,80.75,2310.17,71
CPT,38207,Cryopreserve stem cells,,,106.21,758.56,35
CPT,38208,Thaw preserved stem cells,,,66.78,1936.08,35
CPT,38209,Wash harvest stem cells,,,28.18,758.56,35
CPT,38210,T-cell depletion of harvest,,,188.99,758.56,35
CPT,38211,Tumor cell deplete of harvst,,,172.05,758.56,35
CPT,38212,Rbc depletion of harvest,,,113.38,758.56,35
CPT,38213,Platelet deplete of harvest,,,28.18,758.56,35
CPT,38214,HC TRANSPLANT PREP PLASMA DEPLETION,10657.88,7993.41,127.89,9592.09,119
CPT,38214,Volume deplete of harvest,,,96.54,758.56,35
CPT,38215,Harvest stem cell concentrte,,,113.38,758.56,35
CPT,38220,Dx bone marrow aspirations,,,98.34,1803.33,71
CPT,38220,HC BONE MARROW ASPIRATION ONLY BILATERAL,371.85,278.89,4.46,334.66,119
CPT,38220,HC BONE MARROW ASPIRATION ONLY UNILATERAL,447.45,335.59,5.37,402.7,119
CPT,38221,Dx bone marrow biopsies,,,101.94,1803.33,71
CPT,38221,HC BIOPSY BONE MARROW NEEDLE/TROCAR UNILATERAL,1420.06,1065.04,17.04,1278.05,119
CPT,38222,Dx bone marrow bx & aspir,,,110.01,3236.54,71
CPT,38222,HC BONE MARROW DIAGNOSTIC; BIOPSY(IES) & ASPIRATION(S) BILATERAL,4771.68,3578.76,57.26,4294.51,119
CPT,38222,HC BONE MARROW DIAGNOSTIC; BIOPSY(IES) & ASPIRATION(S) UNILATERAL,2385.84,1789.38,28.63,2147.26,119
CPT,38225,Car-t hrv bld-drv t lymphcyt,,,233.21,903.73,16
CPT,38226,Car-t prep t lymphcyt f/trns,,,94.15,2712.45,16
CPT,38227,Car-t receipt&prepj admn,,,94.96,757.41,16
CPT,38228,Car-t admn autologous,,,305.77,2639.54,35
CPT,38230,Bone marrow harvest allogen,,,196.21,2310.17,71
CPT,38232,Bone marrow harvest autolog,,,186.59,6034.02,71
CPT,38240,Transplt allo hct/donor,,,231.35,65825.66,71
CPT,38241,Transplt autol hct/donor,,,170.93,5056.94,71
CPT,38242,Transplt allo lymphocytes,,,121.11,18185.73,71
CPT,38243,Transplj hematopoietic boost,,,118.65,2310.17,71
CPT,38300,Drainage lymph node lesion,,,161.41,3236.54,71
CPT,38305,Drainage lymph node lesion,,,349.65,3236.54,71
CPT,38305,HC DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,1340.5,1005.38,16.09,1206.45,119
CPT,38308,Incision of lymph channels,,,72.26,4266.34,107
CPT,38380,Thoracic duct procedure,,,88.97,15039.8,107
CPT,38381,Thoracic duct procedure,,,123.81,15039.8,107
CPT,38382,Thoracic duct procedure,,,105.35,15039.8,107
CPT,38500,Biopsy/removal lymph nodes,,,198.18,6281.75,107
CPT,38505,HC NEDL BX LYMPH NODE BILATERAL,2681.16,2010.87,32.17,2413.04,119
CPT,38505,HC NEDL BX LYMPH NODE UNILATERAL,1340.58,1005.44,16.09,1206.52,119
CPT,38505,Needle biopsy lymph nodes,,,125.01,5303.64,71
CPT,38510,Biopsy/removal lymph nodes,,,326.21,4266.34,107
CPT,38520,Biopsy/removal lymph nodes,,,332.07,4266.34,107
CPT,38525,Biopsy/removal lymph nodes,,,312.24,4266.34,107
CPT,38530,Biopsy/removal lymph nodes,,,87.59,4266.34,143
CPT,38531,Open bx/exc inguinofem nodes,,,316.94,4266.34,107
CPT,38542,Explore deep node(s) neck,,,81.52,7571.84,143
CPT,38550,Removal neck/armpit lesion,,,369.53,4266.34,71
CPT,38555,Removal neck/armpit lesion,,,159.24,7258.41,107
CPT,38562,Removal pelvic lymph nodes,,,109.54,15039.8,107
CPT,38564,Removal abdomen lymph nodes,,,108.99,15039.8,107
CPT,38570,Laparoscopy lymph node biop,,,80.0,7571.84,143
CPT,38571,Laparoscopy lymphadenectomy,,,102.61,12412.85,143
CPT,38572,Laparoscopy lymphadenectomy,,,140.66,12412.85,143
CPT,38573,Laps pelvic lymphadec,,,182.54,12412.85,143
CPT,38589,Unlisted laps px lymphtc sys,,,5593.17,6493.67,19
CPT,38700,Removal of lymph nodes neck,,,126.03,10402.86,143
CPT,38720,Removal of lymph nodes neck,,,208.83,10402.86,143
CPT,38724,Removal of lymph nodes neck,,,226.46,15039.8,143
CPT,38740,Remove armpit lymph nodes,,,108.96,7571.84,143
CPT,38745,Remove armpit lymph nodes,,,136.95,11331.4,143
CPT,38746,Remove thoracic lymph nodes,,,32.76,15039.8,71
CPT,38747,Remove abdominal lymph nodes,,,41.09,15039.8,71
CPT,38760,Remove groin lymph nodes,,,130.05,7258.41,143
CPT,38765,Remove groin lymph nodes,,,203.49,15039.8,143
CPT,38770,Remove pelvis lymph nodes,,,124.85,15039.8,143
CPT,38780,Remove abdomen lymph nodes,,,161.57,15039.8,107
CPT,38790,HC INJECTION LYMPHANGIOGRAM BILATERAL,4017.5,3013.12,48.21,3615.75,119
CPT,38790,HC INJECTION LYMPHANGIOGRAM UNILATERAL,2008.75,1506.56,24.1,1807.88,119
CPT,38790,Inject for lymphatic x-ray,,,118.61,6294.88,52
CPT,38792,HC INJECTION FOR SENTINEL NODE BILATERAL,561.63,421.22,6.74,505.47,119
CPT,38792,HC INJECTION FOR SENTINEL NODE UNILATERAL,521.31,390.98,6.26,469.18,119
CPT,38792,Ra tracer id of sentinl node,,,47.39,8255.9,71
CPT,38794,Access thoracic lymph duct,,,197.59,2620.33,52
CPT,38900,Io map of sent lymph node,,,21.2,1275.28,88
CPT,38999,"HC UNLISTED PROCEDURE, HEMI OR LYMPHATIC SYSTEM",1565.19,1173.89,18.78,1408.67,119
CPT,38999,Unlistd px hemic/lymphtc sys,,,419.1,486.58,19
CPT,39000,Exploration of chest,,,74.47,15039.8,107
CPT,39010,Exploration of chest,,,121.22,15039.8,107
CPT,39200,Resect mediastinal cyst,,,133.69,15039.8,107
CPT,39220,Resect mediastinal tumor,,,174.81,15039.8,107
CPT,39401,Mediastinoscpy w/medstnl bx,,,295.29,7571.84,71
CPT,39402,Mediastinoscpy w/lmph nod bx,,,385.85,8809.22,71
CPT,39499,Unlisted px mediastinum,,,12954.18,15039.8,19
CPT,39501,Repair diaphragm laceration,,,131.41,15039.8,107
CPT,39503,Repair of diaphragm hernia,,,891.52,53243.85,107
CPT,39540,Repair of diaphragm hernia,,,133.88,15039.8,107
CPT,39541,Repair of diaphragm hernia,,,144.45,44623.52,107
CPT,39545,Revision of diaphragm,,,137.88,15039.8,107
CPT,39560,Resect diaphragm simple,,,124.14,15039.8,107
CPT,39561,Resect diaphragm complex,,,193.17,15039.8,107
CPT,39599,Unlisted px diaphragm,,,12954.18,15039.8,19
CPT,40490,Biopsy of lip,,,67.14,6266.3,71
CPT,40500,Partial excision of lip,,,290.24,9783.95,71
CPT,40510,Partial excision of lip,,,215.76,3825.0,71
CPT,40520,Partial excision of lip,,,281.76,3825.0,71
CPT,40525,Reconstruct lip with flap,,,434.33,3825.0,71
CPT,40527,Reconstruct lip with flap,,,496.34,7571.84,71
CPT,40530,Partial removal of lip,,,320.18,3825.0,71
CPT,40650,"HC REPAIR LIP,FULL THICK,VERMILION",1650.42,1237.82,19.81,1485.38,119
CPT,40650,Rpr lip fth vermilion only,,,246.65,6345.74,71
CPT,40652,"HC REPAIR LIP,<1/2 VERT HEIGHT",726.31,544.73,8.72,653.68,119
CPT,40652,Rpr lip fth<half ver height,,,283.52,3205.62,71
CPT,40654,HC RPR LIP FTH>1HALF VER HT/CPX,4800.65,3600.49,57.61,4320.58,119
CPT,40654,Rpr lip fth>1half ver ht/cpx,,,334.59,1850.43,71
CPT,40700,Repair cleft lip/nasal,,,751.32,7571.84,71
CPT,40701,Repair cleft lip/nasal,,,184.52,7571.84,107
CPT,40702,Repair cleft lip/nasal,,,154.9,7571.84,107
CPT,40720,Repair cleft lip/nasal,,,805.75,6345.74,107
CPT,40761,Repair cleft lip/nasal,,,847.1,7571.84,71
CPT,40799,Unlisted procedure lips,,,222.62,258.46,19
CPT,40800,Drainage of mouth lesion,,,91.14,3205.62,71
CPT,40800,HC DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,643.27,482.45,7.72,578.94,119
CPT,40801,Drainage of mouth lesion,,,152.7,6345.74,71
CPT,40801,HC DRAINAGE OF MOUTH LESION,726.31,544.73,8.72,653.68,119
CPT,40804,HC REMOVAL FOREIGN BODY MOUTH,643.27,482.45,7.72,578.94,119
CPT,40804,Removal foreign body mouth,,,87.18,1788.34,71
CPT,40805,HC RMVL EMBEDDED FB VESTIBULE MOUTH COMP,643.27,482.45,7.72,578.94,119
CPT,40805,Removal foreign body mouth,,,152.78,810.42,71
CPT,40806,Incision of lip fold,,,27.68,1498.81,71
CPT,40808,Biopsy of mouth lesion,,,68.43,566.8,71
CPT,40810,Excision of mouth lesion,,,95.06,3609.55,71
CPT,40812,Excise/repair mouth lesion,,,142.39,1648.68,71
CPT,40814,Excise/repair mouth lesion,,,222.56,3825.0,71
CPT,40816,Excision of mouth lesion,,,237.46,3825.0,71
CPT,40818,Excise oral mucosa for graft,,,208.27,3205.62,71
CPT,40819,Excise lip or cheek fold,,,155.44,3205.62,71
CPT,40820,Treatment of mouth lesion,,,127.47,3609.55,71
CPT,40830,HC CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,752.61,564.46,9.03,677.35,119
CPT,40830,Repair mouth laceration,,,112.74,1550.8,71
CPT,40831,HC CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,726.31,544.73,8.72,653.68,119
CPT,40831,Repair mouth laceration,,,155.8,896.48,71
CPT,40840,Reconstruction of mouth,,,98.66,7571.84,107
CPT,40842,Reconstruction of mouth,,,532.31,7571.84,71
CPT,40843,Reconstruction of mouth,,,135.21,7571.84,107
CPT,40844,Reconstruction of mouth,,,182.72,7571.84,107
CPT,40845,Reconstruction of mouth,,,953.12,7571.84,71
CPT,40899,Unlisted px vestibule mouth,,,222.62,258.46,19
CPT,41000,Drainage of mouth lesion,,,81.74,6345.74,71
CPT,41000,HC INTRAORAL I&D TONGUE/FLOOR LINGUAL,726.31,544.73,8.72,653.68,119
CPT,41005,Drainage of mouth lesion,,,92.47,6345.74,71
CPT,41005,HC INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,726.31,544.73,8.72,653.68,119
CPT,41006,Drainage of mouth lesion,,,181.34,1850.43,71
CPT,41007,Drainage of mouth lesion,,,172.99,1850.43,71
CPT,41007,HC INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,726.31,544.73,8.72,653.68,119
CPT,41008,Drainage of mouth lesion,,,201.31,3825.0,71
CPT,41008,HC INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,10510.4,7882.8,126.12,9459.36,119
CPT,41009,Drainage of mouth lesion,,,222.9,1550.8,71
CPT,41009,HC INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,726.31,544.73,8.72,653.68,119
CPT,41010,HC INCISION OF LINGUAL FRENUM (FRENOTOMY),2386.86,1790.14,28.64,2148.17,119
CPT,41010,Incision of tongue fold,,,85.29,3205.62,71
CPT,41015,Drainage of mouth lesion,,,233.88,1135.75,71
CPT,41016,Drainage of mouth lesion,,,270.08,7571.84,71
CPT,41017,Drainage of mouth lesion,,,269.07,3825.0,71
CPT,41018,Drainage of mouth lesion,,,313.66,6345.74,71
CPT,41019,Place needles h&n for rt,,,475.74,7571.84,71
CPT,41100,Biopsy of tongue,,,83.37,1550.8,71
CPT,41105,Biopsy of tongue,,,85.48,6345.74,71
CPT,41108,Biopsy of floor of mouth,,,70.96,1803.33,71
CPT,41110,Excision of tongue lesion,,,100.92,3609.55,71
CPT,41112,Excision of tongue lesion,,,190.71,3825.0,71
CPT,41113,Excision of tongue lesion,,,208.11,3825.0,71
CPT,41114,Excision of tongue lesion,,,490.1,3825.0,71
CPT,41115,Excision of tongue fold,,,113.63,3205.62,71
CPT,41116,Excision of mouth lesion,,,169.26,3825.0,71
CPT,41120,Partial removal of tongue,,,163.95,7571.84,107
CPT,41130,Partial removal of tongue,,,203.17,15039.8,107
CPT,41135,Tongue and neck surgery,,,335.54,19847.39,107
CPT,41140,Removal of tongue,,,338.03,19942.3,107
CPT,41145,Tongue removal neck surgery,,,426.14,25134.37,107
CPT,41150,Tongue mouth jaw surgery,,,340.38,20114.96,107
CPT,41153,Tongue mouth neck surgery,,,369.54,21934.05,107
CPT,41155,Tongue jaw & neck surgery,,,463.92,27348.65,107
CPT,41250,"HC REPAIR TONGUE LACER,<2.6 CM",1293.24,969.93,15.52,1163.92,119
CPT,41250,Repair tongue laceration,,,119.05,18382.87,71
CPT,41251,"HC REPAIR TONGUE LACER,POST 1/3",726.31,544.73,8.72,653.68,119
CPT,41251,Repair tongue laceration,,,142.17,22920.83,71
CPT,41252,"HC REPAIR TONGUE LACER,2.6 CM+/COMPLX",752.61,564.46,9.03,677.35,119
CPT,41252,Repair tongue laceration,,,162.9,2153.55,71
CPT,41510,Tongue to lip surgery,,,355.27,3825.0,71
CPT,41512,Tongue suspension,,,369.88,9534.91,70
CPT,41520,Reconstruction tongue fold,,,197.49,3825.0,71
CPT,41530,Tongue base vol reduction,,,364.28,7990.93,70
CPT,41599,Unlisted px tongue flr mouth,,,222.62,258.46,19
CPT,41800,Drainage of gum lesion,,,118.16,3205.62,71
CPT,41800,HC DRAINAGE OF GUM LESION,643.27,482.45,7.72,578.94,119
CPT,41805,HC REMOVAL FOREIGN BODY GUM,643.27,482.45,7.72,578.94,119
CPT,41805,Removal foreign body gum,,,151.07,1820.5,71
CPT,41806,Removal foreign body jawbone,,,214.51,2273.48,71
CPT,41820,Excision gum each quadrant,,,693.53,3825.0,27
CPT,41821,Excision of gum flap,,,838.01,1850.43,27
CPT,41822,Excision of gum lesion,,,155.48,3205.62,71
CPT,41823,Excision of gum lesion,,,285.62,6584.15,71
CPT,41825,Excision of gum lesion,,,93.67,3609.55,71
CPT,41826,Excision of gum lesion,,,152.54,3609.55,71
CPT,41827,Excision of gum lesion,,,225.41,7571.84,71
CPT,41828,Excision of gum lesion,,,172.31,1648.68,71
CPT,41830,Removal of gum tissue,,,243.1,6345.74,71
CPT,41850,Treatment of gum lesion,,,664.63,1850.43,27
CPT,41870,Periodontal mucosal grafting,,,943.96,1850.43,27
CPT,41872,Gingivoplasty each quadrant,,,236.75,3609.55,71
CPT,41874,Alveoloplasty each quadrant,,,189.43,3609.55,71
CPT,41899,Unlisted px dentalvlr strux,,,222.62,258.46,19
CPT,42000,Drainage mouth roof lesion,,,84.34,943.96,71
CPT,42000,HC DRAINAGE MOUTH ROOF LESION,752.61,564.46,9.03,677.35,119
CPT,42100,Biopsy roof of mouth,,,85.27,1648.68,71
CPT,42104,Excision lesion mouth roof,,,104.45,3609.55,71
CPT,42106,Excision lesion mouth roof,,,125.9,3609.55,71
CPT,42107,Excision lesion mouth roof,,,258.45,7571.84,71
CPT,42120,Remove palate/lesion,,,155.68,7571.84,107
CPT,42140,Excision of uvula,,,127.07,6345.74,71
CPT,42145,Repair palate pharynx/uvula,,,543.45,7571.84,71
CPT,42160,Treatment mouth roof lesion,,,111.24,3609.55,71
CPT,42180,HC REPAIR LAC PALATE<2 CM,726.31,544.73,8.72,653.68,119
CPT,42180,Repair lac palate<2 cm,,,145.86,6345.74,71
CPT,42182,HC REPAIR PALATE,1701.62,1276.21,20.42,1531.46,119
CPT,42182,Repair palate,,,201.41,7571.84,71
CPT,42200,Reconstruct cleft palate,,,143.8,7571.84,107
CPT,42205,Reconstruct cleft palate,,,149.72,6345.74,107
CPT,42210,Reconstruct cleft palate,,,167.05,7571.84,107
CPT,42215,Reconstruct cleft palate,,,108.91,7571.84,107
CPT,42220,Reconstruct cleft palate,,,89.66,7571.84,107
CPT,42225,Reconstruct cleft palate,,,151.75,7571.84,107
CPT,42226,Lengthening of palate,,,140.68,7571.84,107
CPT,42227,Lengthening of palate,,,131.09,7571.84,107
CPT,42235,Repair palate,,,115.1,7571.84,107
CPT,42260,Repair nose to lip fistula,,,104.74,7571.84,107
CPT,42280,Preparation palate mold,,,85.0,6345.74,71
CPT,42281,Insertion palate prosthesis,,,124.66,7571.84,71
CPT,42299,Unlisted px palate uvula,,,222.62,258.46,19
CPT,42300,Drainage of salivary gland,,,121.73,1850.43,71
CPT,42305,Drainage of salivary gland,,,334.7,6345.74,71
CPT,42310,Drainage of salivary gland,,,104.86,1550.8,71
CPT,42320,Drainage of salivary gland,,,139.79,3205.62,71
CPT,42330,Removal of salivary stone,,,128.8,3609.55,71
CPT,42335,Removal of salivary stone,,,206.68,3609.55,71
CPT,42340,Removal of salivary stone,,,272.05,3825.0,107
CPT,42400,Biopsy of salivary gland,,,51.06,783.1,71
CPT,42400,HC BIOPSY SALIVARY GLAND,2352.06,1764.04,28.22,2116.85,119
CPT,42405,Biopsy of salivary gland,,,176.9,3205.62,71
CPT,42408,Excision of salivary cyst,,,184.94,3825.0,71
CPT,42409,Drainage of salivary cyst,,,36.07,3825.0,107
CPT,42410,Excise parotid gland/lesion,,,98.49,7571.84,143
CPT,42415,Excise parotid gland/lesion,,,165.42,7571.84,143
CPT,42420,Excise parotid gland/lesion,,,185.38,7571.84,143
CPT,42425,Excise parotid gland/lesion,,,131.4,7571.84,143
CPT,42426,Excise parotid gland/lesion,,,210.85,15039.8,143
CPT,42440,Excise submaxillary gland,,,65.03,7571.84,143
CPT,42450,Excise sublingual gland,,,287.81,10548.13,71
CPT,42500,Repair salivary duct,,,272.84,7571.84,71
CPT,42505,Repair salivary duct,,,362.61,7571.84,71
CPT,42507,Parotid duct diversion,,,77.17,7571.84,107
CPT,42509,Parotid duct diversion,,,646.87,7571.84,71
CPT,42510,Parotid duct diversion,,,94.89,6345.74,107
CPT,42550,HC SIALOGRAM INJECTION,266.67,200.0,3.2,240.0,119
CPT,42550,Injection for salivary x-ray,,,60.02,6345.74,52
CPT,42600,Closure of salivary fistula,,,281.57,3825.0,71
CPT,42650,Dilation of salivary duct,,,56.93,1648.68,71
CPT,42660,Dilation of salivary duct,,,85.35,3205.62,71
CPT,42665,Ligation of salivary duct,,,154.12,3825.0,71
CPT,42699,Unlisted px salivry glnd/dux,,,222.62,258.46,19
CPT,42700,HC I&D ABSCESS PERITONSILLAR,643.27,482.45,7.72,578.94,119
CPT,42700,I&d abscess peritonsillar,,,105.61,540.24,71
CPT,42720,I&d absc phrngl ntraorl appr,,,300.94,3825.0,71
CPT,42725,I&d absc phrngl xtrnl appr,,,124.18,7571.84,107
CPT,42800,Biopsy of throat,,,90.42,3205.62,71
CPT,42804,Biopsy of upper nose/throat,,,95.16,6345.74,71
CPT,42806,Biopsy of upper nose/throat,,,109.58,3825.0,71
CPT,42808,Excise pharynx lesion,,,129.67,3825.0,71
CPT,42809,HC REMOVE PHARYNX FOREIGN BODY,583.94,437.96,7.01,525.55,119
CPT,42809,Remove pharynx foreign body,,,98.39,3205.62,71
CPT,42810,Excision of neck cyst,,,43.93,3825.0,143
CPT,42815,Excision of neck cyst,,,84.4,7571.84,143
CPT,42820,Remove tonsils and adenoids,,,230.24,6584.15,88
CPT,42821,Remove tonsils and adenoids,,,241.11,6345.74,88
CPT,42825,Removal of tonsils,,,212.17,6584.15,84
CPT,42826,Removal of tonsils,,,202.14,4523.0,84
CPT,42830,Removal of adenoids,,,167.44,4523.0,84
CPT,42831,Removal of adenoids,,,182.2,4523.0,84
CPT,42835,Removal of adenoids,,,156.24,3958.0,71
CPT,42836,Removal of adenoids,,,193.69,3958.0,71
CPT,42842,Extensive surgery of throat,,,794.08,7571.84,71
CPT,42844,Extensive surgery of throat,,,213.66,7571.84,107
CPT,42845,Extensive surgery of throat,,,342.85,20261.61,107
CPT,42860,Excision of tonsil tags,,,153.05,6345.74,71
CPT,42870,Excision of lingual tonsil,,,462.06,16981.2,71
CPT,42890,Limited pharyngectomy,,,220.39,7571.84,107
CPT,42892,Revision of pharyngeal walls,,,289.58,7571.84,107
CPT,42894,Revision of pharyngeal walls,,,367.82,21732.91,107
CPT,42900,Repair throat wound,,,258.9,6345.74,71
CPT,42950,Reconstruction of throat,,,123.72,18214.29,107
CPT,42953,Repair throat esophagus,,,147.83,15039.8,107
CPT,42955,Surgical opening of throat,,,117.66,6345.74,107
CPT,42960,Control throat bleeding,,,125.28,7344.53,71
CPT,42961,Control throat bleeding,,,65.46,15039.8,107
CPT,42962,Control throat bleeding,,,410.27,3825.0,71
CPT,42970,Control nose/throat bleeding,,,222.62,3275.88,71
CPT,42971,Control nose/throat bleeding,,,70.78,15039.8,107
CPT,42972,Control nose/throat bleeding,,,79.25,3825.0,107
CPT,42975,Dise eval slp do brth flx dx,,,93.25,3542.34,71
CPT,42999,Unlisted px phrnx adnd/tnsl,,,222.62,258.46,19
CPT,43020,Incision of esophagus,,,87.82,3205.62,107
CPT,43030,Cricopharyngeal myotomy,,,81.79,7571.84,107
CPT,43045,Esophagotomy thrc rmvl fb,,,200.59,15039.8,107
CPT,43100,Excision of esophagus lesion,,,99.37,15039.8,107
CPT,43101,Excision of esophagus lesion,,,154.95,15039.8,107
CPT,43107,Removal of esophagus,,,457.66,27368.27,107
CPT,43108,Removal of esophagus,,,681.41,40710.37,107
CPT,43112,Esphg tot w/thrcm,,,533.3,31397.31,143
CPT,43113,Removal of esophagus,,,666.14,39836.11,143
CPT,43116,Partial removal of esophagus,,,761.93,45507.54,107
CPT,43117,Partial removal of esophagus,,,499.8,33386.53,143
CPT,43118,Partial removal of esophagus,,,555.83,38139.74,143
CPT,43121,Partial removal of esophagus,,,438.33,26248.7,143
CPT,43122,Partial removal of esophagus,,,393.37,27839.57,107
CPT,43123,Partial removal of esophagus,,,690.57,41289.76,107
CPT,43124,Removal of esophagus,,,583.84,34940.78,107
CPT,43130,Removal of esophagus pouch,,,123.56,34604.84,107
CPT,43135,Removal of esophagus pouch,,,225.86,29283.78,107
CPT,43180,Esophagoscopy rigid trnso,,,432.22,7571.84,71
CPT,43191,Esophagoscopy rigid trnso dx,,,150.77,11341.56,71
CPT,43192,Esophagoscp rig trnso inject,,,164.93,6345.74,71
CPT,43193,Esophagoscp rig trnso biopsy,,,164.32,2464.18,71
CPT,43194,Esophagoscp rig trnso rem fb,,,187.09,2464.18,71
CPT,43195,Esophagoscopy rigid balloon,,,179.69,5028.36,71
CPT,43196,Esophagoscp guide wire dilat,,,189.71,2464.18,71
CPT,43197,Esophagoscopy flex dx brush,,,79.59,4214.12,71
CPT,43198,Esophagosc flex trnsn biopsy,,,95.68,2065.16,71
CPT,43200,Esophagoscopy flexible brush,,,84.38,1448.17,71
CPT,43201,Esoph scope w/submucous inj,,,99.5,2464.18,71
CPT,43202,Esophagoscopy flex biopsy,,,98.92,2464.18,71
CPT,43204,Esoph scope w/sclerosis inj,,,129.86,2464.18,71
CPT,43205,Esophagus endoscopy/ligation,,,135.16,2464.18,71
CPT,43206,Esoph optical endomicroscopy,,,127.59,2464.18,71
CPT,43210,Egd esophagogastrc fndoplsty,,,413.97,17929.67,71
CPT,43211,Esophagoscop mucosal resect,,,225.72,2464.18,71
CPT,43212,Esophagoscop stent placement,,,182.42,15026.35,71
CPT,43213,Esophagoscopy retro balloon,,,250.47,3232.77,71
CPT,43214,Esophagosc dilate balloon 30,,,187.3,8696.02,71
CPT,43215,Esophagoscopy flex remove fb,,,135.58,2464.18,71
CPT,43216,Esophagoscopy lesion removal,,,127.9,2464.18,71
CPT,43217,Esophagoscopy snare les remv,,,153.24,2464.18,71
CPT,43220,Esophagoscopy balloon <30mm,,,113.34,2464.18,71
CPT,43226,Esoph endoscopy dilation,,,125.39,2464.18,71
CPT,43227,Esophagoscopy control bleed,,,158.38,2464.18,71
CPT,43229,Esophagoscopy lesion ablate,,,188.92,7291.4,71
CPT,43231,Esophagoscop ultrasound exam,,,94.05,2464.18,71
CPT,43232,Esophagoscopy w/us needle bx,,,117.74,6110.72,71
CPT,43233,Egd balloon dil esoph30 mm/>,,,219.54,2464.18,71
CPT,43235,Egd diagnostic brush wash,,,117.67,2065.16,86
CPT,43236,Uppr gi scope w/submuc inj,,,132.21,2065.16,71
CPT,43237,Endoscopic us exam esoph,,,187.99,2464.18,71
CPT,43238,Egd us fine needle bx/aspir,,,222.84,2464.18,71
CPT,43239,Egd biopsy single/multiple,,,132.79,2065.16,86
CPT,43240,Egd w/transmural drain cyst,,,375.84,11033.64,71
CPT,43241,Egd tube/cath insertion,,,136.16,2464.18,71
CPT,43242,Egd us fine needle bx/aspir,,,252.66,9246.98,71
CPT,43243,Egd injection varices,,,227.99,2464.18,71
CPT,43244,Egd varices ligation,,,235.31,2464.18,71
CPT,43245,Egd dilate stricture,,,168.75,2464.18,71
CPT,43246,Egd place gastrostomy tube,,,119.44,2464.18,71
CPT,43246,HC EGD W/PEG PLACEMENT,3444.05,2583.04,41.33,3099.65,119
CPT,43247,Egd remove foreign body,,,169.83,2065.16,71
CPT,43248,Egd guide wire insertion,,,159.39,2065.16,71
CPT,43249,Esoph egd dilation <30 mm,,,147.51,2823.45,71
CPT,43250,Egd cautery tumor polyp,,,163.46,2464.18,71
CPT,43251,Egd remove lesion snare,,,188.27,2464.18,71
CPT,43252,Egd optical endomicroscopy,,,161.4,2464.18,71
CPT,43253,Egd us transmural injxn/mark,,,252.35,2464.18,71
CPT,43254,Egd endo mucosal resection,,,259.27,2464.18,71
CPT,43255,Egd control bleeding any,,,192.28,2464.18,71
CPT,43257,Egd w/thrml txmnt gerd,,,222.96,7291.4,71
CPT,43259,Egd us exam duodenum/jejunum,,,216.33,2464.18,71
CPT,43260,Ercp w/specimen collection,,,309.19,6110.72,71
CPT,43261,Endo cholangiopancreatograph,,,324.91,5028.36,71
CPT,43262,Endo cholangiopancreatograph,,,342.67,5028.36,71
CPT,43263,Ercp sphincter pressure meas,,,342.98,4214.12,71
CPT,43264,Ercp remove duct calculi,,,349.23,5028.36,71
CPT,43265,Ercp lithotripsy calculi,,,415.27,7010.96,71
CPT,43265,HC ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,6271.25,4703.44,75.26,5644.12,119
CPT,43266,Egd endoscopic stent place,,,208.98,10656.66,71
CPT,43270,Egd lesion ablation,,,215.27,5875.69,71
CPT,43273,Endoscopic pancreatoscopy,,,113.99,8931.05,52
CPT,43273,HC SPYGLASS ENDOSCOPIC PANCREATOSCOPY,6640.48,4980.36,79.69,5976.43,119
CPT,43274,Ercp duct stent placement,,,443.8,9254.47,71
CPT,43275,Ercp remove forgn body duct,,,360.74,2464.18,71
CPT,43276,Ercp stent exchange w/dilate,,,462.2,9254.47,71
CPT,43277,Ercp ea duct/ampulla dilate,,,363.04,5028.36,71
CPT,43278,Ercp lesion ablate w/dilate,,,414.93,7755.91,71
CPT,43279,Lap myotomy heller,,,198.83,15039.8,107
CPT,43280,Laparoscopy fundoplasty,,,167.26,11587.73,107
CPT,43281,Lap paraesophag hern repair,,,238.45,11587.73,107
CPT,43282,Lap paraesoph her rpr w/mesh,,,268.24,12412.85,107
CPT,43283,Lap esoph lengthening,,,24.29,15039.8,71
CPT,43284,Laps esophgl sphnctr agmntj,,,101.28,17929.67,106
CPT,43285,Rmvl esophgl sphnctr dev,,,104.24,7571.84,106
CPT,43286,Esphg tot w/laps moblj,,,489.86,29345.73,107
CPT,43287,Esphg dstl 2/3 w/laps moblj,,,545.27,32646.77,143
CPT,43288,Esphg thrsc moblj,,,575.79,34464.97,143
CPT,43289,Unlisted laps px esoph,,,5593.17,6493.67,19
CPT,43290,Egd flx trnsorl dplmnt balo,,,174.29,27361.16,70
CPT,43291,Egd flx trnsorl rmvl balo,,,154.07,28885.0,70
CPT,43300,Repair of esophagus,,,97.8,15039.8,107
CPT,43305,Repair esophagus and fistula,,,171.15,15039.8,107
CPT,43310,Repair of esophagus,,,227.85,15039.8,107
CPT,43312,Repair esophagus and fistula,,,243.77,15039.8,107
CPT,43313,Esophagoplasty congenital,,,449.26,27026.98,107
CPT,43314,Tracheo-esophagoplasty cong,,,481.92,28919.69,107
CPT,43320,Fuse esophagus & stomach,,,216.93,22651.24,107
CPT,43325,Revise esophagus & stomach,,,210.93,24237.51,107
CPT,43327,Esoph fundoplasty lap,,,127.28,15039.8,107
CPT,43328,Esoph fundoplasty thor,,,172.64,15039.8,107
CPT,43330,Esophagomyotomy abdominal,,,207.44,15039.8,107
CPT,43331,Esophagomyotomy thoracic,,,206.08,15039.8,107
CPT,43332,Transab esoph hiat hern rpr,,,177.66,15039.8,107
CPT,43333,Transab esoph hiat hern rpr,,,194.6,15039.8,107
CPT,43334,Transthor diaphrag hern rpr,,,190.99,15039.8,107
CPT,43335,Transthor diaphrag hern rpr,,,204.88,15039.8,107
CPT,43336,Thorabd diaphr hern repair,,,222.54,15039.8,107
CPT,43337,Thorabd diaphr hern repair,,,237.19,15039.8,107
CPT,43338,Esoph lengthening,,,17.63,15039.8,71
CPT,43340,Fuse esophagus & intestine,,,214.17,15039.8,107
CPT,43341,Fuse esophagus & intestine,,,215.25,15039.8,107
CPT,43351,Surgical opening esophagus,,,202.86,15039.8,107
CPT,43352,Surgical opening esophagus,,,164.33,15039.8,107
CPT,43360,Gastrointestinal repair,,,345.38,20694.55,107
CPT,43361,Gastrointestinal repair,,,417.76,25115.54,107
CPT,43400,Ligate esophagus veins,,,236.38,17344.05,107
CPT,43405,Ligate/staple esophagus,,,224.29,21049.27,107
CPT,43410,Repair esophagus wound,,,161.3,15039.8,107
CPT,43415,Repair esophagus wound,,,396.18,23692.54,107
CPT,43420,Repair esophagus opening,,,805.55,8094.09,71
CPT,43425,Repair esophagus opening,,,221.78,19856.65,107
CPT,43450,Dilate esophagus 1/mult pass,,,76.91,3205.62,71
CPT,43453,Dilate esophagus,,,83.16,11149.52,71
CPT,43460,HC ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,2385.78,1789.34,28.63,2147.2,119
CPT,43460,Pressure treatment esophagus,,,204.09,15039.8,71
CPT,43496,Free jejunum flap microvasc,,,2065.16,15039.8,35
CPT,43497,Transorl lwr esophgl myotomy,,,621.53,7292.33,71
CPT,43499,Unlisted procedure esophagus,,,898.8,1043.51,19
CPT,43500,Surgical opening of stomach,,,121.78,15039.8,107
CPT,43501,Surgical repair of stomach,,,209.07,15039.8,107
CPT,43502,Surgical repair of stomach,,,236.92,15039.8,107
CPT,43510,Surgical opening of stomach,,,147.61,10518.07,107
CPT,43520,Incision of pyloric muscle,,,107.23,15039.8,107
CPT,43605,Biopsy of stomach,,,129.43,15039.8,107
CPT,43610,Excision of stomach lesion,,,152.16,15039.8,107
CPT,43611,Excision of stomach lesion,,,190.48,15039.8,107
CPT,43620,Removal of stomach,,,307.46,18451.29,107
CPT,43621,Removal of stomach,,,352.0,21170.07,107
CPT,43622,Removal of stomach,,,358.12,21483.57,107
CPT,43631,Removal of stomach partial,,,224.63,17742.58,107
CPT,43632,Removal of stomach partial,,,315.71,18956.57,107
CPT,43633,Removal of stomach partial,,,298.22,17926.89,107
CPT,43634,Removal of stomach partial,,,329.38,19767.27,107
CPT,43635,Removal of stomach partial,,,17.43,15039.8,71
CPT,43640,Vagotomy & pylorus repair,,,185.06,16566.89,107
CPT,43641,Vagotomy & pylorus repair,,,187.15,15039.8,107
CPT,43644,Lap gastric bypass/roux-en-y,,,269.6,16191.08,107
CPT,43645,Lap gastr bypass incl smll i,,,286.54,17265.11,107
CPT,43647,Lap impl electrode antrum,,,11282.26,27124.38,27
CPT,43648,Lap revise/remv eltrd antrum,,,2074.9,14469.84,35
CPT,43651,Laparoscopy vagus nerve,,,102.09,22732.17,107
CPT,43652,Laparoscopy vagus nerve,,,119.09,10402.86,107
CPT,43653,Laparoscopy gastrostomy,,,89.82,7571.84,107
CPT,43659,Unlisted laps px stomach,,,5593.17,6493.67,19
CPT,43752,HC NASOGASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1185.4,889.05,14.22,1066.86,119
CPT,43752,Nasal/orogastric w/tube plmt,,,39.17,6345.74,71
CPT,43753,HC GASTRIC INTUBATION AND ASPIRATION TX,1755.72,1316.79,21.07,1580.15,119
CPT,43753,Tx gastro intub w/asp,,,3.37,6345.74,71
CPT,43754,Dx gastr intub w/asp spec,,,5.77,2058.77,71
CPT,43755,Dx gastr intub w/asp specs,,,9.18,549.21,71
CPT,43756,Dx duod intub w/asp spec,,,7.86,1725.45,71
CPT,43757,Dx duod intub w/asp specs,,,11.9,1448.17,71
CPT,43761,HC REPOSITIONING NASO/OROGASTRIC FEEDING TUBE,1050.75,788.06,12.61,945.68,119
CPT,43761,Reposition gastrostomy tube,,,101.28,1213.67,71
CPT,43762,HC RPLC GASTROSTOMY TUBE NO REVISION OF TRC,428.54,321.4,5.14,385.69,119
CPT,43762,Rplc gtube no revj trc,,,35.84,1213.67,71
CPT,43763,HC RPLC GASTROSTOMY TUBE W/ REVISION OF TRC,428.54,321.4,5.14,385.69,119
CPT,43763,Rplc gtube revj gstrst trc,,,84.25,897.52,71
CPT,43770,Lap place gastr adj device,,,174.88,16550.47,107
CPT,43771,Lap revise gastr adj device,,,198.66,15039.8,107
CPT,43772,Lap rmvl gastr adj device,,,147.42,13870.47,107
CPT,43773,Lap replace gastr adj device,,,198.66,9997.29,107
CPT,43774,Lap rmvl gastr adj all parts,,,149.37,5028.36,107
CPT,43775,Lap sleeve gastrectomy,,,172.08,15039.8,107
CPT,43800,Pyloroplasty,,,144.37,15039.8,107
CPT,43810,Gastroduodenostomy,,,157.96,15039.8,107
CPT,43820,Gastrojejunostomy wo vagotmy,,,208.72,15039.8,107
CPT,43825,Gastrojejunostomy w/vagotomy,,,203.69,15039.8,107
CPT,43830,Gstrst open wo constj tube,,,109.32,10519.31,107
CPT,43831,Gastrostomy open neonatal,,,94.73,10261.19,107
CPT,43832,Gstrst open w/constj tube,,,162.07,15039.8,107
CPT,43840,Gstrrphy sutr duol/gstr ulcr,,,211.18,15039.8,107
CPT,43842,Gstr rstcv px v-banded gstp,,,2770.23,12954.18,17
CPT,43843,Gstr rstcv oth/thn v-band,,,199.45,15039.8,143
CPT,43845,Gastroplasty duodenal switch,,,304.06,18301.98,107
CPT,43846,Gstr rstcv px shrt roux-en-y,,,256.49,15405.41,107
CPT,43847,Gstr rstcv px sm int rcnstj,,,280.71,16855.03,107
CPT,43848,Revj open gstr rstcv px,,,299.99,18022.78,107
CPT,43860,Revj gstr/jj anast w/o vgtmy,,,254.03,15252.26,107
CPT,43865,Revj gstr/jj anast w/vgtmy,,,265.25,15921.93,107
CPT,43870,Closure gastrostomy surgical,,,110.45,12782.88,107
CPT,43880,Closure gastrocolic fistula,,,246.32,15039.8,107
CPT,43881,Impl/rplcmt gstr nstim eltrd,,,12954.18,15039.8,19
CPT,43882,Rev/rmvl gstr nstim eltrd,,,12954.18,15039.8,19
CPT,43886,Gstr rstcv px opn revj port,,,57.1,4854.81,107
CPT,43887,Gstr rstcv px opn rmvl port,,,51.53,12553.26,107
CPT,43888,Gstr rstcv px opn rmvl&rplc,,,72.29,4854.81,107
CPT,43889,Gstr rstcv px trnsorl esg,,,10762.99,10762.99,9
CPT,43999,HC LAP BAND INJECTION/EVALUATION,17804.08,13353.06,213.65,16023.67,119
CPT,43999,Unlisted procedure stomach,,,898.8,1043.51,19
CPT,44005,Freeing of bowel adhesion,,,169.34,15039.8,107
CPT,44010,Incision of small bowel,,,131.98,15039.8,107
CPT,44015,Insert needle cath bowel,,,21.97,15039.8,71
CPT,44020,Explore small intestine,,,151.13,15039.8,107
CPT,44021,Decompress small bowel,,,151.02,15039.8,107
CPT,44025,Incision of large bowel,,,152.09,15039.8,107
CPT,44050,Reduce bowel obstruction,,,145.37,15039.8,107
CPT,44055,Correct malrotation of bowel,,,230.57,15039.8,107
CPT,44100,Biopsy of bowel,,,102.78,7324.21,71
CPT,44110,Excise intestine lesion(s),,,131.54,15039.8,107
CPT,44111,Excision of bowel lesion(s),,,152.92,15039.8,107
CPT,44120,Removal of small intestine,,,189.43,15039.8,107
CPT,44121,Removal of small intestine,,,37.24,15039.8,71
CPT,44125,Removal of small intestine,,,182.15,15039.8,107
CPT,44126,Enterectomy w/o taper cong,,,382.72,22975.56,107
CPT,44127,Enterectomy w/taper cong,,,442.0,26512.53,107
CPT,44128,Enterectomy cong add-on,,,37.56,19255.76,71
CPT,44130,Bowel to bowel fusion,,,204.03,22220.08,107
CPT,44132,Enterectomy cadaver donor,,,12954.18,15039.8,19
CPT,44133,Enterectomy live donor,,,12954.18,15039.8,19
CPT,44135,Intestine transplnt cadaver,,,12954.18,15039.8,19
CPT,44136,Intestine transplant live,,,12954.18,15039.8,19
CPT,44137,Remove intestinal allograft,,,12954.18,15039.8,19
CPT,44139,Mobilization of colon,,,18.61,15039.8,71
CPT,44140,Partial removal of colon,,,207.96,15039.8,107
CPT,44141,Partial removal of colon,,,280.59,16773.52,107
CPT,44143,Partial removal of colon,,,256.1,15309.91,107
CPT,44144,Partial removal of colon,,,273.33,16357.24,107
CPT,44145,Partial removal of colon,,,255.5,15297.5,107
CPT,44146,Partial removal of colon,,,324.4,19421.94,107
CPT,44147,Partial removal of colon,,,298.84,17965.92,107
CPT,44150,Removal of colon,,,286.63,17154.23,107
CPT,44151,Removal of colon/ileostomy,,,332.84,19918.35,107
CPT,44155,Removal of colon/ileostomy,,,319.25,19103.41,107
CPT,44156,Removal of colon/ileostomy,,,355.98,21291.69,107
CPT,44157,Colectomy w/ileoanal anast,,,338.26,20262.0,107
CPT,44158,Colectomy w/neo-rectum pouch,,,346.76,20764.92,107
CPT,44160,Removal of colon,,,192.48,16981.53,107
CPT,44180,Lap enterolysis,,,142.79,17403.02,107
CPT,44186,Lap jejunostomy,,,101.13,9685.41,107
CPT,44187,Lap ileo/jejuno-stomy,,,169.01,15039.8,107
CPT,44188,Lap colostomy,,,188.05,15039.8,107
CPT,44202,Lap enterectomy,,,215.1,15039.8,107
CPT,44203,Lap resect s/intestine addl,,,37.38,15039.8,71
CPT,44204,Laparo partial colectomy,,,237.79,15039.8,107
CPT,44205,Lap colectomy part w/ileum,,,206.57,15039.8,107
CPT,44206,Lap part colectomy w/stoma,,,269.32,16093.31,107
CPT,44207,L colectomy/coloproctostomy,,,280.11,16745.73,107
CPT,44208,L colectomy/coloproctostomy,,,304.67,18187.46,107
CPT,44210,Laparo total proctocolectomy,,,273.72,16338.61,107
CPT,44211,Lap colectomy w/proctectomy,,,327.0,19492.31,107
CPT,44212,Laparo total proctocolectomy,,,312.59,18733.05,107
CPT,44213,Lap mobil splenic fl add-on,,,28.74,16336.45,71
CPT,44227,Lap close enterostomy,,,256.57,15700.12,107
CPT,44238,Unlisted laps px intestine,,,5593.17,6493.67,19
CPT,44300,Open bowel to skin,,,130.64,15039.8,107
CPT,44310,Ileostomy/jejunostomy,,,161.22,15039.8,107
CPT,44312,Revision of ileostomy,,,468.64,6579.92,71
CPT,44314,Revision of ileostomy,,,155.85,15039.8,107
CPT,44316,Devise bowel pouch,,,219.63,15039.8,107
CPT,44320,Colostomy,,,185.88,15039.8,107
CPT,44322,Colostomy with biopsies,,,155.42,15039.8,107
CPT,44340,Revision of colostomy,,,493.06,9359.07,71
CPT,44345,Revision of colostomy,,,162.95,15039.8,107
CPT,44346,Revision of colostomy,,,183.27,15039.8,107
CPT,44360,Small bowel endoscopy,,,137.75,8199.73,71
CPT,44361,Small bowel endoscopy/biopsy,,,151.91,9224.52,71
CPT,44363,Small bowel endoscopy,,,184.03,2464.18,71
CPT,44364,Small bowel endoscopy,,,196.2,2464.18,71
CPT,44365,Small bowel endoscopy,,,174.54,2464.18,71
CPT,44366,Small bowel endoscopy,,,230.37,2464.18,71
CPT,44369,Small bowel endoscopy,,,235.64,2464.18,71
CPT,44370,Small bowel endoscopy/stent,,,256.01,11033.64,71
CPT,44372,Small bowel endoscopy,,,229.91,2464.18,71
CPT,44373,Small bowel endoscopy,,,183.94,9246.98,71
CPT,44376,Small bowel endoscopy,,,272.79,2464.18,71
CPT,44377,Small bowel endoscopy/biopsy,,,287.45,2464.18,71
CPT,44378,Small bowel endoscopy,,,368.97,2464.18,71
CPT,44379,S bowel endoscope w/stent,,,392.31,7010.96,71
CPT,44380,Small bowel endoscopy br/wa,,,54.67,2065.16,71
CPT,44381,Small bowel endoscopy br/wa,,,81.52,5875.69,71
CPT,44382,Small bowel endoscopy,,,71.3,1448.17,71
CPT,44384,Small bowel endoscopy,,,149.18,2464.18,71
CPT,44385,Endoscopy of bowel pouch,,,70.42,1448.17,71
CPT,44386,Endoscopy bowel pouch/biop,,,85.9,2065.16,71
CPT,44388,Colonoscopy thru stoma spx,,,152.03,1432.66,71
CPT,44389,Colonoscopy with biopsy,,,165.19,1850.43,71
CPT,44390,Colonoscopy for foreign body,,,202.08,1448.17,71
CPT,44391,Colonoscopy for bleeding,,,221.72,1850.43,71
CPT,44392,Colonoscopy & polypectomy,,,191.89,1850.43,71
CPT,44394,Colonoscopy w/snare,,,216.72,1850.43,71
CPT,44401,Colonoscopy with ablation,,,232.94,6134.88,71
CPT,44402,Colonoscopy w/stent plcmt,,,251.33,11861.17,71
CPT,44403,Colonoscopy w/resection,,,292.35,1850.43,71
CPT,44404,Colonoscopy w/injection,,,165.51,9940.51,71
CPT,44405,Colonoscopy w/dilation,,,175.84,1850.43,71
CPT,44406,Colonoscopy w/ultrasound,,,220.18,1850.43,71
CPT,44407,Colonoscopy w/ndl aspir/bx,,,264.47,1850.43,71
CPT,44408,Colonoscopy w/decompression,,,222.16,1550.8,71
CPT,44500,HC LONG GI TUBE PLACEMENT,1338.37,1003.78,16.06,1204.53,119
CPT,44500,Intro gastrointestinal tube,,,18.78,1550.8,71
CPT,44602,Suture small intestine,,,218.21,15039.8,107
CPT,44603,Suture small intestine,,,250.56,15039.8,107
CPT,44604,Suture large intestine,,,163.62,15039.8,107
CPT,44605,Repair of bowel lesion,,,200.92,15039.8,107
CPT,44615,Intestinal stricturoplasty,,,165.33,15039.8,107
CPT,44620,Repair bowel opening,,,134.12,15039.8,107
CPT,44625,Repair bowel opening,,,156.58,15039.8,107
CPT,44626,Repair bowel opening,,,246.65,15039.8,107
CPT,44640,Repair bowel-skin fistula,,,216.11,15039.8,107
CPT,44650,Repair bowel fistula,,,222.99,15039.8,107
CPT,44660,Repair bowel-bladder fistula,,,206.95,15039.8,107
CPT,44661,Repair bowel-bladder fistula,,,239.17,15039.8,107
CPT,44680,Surgical revision intestine,,,167.28,15039.8,107
CPT,44700,Suspend bowel w/prosthesis,,,154.8,15039.8,107
CPT,44701,Intraop colon lavage add-on,,,26.19,8421.67,52
CPT,44705,Prepare fecal microbiota,,,267.98,7771.22,16
CPT,44715,Prepare donor intestine,,,12954.18,15039.8,19
CPT,44720,Prep donor intestine/venous,,,42.31,15039.8,71
CPT,44721,Prep donor intestine/artery,,,59.12,15039.8,71
CPT,44799,Unlisted px small intestine,,,898.8,1043.51,19
CPT,44800,Excision of bowel pouch,,,120.34,15039.8,107
CPT,44820,Excision of mesentery lesion,,,132.3,15039.8,107
CPT,44850,Repair of mesentery,,,115.99,15039.8,107
CPT,44899,Unlisted px meckels dvrtclm,,,12954.18,15039.8,19
CPT,44900,I&d appendix abscess open,,,122.03,15039.8,107
CPT,44950,Appendectomy,,,99.86,8413.15,107
CPT,44955,Appendectomy add-on,,,12.95,6140.18,52
CPT,44960,Appendectomy,,,136.29,15039.8,107
CPT,44970,Laparoscopy appendectomy,,,93.71,6734.09,143
CPT,44979,Unlisted laps px appendix,,,5593.17,6493.67,19
CPT,45000,Drainage of pelvic abscess,,,337.18,6862.41,71
CPT,45005,Drainage of rectal abscess,,,128.98,5643.65,71
CPT,45005,HC I&D SUBMUCOSAL ABSCESS RECTUM,1481.54,1111.16,17.78,1333.39,119
CPT,45020,Drainage of rectal abscess,,,452.53,3825.0,71
CPT,45100,Biopsy of rectum,,,237.76,3825.0,71
CPT,45108,Anorectal myomectomy,,,293.95,3825.0,71
CPT,45110,Removal of rectum,,,281.74,16769.38,107
CPT,45111,Partial removal of rectum,,,168.0,15039.8,107
CPT,45112,Removal of rectum,,,281.17,16780.23,107
CPT,45113,Partial proctectomy,,,288.97,17212.38,107
CPT,45114,Partial removal of rectum,,,281.77,16916.33,107
CPT,45116,Partial removal of rectum,,,239.36,15039.8,107
CPT,45119,Remove rectum w/reservoir,,,291.07,17330.94,107
CPT,45120,Removal of rectum,,,248.29,15039.8,107
CPT,45121,Removal of rectum and colon,,,270.99,16264.6,107
CPT,45123,Partial proctectomy,,,173.1,15039.8,107
CPT,45126,Pelvic exenteration,,,422.61,25254.8,107
CPT,45130,Excision of rectal prolapse,,,168.12,15039.8,107
CPT,45135,Excision of rectal prolapse,,,200.99,21165.98,107
CPT,45136,Excise ileoanal reservior,,,276.32,16459.53,107
CPT,45150,Excision of rectal stricture,,,333.23,10074.6,71
CPT,45160,Excision of rectal lesion,,,159.39,13794.69,107
CPT,45171,Exc rect tum transanal part,,,95.74,3825.0,107
CPT,45172,Exc rect tum transanal full,,,127.79,3825.0,107
CPT,45190,Destruction rectal tumor,,,548.25,3825.0,71
CPT,45300,Proctosigmoidoscopy dx,,,46.63,3205.62,71
CPT,45303,Proctosigmoidoscopy dilate,,,82.43,3205.62,71
CPT,45305,Proctosigmoidoscopy w/bx,,,70.27,1850.43,71
CPT,45307,HC PROCTOSIGMOIDOSCOPY FB,1701.62,1276.21,20.42,1531.46,119
CPT,45307,Proctosigmoidoscopy fb,,,96.7,3825.0,71
CPT,45308,Proctosigmoidoscopy removal,,,81.63,3825.0,71
CPT,45309,Proctosigmoidoscopy removal,,,86.57,3205.62,71
CPT,45315,Proctosigmoidoscopy removal,,,102.22,3205.62,71
CPT,45317,Proctosigmoidoscopy bleed,,,106.5,1850.43,71
CPT,45320,Proctosigmoidoscopy ablate,,,100.94,3825.0,71
CPT,45321,Proctosigmoidoscopy volvul,,,99.6,3825.0,71
CPT,45327,Proctosigmoidoscopy w/stent,,,112.68,10656.66,71
CPT,45330,Diagnostic sigmoidoscopy,,,53.95,3205.62,71
CPT,45331,Sigmoidoscopy and biopsy,,,69.09,8931.05,71
CPT,45332,HC SIGMOIDOSCOPY W/FB REMOVAL,583.94,437.96,7.01,525.55,119
CPT,45332,Sigmoidoscopy w/fb removal,,,100.59,1850.43,71
CPT,45333,Sigmoidoscopy & polypectomy,,,90.02,1448.17,71
CPT,45334,Sigmoidoscopy for bleeding,,,113.07,1850.43,71
CPT,45335,Sigmoidoscopy w/submuc inj,,,64.14,1448.17,71
CPT,45337,Sigmoidoscopy & decompress,,,110.14,1550.8,71
CPT,45338,Sigmoidoscopy w/tumr remove,,,115.37,1850.43,71
CPT,45340,Sig w/tndsc balloon dilation,,,75.25,1850.43,71
CPT,45341,Sigmoidoscopy w/ultrasound,,,118.71,1550.8,71
CPT,45342,Sigmoidoscopy w/us guide bx,,,164.17,1850.43,71
CPT,45346,Sigmoidoscopy w/ablation,,,154.43,5916.06,71
CPT,45347,Sigmoidoscopy w/plcmt stent,,,147.7,10656.66,71
CPT,45349,Sigmoidoscopy w/resection,,,190.59,3825.0,71
CPT,45350,Sgmdsc w/band ligation,,,96.64,8931.05,71
CPT,45378,Diagnostic colonoscopy,,,163.38,3205.62,87
CPT,45378,HC DIAGNOSTIC COLONOSCOPY,3056.41,2292.31,36.68,2750.77,119
CPT,45379,Colonoscopy w/fb removal,,,229.29,1723.91,71
CPT,45380,Colonoscopy and biopsy,,,192.84,1589.0,86
CPT,45381,Colonoscopy submucous njx,,,192.55,1850.43,71
CPT,45382,Colonoscopy w/control bleed,,,248.72,1850.43,71
CPT,45384,Colonoscopy w/lesion removal,,,218.92,1550.8,86
CPT,45385,Colonoscopy w/lesion removal,,,244.1,1550.8,86
CPT,45386,Colonoscopy w/balloon dilat,,,203.35,1850.43,71
CPT,45388,Colonoscopy w/ablation,,,260.38,6355.43,71
CPT,45389,Colonoscopy w/stent plcmt,,,278.84,10656.66,71
CPT,45390,Colonoscopy w/resection,,,319.32,3825.0,71
CPT,45391,Colonoscopy w/endoscope us,,,247.75,8931.05,71
CPT,45392,Colonoscopy w/endoscopic fnb,,,292.35,3205.62,71
CPT,45393,Colonoscopy w/decompression,,,242.1,1850.43,71
CPT,45395,Lap removal of rectum,,,302.57,18039.14,107
CPT,45397,Lap remove rectum w/pouch,,,328.43,19571.15,107
CPT,45398,Colonoscopy w/band ligation,,,226.67,15118.55,71
CPT,45399,Unlisted procedure colon,,,874.02,1014.74,19
CPT,45400,Laparoscopic proc,,,175.34,16402.53,107
CPT,45402,Lap proctopexy w/sig resect,,,234.83,15039.8,107
CPT,45499,Laparoscope proc rectum,,,5593.17,6493.67,19
CPT,45500,Repair of rectum,,,447.6,8793.19,71
CPT,45505,Repair of rectum,,,473.59,11760.24,71
CPT,45520,Treatment of rectal prolapse,,,38.89,3205.62,71
CPT,45540,Correct rectal prolapse,,,163.28,15039.8,107
CPT,45541,Correct rectal prolapse,,,145.63,3825.0,107
CPT,45550,Repair rectum/remove sigmoid,,,225.95,15039.8,107
CPT,45560,Repair of rectocele,,,107.69,3825.0,107
CPT,45562,Exploration/repair of rectum,,,175.78,15039.8,107
CPT,45563,Exploration/repair of rectum,,,257.12,15416.45,107
CPT,45800,Repair rect/bladder fistula,,,197.3,15039.8,107
CPT,45805,Repair fistula w/colostomy,,,227.68,15039.8,107
CPT,45820,Repair rectourethral fistula,,,197.82,15039.8,107
CPT,45825,Repair fistula w/colostomy,,,238.4,15039.8,107
CPT,45900,Reduction of rectal prolapse,,,164.92,9959.96,71
CPT,45905,Dilation of anal sphincter,,,132.05,11978.96,71
CPT,45910,Dilation of rectal narrowing,,,149.75,1850.43,71
CPT,45915,HC REMOVAL OF FECAL IMPACTION/FB W/ ANESTH; NOT ANOSCOPY,775.62,581.72,9.31,698.06,119
CPT,45915,Remove rectal obstruction,,,177.65,1850.43,71
CPT,45990,Surg dx exam anorectal,,,101.48,3825.0,71
CPT,45999,"HC RECTAL FB REMOVAL; W/O ANESTH, NOT ANOSCOPY",583.94,437.96,7.01,525.55,119
CPT,45999,Unlisted procedure rectum,,,874.02,1014.74,19
CPT,46020,Placement of seton,,,112.83,3825.0,71
CPT,46030,Removal anal seton oth mrk,,,84.47,3205.62,71
CPT,46040,HC I&D;PERIRECTAL OR ISCHIAL ABSCESS,3821.26,2865.94,45.86,3439.13,119
CPT,46040,I&d ischiorct&/perirct absc,,,333.85,3205.62,71
CPT,46045,I&d absc tranal under anes,,,345.04,3825.0,71
CPT,46050,HC I&D; PERIANAL ABSCESS,2954.75,2216.06,35.46,2659.28,119
CPT,46050,I&d perianal abscess supfc,,,78.39,1550.8,71
CPT,46060,I&d ischiorectal/ntrmrl absc,,,383.09,3825.0,71
CPT,46070,Incision anal septum infant,,,212.65,3825.0,71
CPT,46080,Sphnctrotmy anal div sphnctr,,,123.22,3825.0,71
CPT,46083,"HC INCISE THROMBOSED HEMORRHOID,EXT",788.21,591.16,9.46,709.39,119
CPT,46083,Inc thrombosed hroid xtrnl,,,85.06,3205.62,71
CPT,46200,Removal of anal fissure,,,264.27,3825.0,71
CPT,46220,Excise anal ext tag/papilla,,,94.13,1850.43,71
CPT,46221,Ligation of hemorrhoid(s),,,149.0,3205.62,71
CPT,46230,Removal of anal tags,,,134.57,3825.0,71
CPT,46250,Remove ext hem groups 2+,,,250.81,3825.0,71
CPT,46255,Remove int/ext hem 1 group,,,279.76,3825.0,71
CPT,46257,Remove in/ex hem grp & fiss,,,327.9,3825.0,71
CPT,46258,Remove in/ex hem grp w/fistu,,,378.38,3825.0,71
CPT,46260,Remove in/ex hem groups 2+,,,379.54,3825.0,71
CPT,46261,Remove in/ex hem grps & fiss,,,417.34,3825.0,71
CPT,46262,Remove in/ex hem grps w/fist,,,461.35,3825.0,71
CPT,46270,Remove anal fist subq,,,314.69,3825.0,71
CPT,46275,Remove anal fist inter,,,331.51,3825.0,71
CPT,46280,Remove anal fist complex,,,378.4,3825.0,71
CPT,46285,Remove anal fist 2 stage,,,331.52,3825.0,71
CPT,46288,Repair anal fistula,,,439.41,3825.0,71
CPT,46320,HC EXCISION EXTERNAL HEMORROID,643.27,482.45,7.72,578.94,119
CPT,46320,Removal of hemorrhoid clot,,,87.7,3205.62,71
CPT,46500,Injection into hemorrhoid(s),,,142.38,3205.62,71
CPT,46505,Chemodenervation anal musc,,,194.5,1850.43,107
CPT,46600,Diagnostic anoscopy spx,,,39.77,1031.85,71
CPT,46600,HC ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,643.27,482.45,7.72,578.94,119
CPT,46601,Diagnostic anoscopy,,,90.17,1550.8,71
CPT,46604,Anoscopy and dilation,,,63.71,1850.43,71
CPT,46606,Anoscopy and biopsy,,,72.57,1312.32,71
CPT,46607,Diagnostic anoscopy & biopsy,,,120.37,1850.43,71
CPT,46608,Anoscopy remove for body,,,81.63,1448.17,71
CPT,46608,HC ANOSCOPY REMOVE FOR BODY,643.27,482.45,7.72,578.94,119
CPT,46610,Anoscopy remove lesion,,,77.69,3825.0,71
CPT,46611,Anoscopy,,,77.55,1448.17,71
CPT,46612,Anoscopy remove lesions,,,91.49,3825.0,71
CPT,46614,Anoscopy control bleeding,,,62.4,1312.32,71
CPT,46615,Anoscopy,,,87.15,3825.0,71
CPT,46700,Repair of anal stricture,,,400.7,3825.0,71
CPT,46705,Repair of anal stricture,,,88.82,15039.8,107
CPT,46706,Repr of anal fistula w/glue,,,138.96,3825.0,71
CPT,46707,Repair anorectal fist w/plug,,,395.88,4854.81,71
CPT,46710,Repr per/vag pouch sngl proc,,,172.44,15039.8,107
CPT,46712,Repr per/vag pouch dbl proc,,,343.72,20581.22,107
CPT,46715,Rep perf anoper fistu,,,86.32,15039.8,107
CPT,46716,Rep perf anoper/vestib fistu,,,191.3,17249.06,107
CPT,46730,Construction of absent anus,,,308.23,18558.12,107
CPT,46735,Construction of absent anus,,,354.62,21344.9,107
CPT,46740,Construction of absent anus,,,336.23,20241.8,107
CPT,46742,Repair of imperforated anus,,,388.43,23356.77,107
CPT,46744,Repair of cloacal anomaly,,,547.94,32917.39,107
CPT,46746,Repair of cloacal anomaly,,,603.58,36243.06,107
CPT,46748,Repair of cloacal anomaly,,,654.09,39266.27,107
CPT,46750,Repair of anal sphincter,,,116.6,30375.21,107
CPT,46751,Repair of anal sphincter,,,104.02,32908.96,107
CPT,46753,Reconstruction of anus,,,488.09,3825.0,71
CPT,46754,Removal of suture from anus,,,186.88,5252.18,71
CPT,46760,Repair of anal sphincter,,,171.32,3825.0,107
CPT,46761,Repair of anal sphincter,,,142.48,3825.0,107
CPT,46900,Destruction anal lesion(s),,,106.33,3205.62,71
CPT,46910,Destruction anal lesion(s),,,104.26,3205.62,71
CPT,46916,Cryosurgery anal lesion(s),,,109.44,722.24,71
CPT,46917,Laser surgery anal lesions,,,100.0,3825.0,71
CPT,46922,Excision of anal lesion(s),,,106.93,3825.0,71
CPT,46924,Destruction anal lesion(s),,,140.23,3825.0,71
CPT,46930,Destroy internal hemorrhoids,,,118.3,3205.62,71
CPT,46940,Treatment of anal fissure,,,113.09,3205.62,71
CPT,46942,Treatment of anal fissure,,,101.33,1014.74,71
CPT,46945,Int hrhc lig 1 hroid w/o img,,,265.51,3825.0,71
CPT,46946,Int hrhc lig 2+hroid w/o img,,,298.45,3825.0,71
CPT,46947,Hemorrhoidopexy by stapling,,,305.95,3825.0,71
CPT,46948,Int hrhc tranal dartlzj 2+,,,349.09,3825.0,71
CPT,46999,Unlisted procedure anus,,,874.02,1014.74,19
CPT,47000,HC BIOPSY LIVER NEEDLE,2030.01,1522.51,24.36,1827.01,119
CPT,47000,Needle biopsy of liver perq,,,85.06,3205.62,71
CPT,47001,Ndl biopsy lvr tm oth maj px,,,100.15,3205.62,52
CPT,47010,Hepatot opn drg absc/cst 1/2,,,188.23,15039.8,107
CPT,47015,Lapt aspir&/njx hep prst cst,,,180.86,15039.8,107
CPT,47100,Wedge biopsy of liver,,,131.73,15039.8,107
CPT,47120,Partial removal of liver,,,362.07,21703.34,107
CPT,47122,Extensive removal of liver,,,530.24,31870.17,107
CPT,47125,Partial removal of liver,,,476.53,28590.42,107
CPT,47130,Partial removal of liver,,,511.9,30658.95,107
CPT,47133,Removal of donor liver,,,12954.18,15039.8,19
CPT,47135,Transplantation of liver,,,834.28,50264.99,143
CPT,47140,Partial removal donor liver,,,552.76,33295.93,143
CPT,47141,Partial removal donor liver,,,660.74,42126.95,143
CPT,47142,Partial removal donor liver,,,725.7,43786.9,107
CPT,47143,Prep donor liver whole,,,519.09,33326.65,35
CPT,47144,Prep donor liver 3-segment,,,919.44,36697.68,35
CPT,47145,Prep donor liver lobe split,,,12954.18,15039.8,19
CPT,47146,Prep donor liver/venous,,,50.62,15039.8,71
CPT,47147,Prep donor liver/arterial,,,58.98,15039.8,71
CPT,47300,Surgery for liver lesion,,,176.47,15039.8,107
CPT,47350,Repair liver wound,,,212.21,15039.8,107
CPT,47360,Repair liver wound,,,290.68,17421.02,107
CPT,47361,Repair liver wound,,,467.7,27948.15,107
CPT,47362,Repair liver wound,,,222.44,15039.8,107
CPT,47370,Laparo ablate liver tumor rf,,,194.79,23423.27,107
CPT,47371,Laparo ablate liver cryosurg,,,195.55,12412.85,107
CPT,47379,Unlisted laps px liver,,,5593.17,6493.67,19
CPT,47380,Open ablate liver tumor rf,,,224.47,15039.8,107
CPT,47381,Open ablate liver tumor cryo,,,229.94,15039.8,107
CPT,47382,HC RF LIVER ABLATION 1 OR >SITES,12915.84,9686.88,154.99,11624.26,119
CPT,47382,Percut ablate liver rf,,,569.46,11298.2,71
CPT,47383,HC LIVER ABLATION CRYO  1 OR MORE SITES,12951.77,9713.83,155.42,11656.59,119
CPT,47383,Perq abltj lvr cryoablation,,,347.18,17929.67,71
CPT,47384,Abltj ire liver 1+ tum perq,,,10762.99,10762.99,9
CPT,47399,Unlisted procedure liver,,,674.5,783.1,19
CPT,47400,Incision of liver duct,,,333.35,19969.6,107
CPT,47420,Incision of bile duct,,,206.81,15039.8,107
CPT,47425,Incision of bile duct,,,212.3,16736.46,107
CPT,47460,Incise bile duct sphincter,,,197.12,15039.8,107
CPT,47480,Incision of gallbladder,,,136.17,15039.8,107
CPT,47490,HC PERCUTANEOUS CHOLECYSTOSTOMY,4430.0,3322.5,53.16,3987.0,119
CPT,47490,Incision of gallbladder,,,255.56,9907.76,71
CPT,47531,HC INJ PERC CHOLANGIO W/IMG EXISTING ACCESS,1565.13,1173.85,18.78,1408.62,119
CPT,47531,Injection for cholangiogram,,,67.34,6867.69,71
CPT,47532,HC INJ PERC CHOLANGIO W/IMG NEW ACCESS,2666.35,1999.76,32.0,2399.72,119
CPT,47532,Injection for cholangiogram,,,202.42,7317.76,71
CPT,47533,HC PLMT PERC BILIARY DRAIN CATH INCL DX CHOLANGIO W/IMG EXT,6269.03,4701.77,75.23,5642.13,119
CPT,47533,Plmt biliary drainage cath,,,253.98,4560.57,71
CPT,47534,HC PLMT PERC BILIARY DRAIN CATH INCL DX CHOLANGIO W/IMG INT-EXT,6479.08,4859.31,77.75,5831.17,119
CPT,47534,Plmt biliary drainage cath,,,355.15,6132.99,71
CPT,47535,Conversion ext bil drg cath,,,188.26,4560.57,71
CPT,47535,HC CONV PERC EXT BILIARY DRAIN CATH TO INT-EXT W/IMG,6488.68,4866.51,77.86,5839.81,119
CPT,47536,Exchange biliary drg cath,,,126.19,4560.57,71
CPT,47536,HC EXCH PERC BILIARY DRAIN CATH W/IMG,4387.81,3290.86,52.65,3949.03,119
CPT,47537,HC REM PERC BILIARY DRAIN CAT REQ FLUOR INC DX CHOLANG W/IMG,1676.48,1257.36,20.12,1508.83,119
CPT,47537,Removal biliary drg cath,,,92.71,3822.09,71
CPT,47538,HC PLMT PERC STENT BILE DUCT W IMG EXIST ACSS,12291.88,9218.91,147.5,11062.69,119
CPT,47538,Perq plmt bile duct stent,,,224.95,10656.66,71
CPT,47539,HC PLMT PERC STENT BILE DCT W IMG  NEW ACSS WO PLMT OF DRN CATH,9347.41,7010.56,112.17,8412.67,119
CPT,47539,Perq plmt bile duct stent,,,408.16,11033.64,71
CPT,47540,HC PLMT PERC STENT BILE DCT W IMG NEW ACSS W PLMT OF DRN CATH,16449.07,12336.8,197.39,14804.16,119
CPT,47540,Perq plmt bile duct stent,,,421.48,11017.45,71
CPT,47541,HC PLMT OF ACCESS BILIARY TREE SM BOWEL PERC W IMG S&I,1535.75,1151.81,18.43,1382.18,119
CPT,47541,Plmt access bil tree sm bwl,,,322.64,9246.98,71
CPT,47542,Dilate biliary duct/ampulla,,,130.81,8460.99,52
CPT,47542,HC BALLOON DILATE BILIARY DUCT OR AMPUL PERC W IMG S&I,5828.88,4371.66,69.95,5245.99,119
CPT,47543,Endoluminal bx biliary tree,,,138.07,7050.82,52
CPT,47543,HC ENDOLUMINAL BX BILIARY TREE PERC W IMG S&I SINGL/MULT,3001.05,2250.79,36.01,2700.94,119
CPT,47544,HC REM PERC DUCT GLBLDR CALCULI INCL DESTRUC W IMG S&I,4273.96,3205.47,51.29,3846.56,119
CPT,47544,Removal duct glbldr calculi,,,150.3,7190.13,52
CPT,47550,Bile duct endoscopy add-on,,,25.37,2880.24,52
CPT,47550,HC BILIARY ENDOSCOPY PERC W/O CALCULI REMOVAL,9900.56,7425.42,118.81,8910.5,119
CPT,47552,Biliary endo perq dx w/speci,,,268.73,8413.15,71
CPT,47553,Biliary endoscopy thru skin,,,270.36,8413.15,71
CPT,47553,HC BILIARY ENDOSCOPY PERC VIA T-TUBE W BX,2905.49,2179.12,34.87,2614.94,119
CPT,47554,Biliary endoscopy thru skin,,,432.85,12412.85,71
CPT,47554,HC BILIARY ENDOSCOPY PERC W CALCULI REMOVAL,12375.69,9281.77,148.51,11138.12,119
CPT,47555,Biliary endoscopy thru skin,,,321.75,7050.82,71
CPT,47555,HC BILIARY DILATION W/O STENT,3023.04,2267.28,36.28,2720.74,119
CPT,47556,Biliary endoscopy thru skin,,,364.49,17929.67,71
CPT,47556,HC BILIARY DILATION W/STENT,4150.15,3112.61,49.8,3735.14,119
CPT,47562,Laparoscopic cholecystectomy,,,102.56,8709.0,124
CPT,47563,Laparo cholecystectomy/graph,,,111.81,15026.35,124
CPT,47564,Laparo cholecystectomy/explr,,,173.6,12412.85,107
CPT,47570,Laparo cholecystoenterostomy,,,120.77,15039.8,107
CPT,47579,Unlisted laps px biliary trc,,,5593.17,6493.67,19
CPT,47600,Cholecystectomy,,,166.18,15039.8,107
CPT,47605,Cholecystectomy w/cholang,,,175.26,15039.8,107
CPT,47610,Removal of gallbladder,,,194.62,15039.8,107
CPT,47612,Removal of gallbladder,,,197.74,15039.8,107
CPT,47620,Removal of gallbladder,,,213.55,15039.8,107
CPT,47700,Exploration of bile ducts,,,164.56,15039.8,107
CPT,47701,Bile duct revision,,,1364.45,16138.25,71
CPT,47711,Excision of bile duct tumor,,,241.92,15039.8,107
CPT,47712,Excision of bile duct tumor,,,309.66,18554.57,107
CPT,47715,Excision of bile duct cyst,,,206.64,15039.8,107
CPT,47720,Fuse gallbladder & bowel,,,179.55,15550.54,107
CPT,47721,Fuse upper gi structures,,,210.44,15039.8,107
CPT,47740,Fuse gallbladder & bowel,,,203.93,15039.8,107
CPT,47741,Fuse gallbladder & bowel,,,229.12,15039.8,107
CPT,47760,Fuse bile ducts and bowel,,,349.16,20903.58,107
CPT,47765,Fuse liver ducts & bowel,,,458.53,28132.05,107
CPT,47780,Fuse bile ducts and bowel,,,383.41,22992.61,107
CPT,47785,Fuse bile ducts and bowel,,,501.71,29983.76,107
CPT,47800,Reconstruction of bile ducts,,,241.96,19270.05,107
CPT,47801,Placement bile duct support,,,173.3,25129.31,107
CPT,47802,Fuse liver duct & intestine,,,236.68,14541.69,88
CPT,47900,Suture bile duct injury,,,214.25,15039.8,107
CPT,47999,Unlisted px biliary tract,,,898.8,1043.51,19
CPT,48000,Drainage of abdomen,,,291.98,17514.84,107
CPT,48001,Placement of drain pancreas,,,357.46,21434.78,107
CPT,48020,Removal of pancreatic stone,,,183.31,15039.8,107
CPT,48100,Biopsy of pancreas open,,,137.91,17964.43,107
CPT,48102,HC PERCUTANEOUS PANCREAS BIOPSY,2620.73,1965.55,31.45,2358.66,119
CPT,48102,Needle biopsy pancreas,,,182.38,9226.83,71
CPT,48105,Resect/debride pancreas,,,438.2,26251.56,107
CPT,48120,Removal of pancreas lesion,,,173.15,15039.8,107
CPT,48140,Partial removal of pancreas,,,243.17,22001.36,107
CPT,48145,Partial removal of pancreas,,,253.43,15208.7,107
CPT,48146,Pancreatectomy,,,292.26,17507.15,107
CPT,48148,Removal of pancreatic duct,,,194.31,15039.8,107
CPT,48150,Partial removal of pancreas,,,482.77,28946.2,107
CPT,48152,Pancreatectomy,,,447.46,26766.5,107
CPT,48153,Pancreatectomy,,,481.19,28781.52,107
CPT,48154,Pancreatectomy,,,449.3,26884.37,107
CPT,48155,Removal of pancreas,,,283.01,24121.71,107
CPT,48160,Pancreas removal/transplant,,,12954.18,12954.18,1
CPT,48400,Injection intraop add-on,,,103.35,22531.72,71
CPT,48500,Surgery of pancreatic cyst,,,178.6,15039.8,107
CPT,48510,Drain pancreatic pseudocyst,,,170.4,15039.8,107
CPT,48520,Fuse pancreas cyst and bowel,,,171.01,15039.8,107
CPT,48540,Fuse pancreas cyst and bowel,,,203.04,15039.8,107
CPT,48545,Pancreatorrhaphy,,,209.11,15039.8,107
CPT,48547,Duodenal exclusion,,,278.08,16681.67,107
CPT,48548,Fuse pancreas and bowel,,,259.37,15559.55,107
CPT,48550,Donor pancreatectomy,,,12954.18,12954.18,1
CPT,48551,Prep donor pancreas,,,604.42,15039.8,35
CPT,48552,Prep donor pancreas/venous,,,36.36,15039.8,71
CPT,48554,Transpl allograft pancreas,,,404.09,24559.6,143
CPT,48556,Removal allograft pancreas,,,199.59,15039.8,143
CPT,48999,Unlisted procedure pancreas,,,674.5,783.1,19
CPT,49000,Exploration of abdomen,,,119.35,20583.34,107
CPT,49002,Reopening of abdomen,,,161.75,15039.8,107
CPT,49010,Exploration behind abdomen,,,142.94,15039.8,107
CPT,49013,Prpertl pel pack hemrrg trma,,,440.58,15039.8,71
CPT,49014,Reexploration pelvic wound,,,366.13,15039.8,71
CPT,49020,Drainage abdom abscess open,,,247.07,15039.8,107
CPT,49040,Drain open abdom abscess,,,155.95,15039.8,107
CPT,49060,Drain open retroperi abscess,,,860.45,15039.8,71
CPT,49062,Drain to peritoneal cavity,,,119.47,15039.8,107
CPT,49082,Abd paracentesis,,,70.5,8629.07,71
CPT,49082,HC HH/HSPC ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,2700.9,2025.68,32.41,2430.81,119
CPT,49082,HC PARACENTESIS,1174.9,881.18,14.1,1057.41,119
CPT,49083,Abd paracentesis w/imaging,,,102.53,6029.25,71
CPT,49083,HC PARACENTESIS WITH IMAGING,2700.9,2025.68,32.41,2430.81,119
CPT,49083,PBB ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,2700.9,2025.68,32.41,2430.81,119
CPT,49084,HC PERITONEAL LAVAGE,1706.33,1279.75,20.48,1535.7,119
CPT,49084,Peritoneal lavage,,,103.89,1448.17,71
CPT,49180,Biopsy abdominal mass,,,80.85,2091.8,71
CPT,49180,HC BIOPSY ABD/RETROPERITONEAL,2113.8,1585.35,25.37,1902.42,119
CPT,49185,HC SCLEROTHERAPY PERC INCL INJECTIONS W IMG AND S&I,4339.03,3254.27,52.07,3905.13,119
CPT,49185,Sclerotx fluid collection,,,114.58,3307.64,71
CPT,49186,Opn exc/dstr ntra-abd 5 cm/<,,,1753.08,15039.8,35
CPT,49187,Opn exc/dstr ntra-abd 5.1-10,,,1753.08,15619.96,35
CPT,49188,Opn exc/dst ntra-abd 10.1-20,,,4815.25,18659.83,35
CPT,49189,Opn exc/dst ntra-abd 20.1-30,,,5603.99,21716.35,35
CPT,49190,Opn exc/dstr ntra-abd >30 cm,,,6911.96,26784.93,35
CPT,49203,Exc abd tum 5 cm or less,,,185.62,18200.41,88
CPT,49204,Exc abd tum over 5 cm,,,236.39,22448.38,88
CPT,49205,Exc abd tum over 10 cm,,,271.38,16691.13,88
CPT,49215,Excise sacral spine tumor,,,341.02,20546.13,107
CPT,49250,Excision of umbilicus,,,467.5,13988.79,71
CPT,49255,Removal of omentum,,,123.09,17219.66,107
CPT,49320,Diag laparo separate proc,,,51.08,7571.84,107
CPT,49321,Laparoscopy biopsy,,,53.55,7571.84,143
CPT,49322,Laparoscopy aspiration,,,58.34,7571.84,143
CPT,49323,Laparo drain lymphocele,,,99.0,7571.84,143
CPT,49324,Lap insert tunnel ip cath,,,60.16,7571.84,143
CPT,49325,Lap revision perm ip cath,,,64.19,7571.84,143
CPT,49326,Lap w/omentopexy add-on,,,29.08,6345.74,52
CPT,49327,Lap ins device for rt,,,20.09,6345.74,52
CPT,49329,Unlstd laps px abd pertm&omn,,,5593.17,6493.67,19
CPT,49400,Air injection into abdomen,,,87.46,1460.4,52
CPT,49400,HC INJ AIR/CONTRAST INTO PERITONEAL CAVITY,812.29,609.22,9.75,731.06,119
CPT,49402,Remove foreign body adbomen,,,671.7,4560.57,71
CPT,49405,HC VISCERAL DRAINAGE W IMAGING GUIDE,4465.91,3349.43,53.59,4019.32,119
CPT,49405,Image cath fluid colxn visc,,,187.48,2358.72,71
CPT,49406,HC PERITON/RETROPERI DRAINAGE W IMAG,4203.75,3152.81,50.44,3783.38,119
CPT,49406,Image cath fluid peri/retro,,,187.48,3822.09,71
CPT,49407,HC TRVAG/TRARECT PERI/RETRO DRAINAGE,3493.62,2620.22,41.92,3144.26,119
CPT,49407,Image cath fluid trns/vgnl,,,198.65,2091.8,71
CPT,49411,HC INS MARK ABD/PEL FOR RT PERC,2360.04,1770.03,28.32,2124.04,119
CPT,49411,Ins mark abd/pel for rt perq,,,178.64,1753.08,71
CPT,49412,Ins device for rt guide open,,,79.25,15039.8,71
CPT,49418,HC INSERT TUN IP CATH PERC,7475.0,5606.25,89.7,6727.5,119
CPT,49418,Insert tun ip cath perc,,,193.87,4560.57,71
CPT,49419,Insert tun ip cath w/port,,,329.62,7852.28,71
CPT,49421,HC INSERT IP CATH DR/DIALYSIS PERM,7525.83,5644.37,90.31,6773.25,119
CPT,49421,Ins tun ip cath for dial opn,,,218.77,4560.57,71
CPT,49422,HC REM OF TUNNELED INTRAPERITONEAL CATH,5921.95,4441.46,71.06,5329.76,119
CPT,49422,Remove tunneled ip cath,,,213.69,6580.77,71
CPT,49423,Exchange drainage catheter,,,68.58,3822.09,71
CPT,49423,HC EXCHANGE DRAINAGE CATHE ABD,3124.16,2343.12,37.49,2811.74,119
CPT,49424,Assess cyst contrast inject,,,36.26,3575.5,52
CPT,49424,HC CONTRAST INJ ABSCESS ASSMT,463.35,347.51,5.56,417.02,119
CPT,49425,Insert abdomen-venous drain,,,121.33,15039.8,107
CPT,49426,Revise abdomen-venous shunt,,,527.9,4560.57,71
CPT,49427,Injection abdominal shunt,,,38.09,6119.03,52
CPT,49428,Ligation of shunt,,,334.78,15039.8,71
CPT,49429,Removal of shunt,,,307.51,4266.34,71
CPT,49435,Insert subq exten to ip cath,,,18.29,3374.58,52
CPT,49436,Embedded ip cath exit-site,,,28.79,3575.5,107
CPT,49440,HC PLACE GASTROSTOMY TUBE PERC,4089.44,3067.08,49.07,3680.5,119
CPT,49440,Place gastrostomy tube perc,,,156.58,2464.18,71
CPT,49441,HC INSERTION DUOD OR JEJUNO TUBE,4285.39,3214.04,51.42,3856.85,119
CPT,49441,Place duod/jej tube perc,,,184.07,2578.17,71
CPT,49442,HC PERC CECOSTOMY OR COLONIC TUBE,2175.22,1631.42,26.1,1957.7,119
CPT,49442,Place cecostomy tube perc,,,158.89,2104.34,71
CPT,49446,Change g-tube to g-j perc,,,141.34,2464.18,71
CPT,49446,HC CHANGE G-TUBE TO G-J TUBE PERC,3351.4,2513.55,40.22,3016.26,119
CPT,49450,HC REPLACE G/C TUBE PERC,2758.72,2069.04,33.1,2482.85,119
CPT,49450,Replace g/c tube perc,,,64.25,1562.07,71
CPT,49451,HC DUOD/JEJUNO TUBE REPLACEMENT,2454.41,1840.81,29.45,2208.97,119
CPT,49451,Replace duod/jej tube perc,,,85.49,2065.16,71
CPT,49452,HC GASTRO-JEJUNOSTOMY CATH CHANGE,3691.84,2768.88,44.3,3322.66,119
CPT,49452,Replace g-j tube perc,,,132.09,2038.97,71
CPT,49460,Fix g/colon tube w/device,,,47.97,1894.62,71
CPT,49460,HC CLEAR G/D/J/GJ TUBE ANY METHOD,1257.53,943.15,15.09,1131.78,119
CPT,49465,Fluoro exam of g/colon tube,,,29.67,1213.67,71
CPT,49465,"HC INJECTION OF G,D,J,GJ TUBE",587.3,440.48,7.05,528.57,119
CPT,49491,Rpr hern preemie reduc,,,124.28,7571.84,143
CPT,49492,Rpr ing hern premie blocked,,,149.26,4560.57,143
CPT,49495,Rpr ing hernia baby reduc,,,63.73,6345.74,143
CPT,49496,Rpr ing hernia baby blocked,,,95.78,4560.57,143
CPT,49500,Rpr ing hernia init reduce,,,64.76,8413.15,143
CPT,49501,Rpr ing hernia init blocked,,,94.51,4560.57,143
CPT,49505,Prp i/hern init reduc >5 yr,,,81.42,7050.82,143
CPT,49507,Prp i/hern init block >5 yr,,,91.57,4560.57,143
CPT,49520,Rerepair ing hernia reduce,,,98.59,4560.57,143
CPT,49521,Rerepair ing hernia blocked,,,111.62,8413.15,143
CPT,49525,Repair ing hernia sliding,,,89.42,4560.57,143
CPT,49540,Repair lumbar hernia,,,105.82,7571.84,143
CPT,49550,Rpr rem hernia init reduce,,,90.03,4560.57,143
CPT,49553,Rpr fem hernia init blocked,,,98.57,6345.74,143
CPT,49555,Rerepair fem hernia reduce,,,94.21,4560.57,143
CPT,49557,Rerepair fem hernia blocked,,,112.71,4560.57,143
CPT,49560,Rpr ventral hern init reduc,,,1837.79,7121.74,16
CPT,49561,Rpr ventral hern init block,,,2313.48,8965.07,16
CPT,49565,Rerepair ventrl hern reduce,,,1912.74,7412.17,16
CPT,49566,Rerepair ventrl hern block,,,2333.74,9043.62,16
CPT,49568,Hernia repair w/mesh,,,660.49,6212.12,16
CPT,49570,Rpr epigastric hern reduce,,,1044.08,7579.43,16
CPT,49572,Rpr epigastric hern blocked,,,1293.93,5014.18,16
CPT,49580,Rpr umbil hern reduc < 5 yr,,,837.86,3390.94,16
CPT,49582,Rpr umbil hern block < 5 yr,,,1210.16,4689.55,16
CPT,49585,Rpr umbil hern reduc > 5 yr,,,1114.48,4318.79,16
CPT,49587,Rpr umbil hern block > 5 yr,,,1190.42,4613.07,16
CPT,49590,Repair spigelian hernia,,,1429.16,5538.19,16
CPT,49591,Rpr aa hrn 1st < 3 cm rdc,,,332.02,4560.58,71
CPT,49592,Rpr aa hrn 1st < 3 ncr/strn,,,462.19,7571.84,71
CPT,49593,Rpr aa hrn 1st 3-10 rdc,,,556.88,8413.16,71
CPT,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,725.15,7571.84,71
CPT,49595,Rpr aa hrn 1st > 10 rdc,,,748.86,8413.16,71
CPT,49596,Rpr aa hrn 1st > 10 ncr/strn,,,994.78,15039.8,71
CPT,49600,Repair umbilical lesion,,,114.39,7050.83,107
CPT,49605,Repair umbilical lesion,,,761.69,45655.66,107
CPT,49606,Repair umbilical lesion,,,176.5,15039.8,107
CPT,49610,Repair umbilical lesion,,,108.1,38263.89,107
CPT,49611,Repair umbilical lesion,,,95.2,15039.8,107
CPT,49613,Rpr aa hrn rcr < 3 rdc,,,409.39,5457.68,71
CPT,49614,Rpr aa hrn rcr < 3 ncr/strn,,,555.6,7571.84,71
CPT,49615,Rpr aa hrn rcr 3-10 rdc,,,621.42,8413.16,71
CPT,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,834.81,15039.8,71
CPT,49617,Rpr aa hrn rcr > 10 rdc,,,860.18,15039.8,71
CPT,49618,Rpr aa hrn rcr > 10 ncr/strn,,,1205.49,15039.8,71
CPT,49621,Rpr parastomal hernia rdc,,,722.1,15039.8,71
CPT,49622,Rpr parastomal hrna ncr/strn,,,891.35,15039.8,71
CPT,49623,Rmvl ninfct mesh hernia rpr,,,192.28,5886.19,52
CPT,49650,Lap ing hernia repair init,,,67.31,7571.84,143
CPT,49651,Lap ing hernia repair recur,,,87.93,7571.84,143
CPT,49652,Lap vent/abd hernia repair,,,1852.62,7179.19,16
CPT,49653,Lap vent/abd hern proc comp,,,2320.46,8992.17,16
CPT,49654,Lap inc hernia repair,,,2102.94,8149.25,16
CPT,49655,Lap inc hern repair comp,,,2576.77,9985.39,16
CPT,49656,Lap inc hernia repair recur,,,2284.96,8854.59,16
CPT,49657,Lap inc hern recur comp,,,3282.76,12721.22,16
CPT,49659,Unlstd laps px hrnap hrnrphy,,,5593.17,6493.67,19
CPT,49900,Repair of abdominal wall,,,127.39,15039.8,107
CPT,49904,Omental flap extra-abdom,,,1077.7,15039.8,71
CPT,49905,Omental flap intra-abdom,,,54.6,15039.8,107
CPT,49906,Free omental flap microvasc,,,3969.42,15382.15,35
CPT,49999,HC ALCOHOL ABLATION PROCEDURE,1641.46,1231.1,19.7,1477.31,119
CPT,49999,Unlisted px abd pertm&omn,,,898.8,1043.51,19
CPT,50010,Renal exploration,,,115.44,15039.8,143
CPT,50020,Drg perirnl/renal absc open,,,812.95,12891.74,71
CPT,50040,Nfros nfrot w/drg,,,741.29,15039.8,107
CPT,50045,Nephrotomy w/exploration,,,143.95,15039.8,143
CPT,50060,Nl removal calculus,,,175.73,15039.8,143
CPT,50065,Nl sec surg operj calculus,,,186.36,15039.8,143
CPT,50070,Nl comp cgen kdn abnormality,,,182.78,15039.8,143
CPT,50075,Nl rmvl lg staghorn calculus,,,224.59,15039.8,143
CPT,50080,Perq nl/pl lithotrp smpl<2cm,,,558.5,12137.01,107
CPT,50081,Perq nl/pl lithotrp cplx>2cm,,,173.81,12137.01,143
CPT,50100,Trnsxj/repos abrrnt rnl vsls,,,167.98,15039.8,143
CPT,50120,Pyelotomy w/exploration,,,146.51,15039.8,143
CPT,50125,Pyelotomy w/drg pyelostomy,,,151.55,15039.8,143
CPT,50130,Pyelotomy w/removal calculus,,,159.39,15039.8,143
CPT,50135,Pyelotomy complicated,,,173.04,10651.71,124
CPT,50200,HC PERCUTANEOUS RENAL BIOPSY BILATERAL,3850.43,2887.82,46.21,3465.39,119
CPT,50200,HC PERCUTANEOUS RENAL BIOPSY UNILATERAL,1925.22,1443.92,23.1,1732.7,119
CPT,50200,Renal biopsy perq,,,182.87,8047.51,71
CPT,50205,Renal bx surg exposure kdn,,,117.15,15039.8,143
CPT,50220,Remove kidney open,,,162.84,15039.8,143
CPT,50225,Removal kidney open complex,,,185.98,15039.8,143
CPT,50230,Removal kidney open radical,,,197.56,15039.8,179
CPT,50234,Removal of kidney & ureter,,,201.17,15039.8,143
CPT,50236,Removal of kidney & ureter,,,225.83,15039.8,143
CPT,50240,Nephrectomy partial,,,204.64,15039.8,143
CPT,50250,Opn abltj 1/> rnl mas crysrg,,,187.68,15039.8,107
CPT,50280,Exc/unroofing cyst kidney,,,148.56,15039.8,143
CPT,50290,Excision perinephric cyst,,,138.84,15039.8,107
CPT,50300,Remove cadaver donor kidney,,,12954.18,15039.8,19
CPT,50320,Remove kidney living donor,,,235.53,15039.8,143
CPT,50323,Prep cadaver renal allograft,,,497.78,15039.8,35
CPT,50325,Prep donor renal graft,,,497.78,15039.8,35
CPT,50327,Prep renal graft/venous,,,33.47,15039.8,71
CPT,50328,Prep renal graft/arterial,,,29.25,15039.8,71
CPT,50329,Prep renal graft/ureteral,,,27.85,15039.8,71
CPT,50340,Recipient nephrectomy,,,148.66,15039.8,143
CPT,50360,Rnl altrnsplj w/o rcp nfrct,,,376.94,22735.98,143
CPT,50365,Rnl altrnsplj w/rcp nfrct,,,448.68,27100.4,179
CPT,50370,Rmvl transplanted rnl algrft,,,188.32,19054.96,107
CPT,50380,Rnl autotrnsplj rimpltj kdn,,,315.6,22712.77,107
CPT,50382,Change ureter stent percut,,,364.47,9547.47,71
CPT,50382,HC CHANGE URETER STENT PERCUT BILATERAL,4514.71,3386.03,54.18,4063.24,119
CPT,50382,HC CHANGE URETER STENT PERCUT UNILATERAL,4514.71,3386.03,54.18,4063.24,119
CPT,50384,"HC REMOVE URETER STENT, PERCUT UNILATERAL",5037.65,3778.24,60.45,4533.88,119
CPT,50384,Remove ureter stent percut,,,328.83,16000.11,71
CPT,50385,Change stent via transureth,,,312.26,2695.2,71
CPT,50386,Remove stent via transureth,,,233.46,2280.0,71
CPT,50387,Change nephroureteral cath,,,120.41,2695.2,71
CPT,50387,HC RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH BILATERAL,8472.07,6354.05,101.66,7624.86,119
CPT,50387,HC RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH UNILATERAL,4236.04,3177.03,50.83,3812.44,119
CPT,50389,HC REMOVE NEPHROSTOMY TUBE BILATERAL,3341.14,2505.86,40.09,3007.03,119
CPT,50389,HC REMOVE NEPHROSTOMY TUBE UNILATERAL,1670.57,1252.93,20.05,1503.51,119
CPT,50389,Remove renal tube w/fluoro,,,77.22,1550.8,71
CPT,50390,Drainage of kidney lesion,,,137.16,2258.77,71
CPT,50390,HC PERC ASP/INJ RENAL CYST/PELVIS BILATERAL,4644.34,3483.26,55.73,4179.91,119
CPT,50390,HC PERC ASP/INJ RENAL CYST/PELVIS UNILATERAL,2322.17,1741.63,27.87,2089.95,119
CPT,50391,Instll rx agnt into rnal tub,,,141.29,780.21,71
CPT,50396,HC MANOMETRY THRU INDWELLING CATH,748.02,561.02,8.98,673.22,119
CPT,50396,Measure kidney pressure,,,167.78,943.96,71
CPT,50400,Revision of kidney/ureter,,,154.12,15039.8,143
CPT,50405,Revision of kidney/ureter,,,215.2,15039.8,143
CPT,50430,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG NEW ACSS BILATERAL,5871.77,4403.83,70.46,5284.59,119
CPT,50430,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG NEW ACSS UNILATERAL,2935.88,2201.91,35.23,2642.29,119
CPT,50430,Njx px nfrosgrm &/urtrgrm,,,221.33,8993.49,71
CPT,50431,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG EXISTNG ACSS BILATERAL,3025.97,2269.48,36.31,2723.37,119
CPT,50431,HC INJ ANTE NEPHROSGRM/URETRGRM W IMG EXISTNG ACSS UNILATERAL,1512.98,1134.73,18.16,1361.68,119
CPT,50431,Njx px nfrosgrm &/urtrgrm,,,94.64,10852.59,71
CPT,50432,HC PLMT PERC NEPHROSTO CATH INCL DX NEPHROS/URETRGRM W/IMG BILATERAL,12200.47,9150.35,146.41,10980.42,119
CPT,50432,HC PLMT PERC NEPHROSTO CATH INCL DX NEPHROS/URETRGRM W/IMG UNILATERAL,6100.24,4575.18,73.2,5490.22,119
CPT,50432,Plmt nephrostomy catheter,,,295.28,4613.37,71
CPT,50433,HC PLMT PERC NEPHROURETRL CATH W IMG NEW ACSS BILATERAL,15396.34,11547.26,184.76,13856.71,119
CPT,50433,HC PLMT PERC NEPHROURETRL CATH W IMG NEW ACSS UNILATERAL,7698.17,5773.63,92.38,6928.35,119
CPT,50433,Plmt nephroureteral catheter,,,366.68,4560.57,71
CPT,50434,Convert nephrostomy catheter,,,275.13,2695.2,71
CPT,50434,HC CONV PERC NEPH CATH TO NEPHURETRL CATH VIA EXIST NEPH TR BILATERAL,15019.11,11264.33,180.23,13517.2,119
CPT,50434,HC CONV PERC NEPH CATH TO NEPHURETRL CATH VIA EXIST NEPH TR UNILATERAL,6240.63,4680.47,74.89,5616.57,119
CPT,50435,Exchange nephrostomy cath,,,143.7,3822.09,71
CPT,50435,HC EXCH PERC NEPHROSTOMY CATH INCL DX NEPHRO/URETRGRM W IMG BILATERAL,15463.25,11597.44,185.56,13916.92,119
CPT,50435,HC EXCH PERC NEPHROSTOMY CATH INCL DX NEPHRO/URETRGRM W IMG UNILATERAL,7731.62,5798.72,92.78,6958.46,119
CPT,50436,Dilat xst trc ndurlgc px,,,214.79,4560.57,70
CPT,50437,Dilat xst trc new access rcs,,,358.98,4560.57,70
CPT,50437,HC PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS UNILATERAL,7791.45,5843.59,93.5,7012.3,119
CPT,50500,Repair of kidney wound,,,193.92,15039.8,107
CPT,50520,Close kidney-skin fistula,,,180.18,15039.8,107
CPT,50525,Close nephrovisceral fistula,,,228.33,15039.8,107
CPT,50526,Close nephrovisceral fistula,,,244.6,15039.8,107
CPT,50540,Revision of horseshoe kidney,,,176.89,15039.8,107
CPT,50541,Laparo ablate renal cyst,,,141.69,12412.85,143
CPT,50542,Laparo ablate renal mass,,,180.17,12412.85,143
CPT,50543,Laparo partial nephrectomy,,,229.72,12412.85,143
CPT,50544,Laparoscopy pyeloplasty,,,191.56,12412.85,143
CPT,50545,Laparo radical nephrectomy,,,205.81,15039.8,143
CPT,50546,Laparoscopic nephrectomy,,,185.76,15039.8,143
CPT,50547,Laparo removal donor kidney,,,250.76,15199.04,143
CPT,50548,Laparo remove w/ureter,,,206.98,15039.8,143
CPT,50549,Unlisted laps px renal,,,5593.17,6493.67,19
CPT,50551,Kidney endoscopy,,,423.75,12738.27,71
CPT,50553,Kidney endoscopy,,,452.84,10432.33,71
CPT,50555,Kidney endoscopy & biopsy,,,490.92,12137.01,71
CPT,50557,Kidney endoscopy & treatment,,,497.34,12137.01,71
CPT,50561,Kidney endoscopy & treatment,,,566.99,10171.68,71
CPT,50562,Renal scope w/tumor resect,,,88.8,12137.01,107
CPT,50570,Kidney endoscopy,,,705.9,7520.88,71
CPT,50572,Kidney endoscopy,,,639.87,10171.68,71
CPT,50574,Kidney endoscopy & biopsy,,,812.1,4560.57,71
CPT,50575,Kidney endoscopy,,,780.21,6896.03,71
CPT,50576,Kidney endoscopy & treatment,,,810.11,12137.01,71
CPT,50580,Kidney endoscopy & treatment,,,872.42,6896.03,71
CPT,50590,Fragmenting of kidney stone,,,457.75,10171.68,107
CPT,50592,HC RENAL TUMOR ABLATION RF UNILATERAL,16531.77,12398.83,198.38,14878.59,119
CPT,50592,Perc rf ablate renal tumor,,,264.1,7571.84,107
CPT,50593,HC ABLATION RENAL CRYO UNILATERAL,16213.47,12160.1,194.56,14592.12,119
CPT,50593,Perc cryo ablate renal tum,,,70.55,17929.67,143
CPT,50600,Exploration of ureter,,,144.74,15039.8,143
CPT,50605,Insert ureteral support,,,155.97,15039.8,143
CPT,50606,Endoluminal bx urtr rnl plvs,,,201.84,7310.25,52
CPT,50606,HC ENDOLUMINAL BX OF URETER AND OR RENAL PELVIS,5535.65,4151.74,66.43,4982.08,119
CPT,50610,Removal of ureter stone,,,145.77,15039.8,143
CPT,50620,Removal of ureter stone,,,139.44,15039.8,143
CPT,50630,Removal of ureter stone,,,137.76,15039.8,143
CPT,50650,Removal of ureter,,,160.02,15039.8,143
CPT,50660,Removal of ureter,,,176.21,15039.8,107
CPT,50684,Injection for ureter x-ray,,,73.16,8087.4,52
CPT,50686,Measure ureter pressure,,,84.69,8894.38,71
CPT,50688,Change of ureter tube/stent,,,59.45,2695.2,71
CPT,50690,HC LOOPOGRAM INJECTION,669.77,502.33,8.04,602.79,119
CPT,50690,Injection for ureter x-ray,,,67.3,1074.52,52
CPT,50693,HC PLMT PERC URETRL STENT W IMG PRE-EXISTNG NEPHRO TRACT BILATERAL,15045.23,11283.92,180.54,13540.71,119
CPT,50693,HC PLMT PERC URETRL STENT W IMG PRE-EXISTNG NEPHRO TRACT UNILATERAL,7522.62,5641.96,90.27,6770.36,119
CPT,50693,Plmt ureteral stent prq,,,292.85,4560.57,71
CPT,50694,HC PLMT PERC URETRL STENT W IMG NEW ACSS WO SEP NEPHRO CATH BILATERAL,16879.01,12659.26,202.55,15191.11,119
CPT,50694,HC PLMT PERC URETRL STENT W IMG NEW ACSS WO SEP NEPHRO CATH UNILATERAL,8439.5,6329.62,101.27,7595.55,119
CPT,50694,Plmt ureteral stent prq,,,383.9,4560.57,71
CPT,50695,HC PLMT PERC URETRL STENT W IMG NEW ACSS W SEP NEPHRO CATH BILATERAL,17748.29,13311.22,212.98,15973.46,119
CPT,50695,HC PLMT PERC URETRL STENT W IMG NEW ACSS W SEP NEPHRO CATH UNILATERAL,8874.15,6655.61,106.49,7986.74,119
CPT,50695,Plmt ureteral stent prq,,,491.9,5603.02,71
CPT,50700,Revision of ureter,,,142.95,15039.8,143
CPT,50705,HC URETERAL EMBOLIZATION/OCCLUSION,7622.03,5716.52,91.46,6859.83,119
CPT,50705,Ureteral embolization/occl,,,257.93,15789.67,52
CPT,50706,Balloon dilate urtrl strix,,,260.7,7227.98,52
CPT,50706,HC BALLOON DILATE URTRL STRICTURE W IMG S&I,6116.06,4587.04,73.39,5504.45,119
CPT,50715,Release of ureter,,,186.91,15039.8,143
CPT,50722,Release of ureter,,,159.25,15039.8,107
CPT,50725,Release/revise ureter,,,170.03,15039.8,107
CPT,50727,Revise ureter,,,78.93,7956.57,143
CPT,50728,Revise ureter,,,108.19,15039.8,143
CPT,50740,Fusion of ureter & kidney,,,190.1,15039.8,143
CPT,50750,Fusion of ureter & kidney,,,177.79,15039.8,143
CPT,50760,Ureteroureterostomy,,,175.23,15039.8,143
CPT,50770,Splicing of ureters,,,177.79,15039.8,107
CPT,50780,Reimplant ureter in bladder,,,171.5,15039.8,143
CPT,50782,Reimplant ureter in bladder,,,165.82,15039.8,179
CPT,50783,Reimplant ureter in bladder,,,173.83,15039.8,179
CPT,50785,Reimplant ureter in bladder,,,187.51,15039.8,143
CPT,50800,Implant ureter in bowel,,,143.07,15039.8,143
CPT,50810,Fusion of ureter & bowel,,,218.26,15039.8,107
CPT,50815,Urine shunt to intestine,,,188.9,15039.8,143
CPT,50820,Construct bowel bladder,,,202.71,15039.8,143
CPT,50825,Construct bowel bladder,,,253.8,15273.15,107
CPT,50830,Revise urine flow,,,277.62,16698.03,107
CPT,50840,Replace ureter by bowel,,,189.95,15039.8,143
CPT,50845,Appendico-vesicostomy,,,193.49,15039.8,107
CPT,50860,Transplant ureter to skin,,,145.91,15039.8,143
CPT,50900,Repair of ureter,,,130.21,15039.8,143
CPT,50920,Closure ureter/skin fistula,,,136.16,15039.8,107
CPT,50925,HC FETAL NON-STRESS TEST,509.64,382.23,6.12,458.68,119
CPT,50930,Closure ureter/bowel fistula,,,169.98,15039.8,107
CPT,50940,Release of ureter,,,137.2,15039.8,143
CPT,50945,Laparoscopy ureterolithotomy,,,149.79,8572.99,143
CPT,50947,Laparo new ureter/bladder,,,213.36,12412.85,143
CPT,50948,Laparo new ureter/bladder,,,196.43,12412.85,143
CPT,50949,Unlisted laps px ureter,,,5593.17,6493.67,19
CPT,50951,Endoscopy of ureter,,,440.6,10402.86,71
CPT,50953,Endoscopy of ureter,,,469.71,10402.86,71
CPT,50955,Ureter endoscopy & biopsy,,,506.31,6896.03,71
CPT,50957,Ureter endoscopy & treatment,,,509.25,6896.03,71
CPT,50961,Ureter endoscopy & treatment,,,455.88,6896.03,71
CPT,50970,Ureter endoscopy,,,532.56,5779.37,71
CPT,50972,Ureter endoscopy & catheter,,,515.21,5779.37,71
CPT,50974,Ureter endoscopy & biopsy,,,679.67,6896.03,71
CPT,50976,Ureter endoscopy & treatment,,,669.41,6896.03,71
CPT,50980,Ureter endoscopy & treatment,,,512.24,6896.03,71
CPT,51020,Cystotomy/cystostomy w/fulg,,,72.72,5779.37,107
CPT,51030,Incise & treat bladder,,,379.58,5779.37,52
CPT,51040,Incise & drain bladder,,,45.0,3822.09,107
CPT,51045,Incise bladder/drain ureter,,,77.51,3457.61,107
CPT,51050,Removal of bladder stone,,,72.97,6896.03,107
CPT,51060,Removal of ureter stone,,,90.21,2695.2,107
CPT,51065,Remove ureter calculus,,,465.86,5779.37,71
CPT,51080,Drainage of bladder abscess,,,63.28,3236.54,107
CPT,51100,Drain bladder by needle,,,37.84,3822.09,71
CPT,51100,HC NEEDLE ASPIRATION BLADDER,1617.32,1212.99,19.41,1455.59,119
CPT,51101,Drain bladder by trocar/cath,,,49.07,2712.45,71
CPT,51101,HC DRAIN BLADDER BY TROCAR/CATH,583.94,437.96,7.01,525.55,119
CPT,51102,Drain bl w/cath insertion,,,138.57,2695.2,71
CPT,51102,HC SUPRAPUBIC CATH INSERTION,2962.42,2221.82,35.55,2666.18,119
CPT,51500,Removal of bladder cyst,,,98.59,7571.84,107
CPT,51520,Removal of bladder lesion,,,92.16,4560.57,107
CPT,51525,Removal of bladder lesion,,,132.88,15039.8,107
CPT,51530,Removal of bladder lesion,,,119.03,15039.8,107
CPT,51535,Repair of ureter lesion,,,120.56,6693.25,143
CPT,51550,Partial removal of bladder,,,148.73,15039.8,107
CPT,51555,Partial removal of bladder,,,194.41,15039.8,107
CPT,51565,Revise bladder & ureter(s),,,198.8,15039.8,107
CPT,51570,Removal of bladder,,,227.29,15039.8,107
CPT,51575,Removal of bladder & nodes,,,280.51,16825.76,107
CPT,51580,Remove bladder/revise tract,,,292.05,17573.77,107
CPT,51585,Removal of bladder & nodes,,,324.93,19541.29,107
CPT,51590,Remove bladder/revise tract,,,297.44,17894.47,107
CPT,51595,Remove bladder/revise tract,,,336.66,20246.04,107
CPT,51596,Remove bladder/create pouch,,,363.29,21863.88,107
CPT,51597,Removal of pelvic structures,,,354.2,21286.76,107
CPT,51600,HC CYSTOGRAPHY INJECTION,509.66,382.24,6.12,458.69,119
CPT,51600,Injection for bladder x-ray,,,42.48,18324.06,52
CPT,51605,Preparation for bladder xray,,,36.9,17840.37,52
CPT,51610,HC URETHROCYSTOGRAPHY RETROGRADE INJ,549.23,411.92,6.59,494.31,119
CPT,51610,Injection for bladder x-ray,,,61.69,1541.26,52
CPT,51700,HC BLADDER IRRIGATION,815.6,611.7,9.79,734.04,119
CPT,51700,Irrigation of bladder,,,29.27,298.09,71
CPT,51701,HC NON-INDWELLING CATHETER,621.35,466.01,7.46,559.22,119
CPT,51701,Insert bladder catheter,,,24.64,970.93,71
CPT,51702,HC FOLEY CATHETER INSERTION,777.86,583.4,9.33,700.07,119
CPT,51702,Insert temp bladder cath,,,24.35,560.87,71
CPT,51703,HC INSERT COMPLEX CATHETER,1024.55,768.41,12.29,922.1,119
CPT,51703,Insert bladder cath complex,,,73.92,415.31,71
CPT,51705,Change of bladder tube,,,49.73,470.06,71
CPT,51705,HC CYSTOSTOMY TUBE CHANGE; SIMPLE,583.94,437.96,7.01,525.55,119
CPT,51710,Change of bladder tube,,,77.07,930.96,71
CPT,51710,HC CHANGE OF CYSTOSTOMY TUBE; COMPLICATED,583.94,437.96,7.01,525.55,119
CPT,51715,Endoscopic injection/implant,,,184.94,6034.02,71
CPT,51720,HC TREATMENT BLADDER LESION; INSTILL ANTICARCINOGENIC,1288.33,966.25,14.85,1205.35,238
CPT,51720,Treatment of bladder lesion,,,42.43,780.21,71
CPT,51721,Ins trurl ablt trnsdc thr us,,,1269.41,5056.94,16
CPT,51725,Simple cystometrogram,,,73.73,698.35,107
CPT,51726,Complex cystometrogram,,,82.07,779.95,107
CPT,51727,Cystometrogram w/up,,,102.43,975.77,107
CPT,51728,Cystometrogram w/vp,,,100.29,954.98,107
CPT,51728,HC COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,2166.0,1624.5,25.99,1949.4,119
CPT,51729,Cystometrogram w/vp&up,,,121.55,1162.73,107
CPT,51736,Urine flow measurement,,,5.0,577.94,107
CPT,51741,Electro-uroflowmetry first,,,5.31,346.59,107
CPT,51784,Anal/urinary muscle study,,,25.71,340.2,107
CPT,51785,Anal/urinary muscle study,,,89.12,1092.36,107
CPT,51785,HC NDL EMG ANAL/URETHRL SPINCTER,319.34,239.5,3.83,287.41,119
CPT,51792,Urinary reflex study,,,52.45,2166.48,107
CPT,51797,Intraabdominal pressure test,,,38.55,1906.5,88
CPT,51798,HC BLADDER SCAN/URINE CAPACITY MEASUREMENT,392.76,294.57,4.71,353.48,119
CPT,51798,Us urine capacity measure,,,10.02,1255.64,71
CPT,51800,Revision of bladder/urethra,,,160.27,15039.8,107
CPT,51820,Revision of urinary tract,,,87.22,15039.8,107
CPT,51840,Attach bladder/urethra,,,107.89,15039.8,107
CPT,51841,Attach bladder/urethra,,,124.65,15039.8,107
CPT,51845,Repair bladder neck,,,90.13,5890.36,107
CPT,51860,Repair of bladder wound,,,115.48,12137.01,107
CPT,51865,Repair of bladder wound,,,138.63,15039.8,107
CPT,51880,Repair of bladder opening,,,71.86,10171.68,107
CPT,51900,Repair bladder/vagina lesion,,,127.35,15039.8,107
CPT,51920,Close bladder-uterus fistula,,,118.02,15039.8,107
CPT,51925,Hysterectomy/bladder repair,,,168.45,15039.8,107
CPT,51940,Correction of bladder defect,,,252.89,15210.28,107
CPT,51960,Revision of bladder & bowel,,,213.49,15039.8,107
CPT,51980,Construct bladder opening,,,110.38,15039.8,107
CPT,51990,Laparo urethral suspension,,,115.13,10769.58,107
CPT,51992,Laparo sling operation,,,129.64,10376.22,107
CPT,51999,Unlisted laps px bladder,,,5593.17,6493.67,19
CPT,52000,Cystourethroscopy,,,77.5,6345.74,71
CPT,52000,HC CYSTOURETHROSCOPY,2112.35,1584.26,25.35,1901.12,119
CPT,52001,Cysto w/irrg&evac mlt clots,,,275.26,8696.02,71
CPT,52005,Cysto w/urtrl cathj,,,126.82,2695.2,71
CPT,52007,Cysto urtrl cathj brush bx,,,238.5,4560.57,71
CPT,52010,Cystoscopy & duct catheter,,,158.39,2258.77,71
CPT,52204,Cystoscopy w/biopsy(s),,,135.16,3822.09,71
CPT,52214,Cystoscopy and treatment,,,168.57,4560.57,71
CPT,52224,Cystoscopy and treatment,,,195.22,4560.57,71
CPT,52234,Cystoscopy and treatment,,,235.75,4560.57,71
CPT,52235,Cystoscopy and treatment,,,276.51,4560.57,71
CPT,52240,Cystoscopy and treatment,,,375.62,6896.03,71
CPT,52250,Cystoscopy and radiotracer,,,229.49,4560.57,71
CPT,52260,Cystoscopy and treatment,,,202.38,5779.37,71
CPT,52265,Cystoscopy and treatment,,,155.95,3822.09,71
CPT,52270,Cystoscopy & revise urethra,,,173.91,2695.2,71
CPT,52275,Cystoscopy & revise urethra,,,237.81,2695.2,71
CPT,52276,Cystoscopy and treatment,,,253.23,2695.2,71
CPT,52277,Cystoscopy and treatment,,,309.85,4560.57,71
CPT,52281,Cystoscopy and treatment,,,145.83,2695.2,71
CPT,52282,Cystoscopy implant stent,,,322.56,4560.57,71
CPT,52283,Cystoscopy and treatment,,,192.96,2695.2,71
CPT,52284,Cysto rx balo cath urtl strx,,,3822.09,9534.91,35
CPT,52285,Cystoscopy and treatment,,,187.61,2258.77,71
CPT,52287,Cystoscopy chemodenervation,,,162.82,7990.93,71
CPT,52290,Cystoscopy and treatment,,,233.77,2695.2,71
CPT,52300,Cystoscopy and treatment,,,268.95,4560.57,71
CPT,52301,Cystoscopy and treatment,,,277.92,4560.57,71
CPT,52305,Cystoscopy and treatment,,,267.38,6896.03,71
CPT,52310,Cystoscopy and treatment,,,145.33,3822.09,71
CPT,52315,Cystoscopy and treatment,,,263.69,5779.37,71
CPT,52317,Remove bladder stone,,,332.44,4560.57,71
CPT,52318,Remove bladder stone,,,453.78,4560.57,71
CPT,52320,Cystoscopy and treatment,,,353.9,4560.57,71
CPT,52325,Cystoscopy stone removal,,,460.5,6896.03,71
CPT,52327,Cystoscopy inject material,,,373.47,9534.91,71
CPT,52330,Cystoscopy and treatment,,,378.59,5779.37,71
CPT,52332,Cystoscopy and treatment,,,223.7,7990.93,71
CPT,52334,Create passage to kidney,,,175.48,4560.57,71
CPT,52341,Cysto w/ureter stricture tx,,,408.78,4560.57,71
CPT,52342,Cysto w/up stricture tx,,,443.96,4560.57,71
CPT,52343,Cysto w/renal stricture tx,,,494.79,4560.57,71
CPT,52344,Cysto/uretero stricture tx,,,529.94,4560.57,71
CPT,52345,Cysto/uretero w/up stricture,,,566.43,4560.57,71
CPT,52346,Cystouretero w/renal strict,,,641.01,6896.03,71
CPT,52351,Cystouretero & or pyeloscope,,,289.8,4560.57,71
CPT,52352,Cystouretero w/stone remove,,,509.13,5779.37,71
CPT,52353,Cystouretero w/lithotripsy,,,563.43,6896.03,71
CPT,52354,Cystouretero w/biopsy,,,599.04,6896.03,71
CPT,52355,Cystouretero w/excise tumor,,,671.18,6896.03,71
CPT,52356,Cysto/uretero w/lithotripsy,,,597.15,6896.03,71
CPT,52400,Cysto cgen post urtl valves,,,381.99,5779.37,71
CPT,52402,Cysto trurl rescj ejacul dux,,,255.71,5779.37,71
CPT,52441,Cysto insj trnsprstc 1 implt,,,201.1,11944.02,52
CPT,52442,Cysto ins trnsprstc implt ea,,,48.73,7305.44,52
CPT,52443,Cysto 1st trurl prst8 comis,,,9585.03,9585.03,9
CPT,52450,Transurethral inc prostate,,,380.04,10009.94,71
CPT,52500,Trurl resection bladder neck,,,394.76,6122.67,71
CPT,52597,Trurl rbtc wtrjt rescj prst8,,,9585.03,9585.03,9
CPT,52601,Prostatectomy (turp),,,583.64,6896.03,71
CPT,52630,Remove prostate regrowth,,,325.09,6896.03,71
CPT,52640,Relieve bladder contracture,,,257.96,5779.37,71
CPT,52647,Laser surgery of prostate,,,520.78,6326.03,62
CPT,52648,Laser surgery of prostate,,,555.16,6896.03,71
CPT,52649,Prostate laser enucleation,,,661.53,6896.03,71
CPT,52700,Drainage of prostate abscess,,,355.23,5779.37,71
CPT,53000,Incision of urethra,,,114.43,5779.37,71
CPT,53010,Incision of urethra,,,237.81,6896.03,71
CPT,53020,Incision of urethra,,,93.1,2695.2,71
CPT,53025,Incision of urethra,,,65.93,5779.37,71
CPT,53040,Drainage of urethra abscess,,,315.2,4560.57,71
CPT,53060,Drainage of urethra abscess,,,129.42,2280.0,71
CPT,53080,Drainage of urinary leakage,,,337.52,3822.09,71
CPT,53085,Drainage of urinary leakage,,,100.25,2695.2,107
CPT,53200,Biopsy of urethra,,,136.64,2695.2,71
CPT,53210,Removal of urethra,,,120.02,4560.57,107
CPT,53215,Removal of urethra,,,143.31,6896.03,107
CPT,53220,Treatment of urethra lesion,,,362.8,4560.57,71
CPT,53230,Removal of urethra lesion,,,94.36,6896.03,107
CPT,53235,Removal of urethra lesion,,,98.07,6896.03,107
CPT,53240,Surgery for urethra pouch,,,341.2,5779.37,71
CPT,53250,Removal of urethra gland,,,318.26,5779.37,71
CPT,53260,Treatment of urethra lesion,,,140.71,4560.57,71
CPT,53265,Treatment of urethra lesion,,,146.71,3822.09,71
CPT,53270,Removal of urethra gland,,,143.01,4560.57,71
CPT,53275,Repair of urethra defect,,,203.75,4560.57,71
CPT,53400,Revise urethra stage 1,,,123.69,6896.03,107
CPT,53405,Revise urethra stage 2,,,134.95,6896.03,107
CPT,53410,Reconstruction of urethra,,,151.2,6896.03,107
CPT,53415,Reconstruction of urethra,,,174.33,15039.8,107
CPT,53420,Reconstruct urethra stage 1,,,673.9,6896.03,71
CPT,53425,Reconstruct urethra stage 2,,,144.6,8791.46,107
CPT,53430,Reconstruction of urethra,,,150.7,6896.03,107
CPT,53431,Reconstruct urethra/bladder,,,177.82,6896.03,107
CPT,53440,Male sling procedure,,,116.4,27124.38,107
CPT,53442,Remove/revise male sling,,,121.41,6896.03,107
CPT,53444,Insert tandem cuff,,,122.58,31193.03,107
CPT,53445,Insert uro/ves nck sphincter,,,116.97,33547.48,107
CPT,53446,Remove uro sphincter,,,99.33,26141.99,107
CPT,53447,Remove/replace ur sphincter,,,124.61,31193.03,107
CPT,53448,Remov/replc ur sphinctr comp,,,196.91,15039.8,107
CPT,53449,Repair uro sphincter,,,94.99,26141.99,107
CPT,53450,Revision of urethra,,,328.38,9932.04,71
CPT,53451,Tprnl balo cntnc dev bi,,,1633.88,27124.38,35
CPT,53452,Tprnl balo cntnc dev uni,,,1143.73,17929.67,35
CPT,53453,Tprnl balo cntnc dev rmvl ea,,,116.64,22732.17,35
CPT,53454,Tprnl balo cntnc dev adjmt,,,136.44,15026.35,35
CPT,53460,Revision of urethra,,,367.22,4560.57,71
CPT,53500,Urethrlys transvag w/ scope,,,116.21,4560.57,107
CPT,53502,Repair of urethra injury,,,390.04,4560.57,71
CPT,53505,Repair of urethra injury,,,75.14,8693.6,107
CPT,53510,Repair of urethra injury,,,97.85,6896.03,107
CPT,53515,Repair of urethra injury,,,122.93,7285.85,107
CPT,53520,Repair of urethra defect,,,448.57,6896.03,71
CPT,53600,Dilate urethra stricture,,,61.99,5779.37,71
CPT,53601,Dilate urethra stricture,,,51.48,5779.37,71
CPT,53605,Dilate urethra stricture,,,62.17,4560.57,71
CPT,53620,Dilate urethra stricture,,,83.69,742.89,71
CPT,53621,Dilate urethra stricture,,,69.24,3822.09,71
CPT,53660,Dilation of urethra,,,40.17,339.05,71
CPT,53661,Dilation of urethra,,,39.25,681.49,71
CPT,53665,Dilation of urethra,,,36.84,2695.2,71
CPT,53850,Prostatic microwave thermotx,,,284.42,3838.72,71
CPT,53852,Prostatic rf thermotx,,,305.16,3838.72,71
CPT,53854,Trurl dstrj prst8 tiss rf wv,,,304.91,4560.57,71
CPT,53855,Insert prost urethral stent,,,79.03,4119.22,71
CPT,53860,Transurethral rf treatment,,,178.31,6246.91,71
CPT,53865,Cysto insj dev ischmc rmdlg,,,3452.2,26233.33,35
CPT,53866,Cathj rmvl dev ischmc rmdlg,,,233.15,2258.77,35
CPT,53899,Unlisted px urinary system,,,233.15,270.69,19
CPT,54000,Slitting of prepuce,,,85.22,21986.08,71
CPT,54001,Slitting of prepuce,,,108.48,2695.2,71
CPT,54015,I&d penis deep,,,235.61,3822.09,71
CPT,54050,Destruction penis lesion(s),,,82.38,2258.77,71
CPT,54055,Destruction penis lesion(s),,,74.02,2089.12,71
CPT,54056,Cryosurgery penis lesion(s),,,85.7,1342.0,71
CPT,54057,Laser surg penis lesion(s),,,75.61,3080.23,71
CPT,54060,Excision of penis lesion(s),,,101.25,3080.23,71
CPT,54065,Destruction penis lesion(s),,,132.55,3080.23,71
CPT,54100,Biopsy of penis,,,116.69,2581.45,71
CPT,54105,Biopsy of penis,,,164.31,3236.54,71
CPT,54110,Treatment of penis lesion,,,96.54,4560.57,107
CPT,54111,Treat penis lesion graft,,,123.51,6896.03,107
CPT,54112,Treat penis lesion graft,,,144.77,12137.01,107
CPT,54115,Treatment of penis lesion,,,65.93,5779.37,107
CPT,54120,Partial removal of penis,,,97.77,10171.68,107
CPT,54125,Removal of penis,,,127.54,15039.8,107
CPT,54130,Remove penis & nodes,,,184.18,15039.8,107
CPT,54135,Remove penis & nodes,,,232.91,15039.8,107
CPT,54150,Circumcision w/regionl block,,,93.68,9297.78,71
CPT,54150,HC CIRCUMCISION,541.5,406.12,6.5,487.35,119
CPT,54160,Circumcision neonate,,,112.53,11748.68,71
CPT,54161,Circum 28 days or older,,,152.61,2695.2,71
CPT,54162,Lysis penil circumic lesion,,,155.11,2695.2,71
CPT,54163,Repair of circumcision,,,168.92,2695.2,71
CPT,54164,Frenulotomy of penis,,,149.44,2695.2,71
CPT,54200,Injection px peyronie ds,,,66.51,2258.77,71
CPT,54205,Njx px peyronie ds exps plaq,,,82.28,6896.03,107
CPT,54220,HC IRRIGATION CORPORA CAVERNOSA PRIAPISM,747.02,560.26,8.96,672.32,119
CPT,54220,Irrg crpra cavrnosa priapism,,,128.94,628.48,71
CPT,54230,Njx corpora cavernosograpy,,,76.75,5779.37,52
CPT,54231,Dynamic cavernosometry,,,111.29,412.63,71
CPT,54235,Njx corpora cavernosa rx agt,,,71.35,829.03,71
CPT,54240,Penile plethysmography,,,39.18,601.86,107
CPT,54250,Nctrnl pen tmscn&/rgdity tst,,,13.47,999.03,107
CPT,54300,Revision of penis,,,61.65,4560.57,107
CPT,54304,Revision of penis,,,115.57,4560.57,107
CPT,54308,Reconstruction of urethra,,,110.8,6896.03,107
CPT,54312,Reconstruction of urethra,,,126.5,4560.57,107
CPT,54316,Reconstruction of urethra,,,153.54,12137.01,107
CPT,54318,Reconstruction of urethra,,,110.13,4560.57,107
CPT,54322,Reconstruction of urethra,,,120.78,10171.68,107
CPT,54324,Reconstruction of urethra,,,149.49,4560.57,107
CPT,54326,Reconstruction of urethra,,,145.54,4560.57,107
CPT,54328,Revise penis/urethra,,,144.58,4560.57,107
CPT,54332,Revise penis/urethra,,,155.92,4560.57,107
CPT,54336,Revise penis/urethra,,,183.3,4560.57,107
CPT,54340,Rpr hypspad comp simple,,,88.06,4560.57,107
CPT,54344,Rrp hypspad comp moblj&urtp,,,145.8,12137.01,107
CPT,54348,Rpr hypspad comp dsj & urtp,,,155.9,6896.03,107
CPT,54352,Revj prior hypspad repair,,,218.12,10171.68,107
CPT,54360,Penis plastic surgery,,,111.56,5779.37,107
CPT,54380,Repair penis,,,123.53,5779.37,107
CPT,54385,Repair penis,,,143.76,3822.09,107
CPT,54390,Repair penis and bladder,,,191.65,15039.8,107
CPT,54400,Insert semi-rigid prosthesis,,,411.71,27124.38,71
CPT,54401,Insert self-contd prosthesis,,,512.92,31193.03,71
CPT,54405,Insert multi-comp penis pros,,,125.0,33192.02,107
CPT,54406,Remove muti-comp penis pros,,,113.11,26141.99,107
CPT,54408,Repair multi-comp penis pros,,,122.27,27817.29,107
CPT,54410,Remove/replace penis prosth,,,133.37,32482.97,107
CPT,54411,Remov/replc penis pros comp,,,159.16,31193.03,107
CPT,54415,Remove self-contd penis pros,,,82.19,27223.05,107
CPT,54416,Remv/repl penis contain pros,,,110.66,31193.03,107
CPT,54417,Remv/replc penis pros compl,,,138.97,25768.16,107
CPT,54420,Revision of penis,,,108.66,26141.99,107
CPT,54430,Revision of penis,,,98.8,21595.56,107
CPT,54435,Revision of penis,,,320.61,4560.57,71
CPT,54437,Repair corporeal tear,,,104.83,5002.9,107
CPT,54438,Replantation of penis,,,206.19,12702.2,88
CPT,54440,Repair of penis,,,1831.97,4560.57,35
CPT,54450,Preputial stretching,,,55.24,10645.68,71
CPT,54500,Biopsy of testis,,,107.96,3822.09,71
CPT,54505,Biopsy of testis,,,162.22,4560.57,107
CPT,54512,Excise lesion testis,,,415.74,4560.57,107
CPT,54520,Removal of testis,,,253.75,4560.57,107
CPT,54522,Orchiectomy partial,,,90.92,4560.57,143
CPT,54530,Removal of testis,,,78.76,4560.57,143
CPT,54535,Extensive testis surgery,,,115.08,4560.57,143
CPT,54550,Exploration for testis,,,76.09,4560.57,143
CPT,54560,Exploration for testis,,,106.4,3822.09,143
CPT,54600,Reduce testis torsion,,,350.46,4560.57,107
CPT,54620,Suspension of testis,,,231.06,4560.57,107
CPT,54640,Orchiopexy ingun/scrot appr,,,334.21,4560.57,107
CPT,54650,Orchiopexy (fowler-stephens),,,110.17,4560.57,143
CPT,54660,Revision of testis,,,277.26,8974.03,107
CPT,54670,Repair testis injury,,,316.79,4560.57,107
CPT,54680,Relocation of testis(es),,,121.76,7520.88,143
CPT,54690,Laparoscopy orchiectomy,,,101.34,7571.84,143
CPT,54692,Laparoscopy orchiopexy,,,584.18,7571.84,107
CPT,54699,Unlisted laps px testis,,,5593.17,6493.67,19
CPT,54700,HC I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,6638.97,4979.23,79.67,5975.07,119
CPT,54700,I&d epdidyms tstis&/scrot sp,,,164.38,6345.74,107
CPT,54800,Biopsy of epididymis,,,180.2,6345.74,71
CPT,54830,Remove epididymis lesion,,,288.26,4560.57,107
CPT,54840,Remove epididymis lesion,,,249.74,2695.2,107
CPT,54860,Removal of epididymis,,,324.38,4560.57,71
CPT,54861,Removal of epididymis,,,439.55,4560.57,71
CPT,54865,Explore epididymis,,,278.79,4560.57,71
CPT,54900,Fusion of spermatic ducts,,,618.89,3822.09,71
CPT,54901,Fusion of spermatic ducts,,,817.53,4560.57,71
CPT,55000,Drainage of hydrocele,,,122.03,2258.77,71
CPT,55040,Removal of hydrocele,,,261.62,4560.57,71
CPT,55041,Removal of hydroceles,,,215.76,4560.57,71
CPT,55060,Repair of hydrocele,,,294.26,4560.57,107
CPT,55100,Drainage of scrotum abscess,,,129.35,3822.09,71
CPT,55100,HC DRAINAGE SCROTAL WALL ABSCESS,5251.0,3938.25,63.01,4725.9,119
CPT,55110,Explore scrotum,,,300.58,4560.57,71
CPT,55120,HC REMOVAL OF SCROTUM LESION,125.29,93.97,1.5,112.76,119
CPT,55120,Removal of scrotum lesion,,,274.71,2695.2,71
CPT,55150,Removal of scrotum,,,76.43,4560.57,107
CPT,55175,Revision of scrotum,,,282.94,4560.57,71
CPT,55180,Revision of scrotum,,,533.05,6896.03,71
CPT,55200,Incision of sperm duct,,,214.82,4560.57,71
CPT,55250,Removal of sperm duct(s),,,176.8,5779.37,71
CPT,55300,Prepare sperm duct x-ray,,,179.24,3822.09,52
CPT,55400,Repair of sperm duct,,,77.32,4560.57,143
CPT,55500,Removal of hydrocele,,,304.18,4560.57,107
CPT,55520,Removal of sperm cord lesion,,,71.18,4560.57,143
CPT,55530,Revise spermatic cord veins,,,272.7,4560.57,107
CPT,55535,Revise spermatic cord veins,,,66.67,8413.15,143
CPT,55540,Revise hernia & sperm veins,,,431.44,4560.57,107
CPT,55550,Laparo ligate spermatic vein,,,66.52,7571.84,143
CPT,55559,Unlstd laps px sprmatic cord,,,5593.17,6493.67,19
CPT,55600,Vesiculotomy,,,326.74,3822.09,107
CPT,55605,Vesiculotomy complicated,,,405.68,15039.8,107
CPT,55650,Remove sperm duct pouch,,,111.11,15039.8,143
CPT,55680,Remove sperm pouch lesion,,,268.83,4560.57,107
CPT,55700,Biopsy of prostate,,,125.21,5614.45,62
CPT,55700,HCD PROSTATE BIOPSY NEEDLE,952.99,714.74,11.44,857.69,119
CPT,55705,Bx prst8 any approach nonimg,,,204.9,4560.57,71
CPT,55706,Bx prst8 ndl sat sampling,,,58.11,4560.57,107
CPT,55707,Bx prst8 trct us guided,,,3569.13,3569.13,9
CPT,55708,Bx prst8 trct us w/mri fus 1,,,3569.13,3569.13,9
CPT,55709,Bx prst8 tprnl us guided,,,3569.13,3569.13,9
CPT,55710,Bx prst8 tprn us w/mri fus 1,,,3569.13,3569.13,9
CPT,55711,Bx prst8 trct mri-us 1st,,,3569.13,3569.13,9
CPT,55712,Bx prst8 tprnl mri-us 1st,,,3569.13,3569.13,9
CPT,55713,Bx prst8 in-bore ct/mri bx 1,,,5428.95,5428.95,9
CPT,55714,Bx prst8 in-bore ct/mri 1,,,5428.95,5428.95,9
CPT,55715,Bx prst8 ea add mri-us/ct/mr,,,,,0
CPT,55720,Drainage of prostate abscess,,,69.93,4560.57,107
CPT,55725,Drainage of prostate abscess,,,92.15,4560.57,107
CPT,55801,Removal of prostate,,,169.13,15039.8,107
CPT,55810,Extensive prostate surgery,,,201.59,15039.8,107
CPT,55812,Extensive prostate surgery,,,247.94,15039.8,107
CPT,55815,Extensive prostate surgery,,,271.49,16329.64,107
CPT,55821,Removal of prostate,,,129.61,15039.8,107
CPT,55831,Removal of prostate,,,133.06,15039.8,107
CPT,55840,Extensive prostate surgery,,,180.39,15039.8,107
CPT,55842,Extensive prostate surgery,,,180.48,15039.8,107
CPT,55845,Extensive prostate surgery,,,209.93,15039.8,107
CPT,55860,Surgical exposure prostate,,,676.31,9099.79,71
CPT,55862,Extensive prostate surgery,,,169.16,15039.8,107
CPT,55865,Extensive prostate surgery,,,205.86,15039.8,107
CPT,55866,Laps surg prst8ect rpbic rad,,,184.75,12412.85,107
CPT,55867,Laps surg prst8ect smpl stot,,,1013.47,11587.73,71
CPT,55868,Lap srg prst8ct lymph nod bx,,,10762.99,10762.99,9
CPT,55869,Lap srg prst8ct bi pl lmphad,,,10762.99,10762.99,9
CPT,55870,Electroejaculation,,,135.76,10402.86,71
CPT,55873,Cryoablate prostate,,,613.12,17929.67,71
CPT,55874,HC TRANSPERINEAL PLMT BIODEGRDABL MATRL,12709.01,9531.76,152.51,11438.11,119
CPT,55874,Tprnl plmt biodegrdabl matrl,,,158.54,10376.22,71
CPT,55875,HC TRANSPERI NEEDLE PLACE PROS,13763.86,10322.9,165.17,12387.47,119
CPT,55875,Transperi needle place pros,,,602.59,15026.35,71
CPT,55876,HC PLACEMENT OF FIDUCIAL MARKERS FOR PROSTATE BRACHYTHERAPY,2683.41,2012.56,32.2,2415.07,119
CPT,55876,Place rt device/marker pros,,,98.08,8696.02,71
CPT,55877,Abltj ire prst8 1+ tum perq,,,10762.99,10762.99,9
CPT,55880,Abltj mal prst8 tiss hifu,,,784.44,12137.01,70
CPT,55881,Ablt trurl prst8 tis thrm us,,,2258.77,78446.12,16
CPT,55882,Ablt trurl prst8 tis trnsdcr,,,10171.68,81206.49,34
CPT,55899,Unlisted px male genital sys,,,233.15,270.69,19
CPT,55920,HC PLACE NEEDLES PELVIC FOR RT,2683.41,2012.56,32.2,2415.07,119
CPT,55920,Place needles pelvic for rt,,,448.41,65745.48,71
CPT,55970,Sex transformation m to f,,,4732.38,68058.94,27
CPT,55980,Sex transformation f to m,,,3306.39,4936.54,27
CPT,56405,HC VULVA/PERINEAL ABSCESS I/D,985.84,739.38,11.83,887.26,119
CPT,56405,I&d vulva/perineal abscess,,,76.51,4936.54,107
CPT,56420,HC I/D BARTHOLIN GLAND ABSCESS,651.97,488.98,7.82,586.77,119
CPT,56420,I&d bartholins gland abscess,,,86.58,3822.09,71
CPT,56440,HC MARSUPIALIZATION BARTHOLINS GLAND CYST,546.11,409.58,6.55,491.5,119
CPT,56440,Mrsplzatn brthlns glnd cst,,,141.34,4560.57,71
CPT,56441,Lysis of labial adhesions,,,120.29,4560.57,71
CPT,56442,Hymenotomy,,,46.02,4560.57,71
CPT,56501,Destroy vulva lesions sim,,,103.92,3822.09,71
CPT,56515,Destroy vulva lesion/s compl,,,166.02,3822.09,71
CPT,56605,Biopsy of vulva/perineum,,,35.92,969.14,71
CPT,56606,Biopsy of vulva/perineum,,,17.85,2581.45,52
CPT,56620,Vulvectomy simple partial,,,91.22,4560.57,107
CPT,56625,Vulvectomy simple complete,,,104.03,4560.57,107
CPT,56630,Vulvectomy radical partial,,,149.83,15039.8,107
CPT,56631,Vlvctmy rad prtl uni lymphad,,,184.83,15039.8,143
CPT,56632,Vlvctmy rad prtl bi lymphad,,,223.52,15039.8,143
CPT,56633,Vulvectomy radical complete,,,192.12,15039.8,143
CPT,56634,Vlvctmy rad comp uni lymphad,,,201.57,15039.8,143
CPT,56637,Vlvctmy rad comp bi lymphad,,,236.22,15039.8,143
CPT,56640,Vlvctmy rad comp w/lymphadec,,,237.64,15039.8,143
CPT,56700,Prtl hymnctmy/revj hymnl rng,,,31.76,11891.24,107
CPT,56740,Exc bartholins gland/cyst,,,246.42,11939.15,107
CPT,56800,Plastic repair introitus,,,39.62,4560.57,107
CPT,56805,Clitoroplasty intersex state,,,182.62,4560.57,107
CPT,56810,Perineoplasty rpr per nonob,,,42.51,4560.57,143
CPT,56820,Colposcopy vulva,,,82.32,3822.09,71
CPT,56821,Colposcopy vulva w/biopsy,,,110.48,3822.09,71
CPT,57000,Colpotomy w/exploration,,,158.11,4560.57,71
CPT,57010,Colpotomy drg pel abscess,,,246.59,4560.57,71
CPT,57020,Colpocentesis sep px,,,77.61,5890.36,71
CPT,57022,I&d vaginal hematoma ob/pp,,,141.82,3822.09,71
CPT,57023,I&d vaginal hematoma non-ob,,,250.23,4936.54,71
CPT,57061,Destruction vag lesions smpl,,,89.61,3538.83,71
CPT,57065,Destruction vag lesion xtnsv,,,145.21,4560.57,71
CPT,57100,Biopsy vaginal mucosa simple,,,63.49,969.14,71
CPT,57105,Biopsy vaginal mucosa xtnsv,,,113.75,4560.57,71
CPT,57106,Vagnc prtl rmvl vag wall,,,83.65,4560.57,107
CPT,57107,Vagnc compl rmvl paravag tis,,,227.37,4560.57,107
CPT,57109,Vagnc bi total pel lymphadec,,,269.42,4974.94,107
CPT,57110,Vagnc compl rmvl vag wall,,,141.55,15039.8,107
CPT,57111,Vagnc compl rmvl paravag tis,,,269.42,16157.37,107
CPT,57120,Colpocleisis le fort type,,,83.02,7045.36,107
CPT,57130,Excision vaginal septum,,,27.06,13541.45,107
CPT,57135,Excision vaginal cyst/tumor,,,146.78,4936.54,71
CPT,57150,Treat vagina infection,,,25.25,3822.09,71
CPT,57155,HC INSERT UTERI TANDEM/OVOIDS,4068.46,3051.34,48.82,3661.61,119
CPT,57155,Insert uteri tandem/ovoids,,,171.65,5890.36,71
CPT,57156,HC INSERT VAG CYLINDER BRACHYTHERAPY,1125.61,844.21,13.51,1013.05,119
CPT,57156,Ins vag brachytx device,,,147.81,654.12,71
CPT,57160,Insert pessary/other device,,,44.93,4936.54,71
CPT,57170,Fitting of diaphragm/cap,,,46.8,462.35,71
CPT,57180,Treat vaginal bleeding,,,94.72,549.12,71
CPT,57200,Repair of vagina,,,51.64,4560.57,107
CPT,57210,Repair vagina/perineum,,,61.39,4560.57,107
CPT,57220,Revision of urethra,,,54.01,5890.36,107
CPT,57230,Repair of urethral lesion,,,65.69,4560.57,107
CPT,57240,Anterior colporrhaphy,,,95.97,5890.36,107
CPT,57250,Repair rectum & vagina,,,96.4,5890.36,107
CPT,57260,Cmbn ant pst colprhy,,,121.91,5890.36,107
CPT,57265,Cmbn ap colprhy w/ntrcl rpr,,,136.51,5890.36,107
CPT,57267,Insert mesh/pelvic flr addon,,,39.07,4936.54,52
CPT,57268,Repair of bowel bulge,,,79.16,5890.36,107
CPT,57270,Repair of bowel pouch,,,127.41,15039.8,107
CPT,57280,Suspension of vagina,,,150.96,15039.8,107
CPT,57282,Colpopexy extraperitoneal,,,108.61,8230.46,107
CPT,57283,Colpopexy intraperitoneal,,,109.49,8230.46,107
CPT,57284,Repair paravag defect open,,,129.95,7571.84,143
CPT,57285,Repair paravag defect vag,,,108.35,8230.46,143
CPT,57287,Revise/remove sling repair,,,115.7,6345.74,107
CPT,57288,Repair bladder defect,,,115.99,7571.84,107
CPT,57289,Repair bladder & vagina,,,124.24,8230.46,107
CPT,57291,Construction of vagina,,,86.0,6345.74,107
CPT,57292,Construct vagina with graft,,,129.82,6815.79,107
CPT,57295,Revise vag graft via vagina,,,78.41,4936.54,107
CPT,57296,Revise vag graft open abd,,,150.18,15039.8,107
CPT,57300,Repair rectum-vagina fistula,,,95.34,4560.57,107
CPT,57305,Repair rectum-vagina fistula,,,153.56,15039.8,107
CPT,57307,Fistula repair & colostomy,,,168.76,15039.8,107
CPT,57308,Fistula repair transperine,,,103.5,15039.8,107
CPT,57310,Repair urethrovaginal lesion,,,76.52,8396.89,107
CPT,57311,Repair urethrovaginal lesion,,,86.27,15039.8,107
CPT,57320,Repair bladder-vagina lesion,,,88.53,6815.79,107
CPT,57330,Repair bladder-vagina lesion,,,119.06,8230.46,107
CPT,57335,Repair vagina,,,184.42,5890.36,107
CPT,57400,Dilation of vagina,,,126.05,6815.79,71
CPT,57410,Pelvic examination,,,102.36,4936.54,71
CPT,57415,HC REMOVE VAGINAL FOREIGN BODY,1701.62,1276.21,20.42,1531.46,119
CPT,57415,Remove vaginal foreign body,,,136.66,4560.57,71
CPT,57420,Exam of vagina w/scope,,,86.97,3822.09,71
CPT,57421,Exam/biopsy of vag w/scope,,,118.05,3822.09,71
CPT,57423,Repair paravag defect lap,,,145.24,12412.85,143
CPT,57425,Laparoscopy surg colpopexy,,,152.07,12412.85,107
CPT,57426,Revise prosth vag graft lap,,,136.07,10402.86,107
CPT,57452,Exam of cervix w/scope,,,88.28,10402.86,72
CPT,57454,Bx/curett of cervix w/scope,,,129.34,6815.79,72
CPT,57455,Biopsy of cervix w/scope,,,105.71,458.06,72
CPT,57456,Endocerv curettage w/scope,,,98.47,428.78,72
CPT,57460,Bx of cervix w/scope leep,,,155.2,3538.83,72
CPT,57461,Conz of cervix w/scope leep,,,178.78,3538.83,72
CPT,57465,Cam cervix uteri drg colp,,,41.91,520.14,52
CPT,57500,Biopsy of cervix,,,72.59,969.14,72
CPT,57505,Endocervical curettage,,,84.66,969.14,72
CPT,57510,Cauterization of cervix,,,87.66,3538.83,71
CPT,57511,Cryocautery of cervix,,,114.61,556.71,71
CPT,57513,Laser surgery of cervix,,,114.36,4560.57,71
CPT,57520,Conization of cervix,,,213.73,4560.57,72
CPT,57522,Conization of cervix,,,184.01,4560.57,72
CPT,57530,Removal of cervix,,,58.37,5890.36,107
CPT,57531,Removal of cervix radical,,,284.85,17007.29,107
CPT,57540,Removal of residual cervix,,,124.05,15039.8,107
CPT,57545,Remove cervix/repair pelvis,,,130.66,15039.8,107
CPT,57550,Removal of residual cervix,,,67.56,6176.27,107
CPT,57555,Remove cervix/repair vagina,,,97.03,6502.28,107
CPT,57556,Remove cervix repair bowel,,,92.11,5890.36,107
CPT,57558,D&c of cervical stump,,,100.41,4936.54,71
CPT,57700,Revision of cervix,,,257.29,4936.54,71
CPT,57720,Revision of cervix,,,52.26,4560.57,107
CPT,57800,Dilation of cervical canal,,,46.24,3822.09,71
CPT,58100,Biopsy of uterus lining,,,61.64,3822.09,72
CPT,58110,Bx done w/colposcopy add-on,,,39.02,462.51,53
CPT,58120,Dilation and curettage,,,154.12,4560.57,71
CPT,58140,Myomectomy abdom method,,,146.21,15039.8,107
CPT,58145,Myomectomy vag method,,,88.84,4560.57,107
CPT,58146,Myomectomy abdom complex,,,180.97,15039.8,107
CPT,58150,Total hysterectomy,,,158.43,15039.8,124
CPT,58152,Total hysterectomy,,,193.85,15039.8,107
CPT,58180,Partial hysterectomy,,,150.0,15039.8,107
CPT,58200,Extensive hysterectomy,,,209.9,15039.8,107
CPT,58210,Extensive hysterectomy,,,283.89,16978.02,107
CPT,58240,Removal of pelvis contents,,,456.79,27337.91,107
CPT,58260,Vaginal hysterectomy,,,131.43,14229.23,107
CPT,58262,Vag hyst including t/o,,,145.17,22911.83,143
CPT,58263,Vag hyst w/t/o & vag repair,,,155.76,5890.36,143
CPT,58267,Vag hyst w/urinary repair,,,167.63,15039.8,107
CPT,58270,Vag hyst w/enterocele repair,,,140.27,5890.36,107
CPT,58275,Hysterectomy/revise vagina,,,154.86,15039.8,107
CPT,58280,Hysterectomy/revise vagina,,,166.11,15039.8,107
CPT,58285,Extensive hysterectomy,,,221.48,15039.8,107
CPT,58290,Vag hyst complex,,,180.39,8264.99,107
CPT,58291,Vag hyst incl t/o complex,,,194.97,11114.17,143
CPT,58292,Vag hyst t/o & repair compl,,,205.5,8230.46,143
CPT,58294,Vag hyst w/enterocele compl,,,190.82,5890.36,107
CPT,58300,HC INSERTION IUD,85.49,64.12,1.03,76.94,119
CPT,58300,Insert intrauterine device,,,48.83,6815.79,17
CPT,58301,HC REMOVAL IUD,985.84,739.38,11.83,887.26,119
CPT,58301,Remove intrauterine device,,,64.59,4936.54,71
CPT,58321,Artificial insemination,,,47.46,828.12,70
CPT,58322,Artificial insemination,,,56.34,258.11,70
CPT,58323,Sperm washing,,,11.79,223.91,70
CPT,58340,Catheter for hysterography,,,55.58,2094.65,52
CPT,58340,HC HYSTEROSALPINGOGRAM INJECTION,509.31,381.98,6.11,458.38,119
CPT,58345,HC INTRO FALLOPIAN TUBE CATH BILATERAL,13444.45,10083.34,161.33,12100.0,119
CPT,58345,HC INTRO FALLOPIAN TUBE CATH UNILATERAL,6722.22,5041.66,80.67,6050.0,119
CPT,58345,Reopen fallopian tube,,,30.82,4560.57,179
CPT,58346,Insert heyman uteri capsule,,,357.74,5890.36,71
CPT,58350,Reopen fallopian tube,,,74.13,5890.36,107
CPT,58353,Endometr ablate thermal,,,140.25,5890.36,107
CPT,58356,Endometrial cryoablation,,,55.54,5494.29,143
CPT,58400,Suspension of uterus,,,72.45,15039.8,107
CPT,58410,Suspension of uterus,,,127.89,15039.8,107
CPT,58520,Repair of ruptured uterus,,,125.37,15039.8,107
CPT,58540,Revision of uterus,,,143.62,15039.8,107
CPT,58541,Lsh uterus 250 g or less,,,114.31,12412.85,143
CPT,58542,Lsh w/t/o ut 250 g or less,,,130.09,12412.85,143
CPT,58543,Lsh uterus above 250 g,,,132.11,12412.85,143
CPT,58544,Lsh w/t/o uterus above 250 g,,,142.18,12412.85,143
CPT,58545,Laparoscopic myomectomy,,,141.03,10402.86,143
CPT,58546,Laparo-myomectomy complex,,,174.5,12412.85,143
CPT,58548,Lap radical hyst,,,293.24,17534.55,143
CPT,58550,Laparo-asst vag hysterectomy,,,138.04,10402.86,143
CPT,58552,Laparo-vag hyst incl t/o,,,153.57,14695.66,143
CPT,58553,Laparo-vag hyst complex,,,175.45,12412.85,143
CPT,58554,Laparo-vag hyst w/t/o compl,,,203.93,12412.85,143
CPT,58555,Hysteroscopy dx sep proc,,,91.3,10402.86,88
CPT,58558,Hysteroscopy biopsy,,,139.65,10402.86,88
CPT,58559,Hysteroscopy lysis,,,171.41,6290.0,84
CPT,58560,Hysteroscopy resect septum,,,48.69,6290.0,120
CPT,58561,Hysteroscopy remove myoma,,,216.05,6290.0,88
CPT,58562,Hysteroscopy remove fb,,,133.78,6290.0,84
CPT,58563,Hysteroscopy ablation,,,148.61,6290.0,88
CPT,58565,Hysteroscopy sterilization,,,277.65,6290.0,120
CPT,58570,Tlh uterus 250 g or less,,,126.28,13273.0,160
CPT,58571,Tlh w/t/o 250 g or less,,,141.76,13273.0,160
CPT,58572,Tlh uterus over 250 g,,,162.28,13273.0,156
CPT,58573,Tlh w/t/o uterus over 250 g,,,190.02,13273.0,156
CPT,58575,Laps tot hyst resj mal,,,301.06,18016.08,143
CPT,58578,Unlisted laps px uterus,,,5593.17,6493.67,19
CPT,58579,Unlisted hystsc px uterus,,,192.86,223.91,19
CPT,58580,Transcrv abltj utrn fibrd rf,,,6211.87,10656.66,35
CPT,58600,Division of fallopian tube,,,58.08,15099.23,107
CPT,58605,Division of fallopian tube,,,52.79,15039.8,107
CPT,58611,Ligate oviduct(s) add-on,,,11.85,15039.8,71
CPT,58615,Occlude fallopian tube(s),,,39.67,4560.57,107
CPT,58660,Laparoscopy lysis,,,106.61,7571.84,143
CPT,58661,Laparoscopy remove adnexa,,,102.13,7571.84,179
CPT,58662,Laparoscopy excise lesions,,,111.4,7571.84,143
CPT,58670,Laparoscopy tubal cautery,,,225.46,7571.84,107
CPT,58671,Laparoscopy tubal block,,,225.46,7571.84,107
CPT,58672,Laparoscopy fimbrioplasty,,,114.53,7571.84,143
CPT,58673,Laparoscopy salpingostomy,,,124.31,12412.85,143
CPT,58674,Laps abltj uterine fibroids,,,127.44,16550.47,143
CPT,58679,Unlisted laps px ovidct ovry,,,5593.17,6493.67,19
CPT,58700,Removal of fallopian tube,,,125.06,15039.8,107
CPT,58720,Removal of ovary/tube(s),,,118.41,15039.8,107
CPT,58740,Adhesiolysis tube ovary,,,141.06,15039.8,107
CPT,58750,Repair oviduct,,,142.49,15039.8,143
CPT,58752,Revise ovarian tube(s),,,142.14,15039.8,143
CPT,58760,Fimbrioplasty,,,128.69,15039.8,143
CPT,58770,Create new tubal opening,,,135.21,7080.46,143
CPT,58800,Drainage of ovarian cyst(s),,,228.25,6402.01,71
CPT,58805,Drainage of ovarian cyst(s),,,67.04,4560.57,107
CPT,58820,Drain ovary abscess open,,,53.04,4560.57,143
CPT,58822,Drain ovary abscess percut,,,111.99,15039.8,143
CPT,58825,Transposition ovary(s),,,111.18,15039.8,107
CPT,58900,Biopsy of ovary(s),,,68.5,5574.14,107
CPT,58920,Partial removal of ovary(s),,,112.04,8230.46,107
CPT,58925,Removal of ovarian cyst(s),,,120.01,5890.36,107
CPT,58940,Removal of ovary(s),,,86.83,15039.8,107
CPT,58943,Removal of ovary(s),,,182.81,15039.8,107
CPT,58950,Resect ovarian malignancy,,,179.66,15039.8,107
CPT,58951,Resect ovarian malignancy,,,224.89,15039.8,107
CPT,58952,Resect ovarian malignancy,,,256.71,15333.76,107
CPT,58953,Tah rad dissect for debulk,,,312.01,18664.16,107
CPT,58954,Tah rad debulk/lymph remove,,,337.4,20202.97,107
CPT,58956,Bso omentectomy w/tah,,,211.99,15642.39,107
CPT,58957,Resect recurrent gyn mal,,,247.4,16932.05,88
CPT,58958,Resc recr ovr tbl pp utr mal,,,259.51,15410.44,107
CPT,58960,Exploration of abdomen,,,155.09,15039.8,107
CPT,58970,Retrieval of oocyte,,,190.88,12915.45,70
CPT,58974,Embryo transfer intrauterine,,,834.75,7796.08,26
CPT,58976,Transfer of embryo,,,33.1,1213.67,70
CPT,58999,Unlisted px fml genital sys,,,192.86,223.91,19
CPT,59000,Amniocentesis diagnostic,,,77.79,1213.67,71
CPT,59000,HC AMNIOCENTESIS DIAGNOSTIC,389.99,292.49,4.68,350.99,119
CPT,59001,Amniocentesis therapeutic,,,172.6,551.68,71
CPT,59001,HC AMNIOCENTESIS THERAPEUTIC,1447.68,1085.76,17.37,1302.91,119
CPT,59012,Fetal cord puncture prenatal,,,184.94,574.55,71
CPT,59012,HC CORDOCENTESIS INTRAUTERINE ANY METHOD,1389.76,1042.32,16.68,1250.78,119
CPT,59015,Chorion biopsy,,,126.85,969.14,71
CPT,59015,HC CHORIONIC VILLUS SAMPLING,777.9,583.42,9.33,700.11,119
CPT,59020,Fetal contract stress test,,,22.12,462.35,107
CPT,59020,HC FETAL CONTRACTION STRESS TEST,186.28,139.71,2.24,167.65,119
CPT,59025,Fetal non-stress test,,,9.53,269.94,107
CPT,59025,HC FETAL NON-STRESS TEST,764.46,573.345,6.12,917.35,238
CPT,59025,PBB FETAL NONSTRESS TEST,509.64,382.23,6.12,458.68,119
CPT,59030,Fetal scalp blood sampling,,,61.65,551.68,71
CPT,59050,Fetal monitor w/report,,,48.76,464.87,53
CPT,59051,Fetal monitor/interpret only,,,40.63,462.35,53
CPT,59070,Transabdom amnioinfus w/us,,,47.83,1129.29,71
CPT,59072,Umbilical cord occlud w/us,,,291.62,1488.78,71
CPT,59074,Fetal fluid drainage w/us,,,47.83,1089.9,71
CPT,59076,Fetal shunt placement w/us,,,80.74,1488.78,71
CPT,59100,Remove uterus lesion,,,133.53,5890.36,107
CPT,59120,Treat ectopic pregnancy,,,127.44,15039.8,107
CPT,59121,Treat ectopic pregnancy,,,127.47,15039.8,107
CPT,59130,Treat ectopic pregnancy,,,555.38,15039.8,71
CPT,59136,Treat ectopic pregnancy,,,140.42,15039.8,107
CPT,59140,Treat ectopic pregnancy,,,65.11,15039.8,107
CPT,59150,Treat ectopic pregnancy,,,123.67,7571.84,107
CPT,59151,Treat ectopic pregnancy,,,121.01,7571.84,107
CPT,59160,D & c after delivery,,,147.27,6345.74,71
CPT,59200,Insert cervical dilator,,,42.95,6345.74,71
CPT,59300,Episiotomy or vaginal repair,,,142.94,3822.09,71
CPT,59320,HC RESCUE CERCLAGE PLACEMENT L&D OR,5142.6,3856.95,61.71,4628.34,119
CPT,59320,Revision of cervix,,,146.52,4560.57,71
CPT,59325,Revision of cervix,,,233.3,15039.8,71
CPT,59350,Repair of uterus,,,43.36,15039.8,71
CPT,59400,Obstetrical care,,,1876.44,22439.24,52
CPT,59409,Obstetrical care,,,779.97,4560.57,70
CPT,59410,Obstetrical care,,,1031.77,18806.26,52
CPT,59412,Antepartum manipulation,,,99.57,4560.57,71
CPT,59412,HC EXT CEPHALIC VERSION W/WO TOCO,3059.83,2294.87,36.72,2753.85,119
CPT,59414,Deliver placenta,,,88.1,8430.59,71
CPT,59414,HC DELIVERY-PLACENTA ONLY,1302.03,976.52,15.62,1171.83,119
CPT,59425,Antepartum care only,,,422.53,5208.92,52
CPT,59426,Antepartum care only,,,775.95,9536.68,52
CPT,59430,Care after delivery,,,175.06,4365.58,52
CPT,59510,Cesarean delivery,,,2572.16,24923.76,52
CPT,59514,Cesarean delivery only,,,141.14,15039.8,71
CPT,59515,Cesarean delivery,,,1268.04,20888.53,52
CPT,59525,Remove uterus after cesarean,,,74.73,15039.8,71
CPT,59610,Vbac delivery,,,2434.98,23503.22,52
CPT,59612,Vbac delivery only,,,881.42,4560.57,71
CPT,59614,Vbac care after delivery,,,1114.22,19697.98,52
CPT,59618,Attempted vbac delivery,,,2599.62,25190.44,52
CPT,59620,Attempted vbac delivery only,,,145.97,15039.8,71
CPT,59622,Attempted vbac after care,,,1315.88,21112.04,52
CPT,59812,Treatment of miscarriage,,,179.6,7311.16,71
CPT,59820,Care of miscarriage,,,225.22,10806.41,71
CPT,59821,Treatment of miscarriage,,,220.58,4560.57,71
CPT,59830,Treat uterus infection,,,271.63,15039.8,71
CPT,59840,Induced abortion d&c,,,172.99,4560.57,71
CPT,59841,Induced abortion dilat&evac,,,290.49,4560.57,71
CPT,59850,Induced abortion 1+ njx,,,229.06,15039.8,71
CPT,59851,Induced abortion 1+njx d&c,,,250.36,15039.8,71
CPT,59852,Induced abortion 1+njx hyst,,,344.84,15039.8,71
CPT,59855,Induced abortion 1+vag supp,,,249.03,15039.8,71
CPT,59856,Induced ab 1+vag supp d&c,,,291.44,15039.8,71
CPT,59857,Induced ab 1+vag supp hyst,,,339.88,15039.8,71
CPT,59866,Abortion (mpr),,,36.9,3894.12,71
CPT,59870,Evacuate mole of uterus,,,83.57,4560.57,107
CPT,59871,Remove cerclage suture,,,128.89,4560.57,71
CPT,59897,Unlisted fetal invas px w/us,,,192.86,223.91,19
CPT,59898,Unlstd laps px mat care&dlvr,,,5593.17,6493.67,19
CPT,59899,Unlisted px mat care&dlvr,,,192.86,223.91,19
CPT,60000,I&d thyroglssl dux cst infct,,,121.96,3822.09,71
CPT,60100,Biopsy of thyroid,,,75.09,3822.09,71
CPT,60200,Remove thyroid lesion,,,104.22,7571.84,107
CPT,60210,Partial thyroid excision,,,110.25,7571.84,107
CPT,60212,Partial thyroid excision,,,159.51,7571.84,107
CPT,60220,Partial removal of thyroid,,,110.24,7571.84,107
CPT,60225,Partial removal of thyroid,,,145.65,7571.84,107
CPT,60240,Removal of thyroid,,,142.92,7571.84,107
CPT,60252,Removal of thyroid,,,205.78,7571.84,107
CPT,60254,Extensive thyroid surgery,,,260.21,15511.65,107
CPT,60260,Repeat thyroid surgery,,,169.68,7571.84,143
CPT,60270,Removal of thyroid,,,212.34,15039.8,107
CPT,60271,Removal of thyroid,,,164.41,7571.84,107
CPT,60280,Remove thyroid duct lesion,,,70.8,10619.25,107
CPT,60281,Remove thyroid duct lesion,,,93.19,7571.84,107
CPT,60300,Aspir/inj thyroid cyst,,,47.1,6345.74,71
CPT,60500,Explore parathyroid glands,,,150.96,7571.84,107
CPT,60502,Re-explore parathyroids,,,184.94,7571.84,107
CPT,60505,Explore parathyroid glands,,,217.55,15039.8,107
CPT,60512,Autotransplant parathyroid,,,37.53,6345.74,52
CPT,60520,Removal of thymus gland,,,162.92,10887.03,107
CPT,60521,Removal of thymus gland,,,173.18,15039.8,107
CPT,60522,Removal of thymus gland,,,209.86,15039.8,107
CPT,60540,Explore adrenal gland,,,167.0,15039.8,143
CPT,60545,Explore adrenal gland,,,193.57,15039.8,143
CPT,60600,Remove carotid body lesion,,,211.39,15039.8,107
CPT,60605,Remove carotid body lesion,,,252.12,15052.69,107
CPT,60650,Laparoscopy adrenalectomy,,,184.58,15039.8,143
CPT,60659,Unlisted laps px endoc sys,,,5593.17,6493.67,19
CPT,60660,Abltj 1/+thyr ndul 1lobe prq,,,1553.26,22107.61,35
CPT,60661,Abltj 1/+thyr ndul addl prq,,,943.5,9331.31,16
CPT,60699,Unlisted px endocrine system,,,5593.17,6493.67,19
CPT,61000,Remove cranial cavity fluid,,,109.62,18528.32,71
CPT,61001,Remove cranial cavity fluid,,,103.56,3064.27,71
CPT,61020,Remove brain cavity fluid,,,102.44,1367.71,71
CPT,61026,Injection into brain canal,,,103.51,1126.35,71
CPT,61050,HC CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,1407.01,1055.26,16.88,1266.31,119
CPT,61050,Remove brain canal fluid,,,77.91,1146.24,71
CPT,61055,HC CERVICAL PUNCTURE INJECTION,1659.16,1244.37,19.91,1493.24,119
CPT,61055,Injection into brain canal,,,114.68,943.96,71
CPT,61070,Brain canal shunt procedure,,,54.6,1126.35,71
CPT,61070,HC INJ/ASPIRATE CNS SHUNT,961.12,720.84,11.53,865.01,119
CPT,61105,Tdh sdrl/ventr pnxr,,,343.63,15039.8,71
CPT,61107,Tdh pnxr implt ventr cath,,,301.84,15039.8,71
CPT,61108,Tdh pnxr evac&/drg sdrl hmta,,,670.15,15039.8,71
CPT,61120,Burr hole for ventr puncture,,,554.99,15039.8,71
CPT,61140,Burr hole/treph bx brain/les,,,197.52,15039.8,107
CPT,61150,Bur hol/trph drg brn abs/cst,,,997.97,15039.8,71
CPT,61151,Burr hole/treph sbsq tapping,,,735.21,15039.8,71
CPT,61154,Burr hole w/evac&/drg hmtma,,,198.73,15039.8,143
CPT,61156,Burr hol aspir hmtm/cst icer,,,191.75,15039.8,107
CPT,61210,Burr hole implt ventr cath,,,354.62,15039.8,71
CPT,61215,Ins subq rsvr pmp/nfs sys,,,381.63,9801.37,71
CPT,61250,Burr hole/treph sttl expl,,,135.41,15039.8,143
CPT,61253,Burr hole treph ittl uni/bi,,,154.78,15039.8,107
CPT,61304,Crnec/crnot expl supratntorl,,,254.47,15424.73,107
CPT,61305,Crnec/crnot expl infratntorl,,,311.71,18850.53,107
CPT,61312,Crnec/crnot sttl xdrl/sdrl,,,321.63,19429.92,107
CPT,61313,Crnec/crnot sttl icere,,,308.18,18663.57,107
CPT,61314,Crnec/crnot ittl xdrl/sdrl,,,283.28,17169.21,107
CPT,61315,Crnec/crnot ittl ntracereblr,,,321.38,19418.98,107
CPT,61316,Inc&subq plmt crnl bone grf,,,84.54,15039.8,71
CPT,61320,Crnec/crnot drg icr abs sttl,,,294.07,17822.72,107
CPT,61321,Crnec/crnot drg icr abs ittl,,,330.14,19957.87,107
CPT,61322,Crnec/crnot dcmprv w/o lobec,,,369.82,22353.1,107
CPT,61323,Crnec/crnot dcmprv w/lobec,,,371.33,22263.02,107
CPT,61330,Dcmprn orbit only transcrnl,,,278.89,18734.07,143
CPT,61333,Expl orbit w/removal lesion,,,313.29,18947.01,143
CPT,61340,Subtemporal cranial dcmprn,,,224.13,15039.8,143
CPT,61343,Crnec sopl crv lam dcmprn,,,341.27,20572.05,107
CPT,61345,Oth cranial dcmprn pst fossa,,,317.49,19201.97,107
CPT,61450,Crnec stpl sctj cmprn/dcmprn,,,298.3,18042.39,107
CPT,61458,Crnec sopl xpl/dcmpr crl nrv,,,313.43,18958.84,107
CPT,61460,Crnec sopl sctj 1+crnl nrv,,,327.35,19788.26,143
CPT,61500,Crnec exc tum/bone les skull,,,202.73,15889.35,107
CPT,61501,Craniectomy f/osteomyelitis,,,176.55,16584.49,107
CPT,61510,Crnec treph exc brn tum sttl,,,341.99,20698.89,107
CPT,61512,Crnec treph exc mngioma sttl,,,396.6,23954.19,107
CPT,61514,Crnec treph exc brn abs sttl,,,298.08,18026.82,107
CPT,61516,Crnec treph exc cyst sttl,,,290.96,20075.94,107
CPT,61517,Implt brn intrcv chemotx agt,,,83.91,15108.23,71
CPT,61518,Removal of brain lesion,,,429.88,25983.79,107
CPT,61519,Remove brain lining lesion,,,457.54,27622.53,107
CPT,61520,Removal of brain lesion,,,580.08,34859.28,143
CPT,61521,Removal of brain lesion,,,491.81,29666.33,107
CPT,61522,Removal of brain abscess,,,339.91,29215.47,107
CPT,61524,Removal of brain lesion,,,323.99,24863.27,107
CPT,61526,Removal of brain lesion,,,2018.88,31162.75,107
CPT,61530,Removal of brain lesion,,,1846.99,28776.39,107
CPT,61531,Implant brain electrodes,,,190.91,26117.42,143
CPT,61533,Implant brain electrodes,,,237.64,24117.42,107
CPT,61534,Removal of brain lesion,,,256.99,15547.03,107
CPT,61535,Remove brain electrodes,,,156.65,15039.8,107
CPT,61536,Removal of brain lesion,,,400.19,24183.33,107
CPT,61537,Removal of brain tissue,,,381.52,23041.4,107
CPT,61538,Removal of brain tissue,,,412.86,24933.42,107
CPT,61539,Removal of brain tissue,,,366.69,22160.13,107
CPT,61540,Removal of brain tissue,,,338.16,20896.63,107
CPT,61541,Incision of brain tissue,,,334.26,20207.41,107
CPT,61543,Removal of brain tissue,,,337.78,20426.29,107
CPT,61544,Remove & treat brain lesion,,,295.05,17848.15,107
CPT,61545,Excision of brain tumor,,,494.55,29886.2,107
CPT,61546,Removal of pituitary gland,,,358.63,21672.59,107
CPT,61548,Removal of pituitary gland,,,243.64,25047.54,143
CPT,61550,Release of skull seams,,,186.47,18163.74,107
CPT,61552,Release of skull seams,,,231.53,15039.8,107
CPT,61556,Incise skull/sutures,,,265.81,16084.24,107
CPT,61557,Incise skull/sutures,,,262.53,15892.36,107
CPT,61558,Excision of skull/sutures,,,292.81,17711.16,107
CPT,61559,Excision of skull/sutures,,,372.8,22553.16,107
CPT,61563,Excision of skull tumor,,,308.1,18629.18,107
CPT,61564,Excision of skull tumor,,,373.84,22604.02,143
CPT,61566,Removal of brain tissue,,,348.03,21033.18,107
CPT,61567,Incision of brain tissue,,,396.39,23963.06,107
CPT,61570,Remove foreign body brain,,,291.1,17627.85,107
CPT,61571,Incise skull for brain wound,,,309.6,20083.38,107
CPT,61575,Skull base/brainstem surgery,,,388.94,23501.74,107
CPT,61576,Skull base/brainstem surgery,,,646.74,39021.96,107
CPT,61580,Craniofacial approach skull,,,1499.13,22992.22,143
CPT,61581,Craniofacial approach skull,,,1643.4,32704.2,143
CPT,61582,Craniofacial approach skull,,,487.52,28127.52,143
CPT,61583,Craniofacial approach skull,,,455.07,27275.82,143
CPT,61584,Orbitocranial approach/skull,,,449.92,26747.78,179
CPT,61585,Orbitocranial approach/skull,,,509.14,30394.14,179
CPT,61586,Resect nasopharynx skull,,,392.68,23290.54,143
CPT,61590,Infratemporal approach/skull,,,471.57,27898.38,179
CPT,61591,Infratemporal approach/skull,,,478.9,28574.46,179
CPT,61592,Orbitocranial approach/skull,,,491.32,29383.08,179
CPT,61595,Transtemporal approach/skull,,,1437.46,23948.17,143
CPT,61596,Transcochlear approach/skull,,,381.18,24625.88,179
CPT,61597,Transcondylar approach/skull,,,459.16,27215.21,179
CPT,61598,Transpetrosal approach/skull,,,443.0,26481.29,143
CPT,61600,Resect/excise cranial lesion,,,331.7,22809.0,143
CPT,61601,Resect/excise cranial lesion,,,377.57,22443.28,143
CPT,61605,Resect/excise cranial lesion,,,338.86,20088.55,143
CPT,61606,Resect/excise cranial lesion,,,454.12,27055.26,143
CPT,61607,Resect/excise cranial lesion,,,414.36,28262.93,143
CPT,61608,Resect/excise cranial lesion,,,509.48,30483.72,143
CPT,61611,Transect artery sinus,,,72.17,23687.09,107
CPT,61613,Remove aneurysm sinus,,,510.14,30570.65,179
CPT,61615,Resect/excise lesion skull,,,437.12,26126.3,143
CPT,61616,Resect/excise lesion skull,,,518.65,30897.35,143
CPT,61618,Repair dura,,,200.68,21896.38,143
CPT,61619,Repair dura,,,222.84,25894.99,143
CPT,61623,Evasc temp balo artl occ h/n,,,557.37,17929.67,71
CPT,61623,HC TEMP CEREB OCCLUS SNGL VESS,23332.24,17499.18,279.99,20999.02,119
CPT,61624,HC CENTRAL NERV SYST TRANSCAT EMB,8702.37,6526.78,104.43,7832.13,119
CPT,61624,Tcat perm occls/embolj cns,,,1122.09,18561.26,71
CPT,61626,HC TCAT PERM OCCLS/EMBOLJ PERQ NON-CNS HEAD/NECK,6277.24,4707.93,75.33,5649.52,119
CPT,61626,Tcat perm occls/embol noncns,,,869.45,16550.47,71
CPT,61630,Balo angioplasty icr perq,,,211.75,15039.8,71
CPT,61630,HC PTA INTRACRANIAL,6500.6,4875.45,78.01,5850.54,119
CPT,61635,HC ANGIO INTRACRANIAL W/STENT,3058.02,2293.52,36.7,2752.22,119
CPT,61635,Intracran angioplsty w/stent,,,228.87,15039.8,71
CPT,61640,Dilate ic vasospasm init,,,1142.79,10642.29,16
CPT,61640,HC VASO BALLOON DILATION INITIAL,7821.95,5866.46,93.86,7039.76,119
CPT,61641,Dilat ic vspsm ea vsl sm ter,,,401.34,11648.49,16
CPT,61641,HC PERQ BLLN DILAT IC VSPSM EA VSL SAME VASC TER,3968.73,2976.55,47.62,3571.86,119
CPT,61642,Dilat ic vspsm ea diff ter,,,802.68,3711.5,16
CPT,61645,HC PERC ARTERIAL MECH THROMBECT/INFUSION INTRACRANIAL W FLUORO/CATH/INJ,29274.43,21955.82,351.29,26346.99,119
CPT,61645,Perq art m-thrombect &/nfs,,,1221.23,15039.8,71
CPT,61650,Evasc prlng admn rx agnt 1st,,,553.41,15039.8,71
CPT,61650,HC ENDOVASC INTRACRAN PRLNG ADMN RX AGNT W/IMG INITIAL,31806.0,23854.5,381.67,28625.4,119
CPT,61651,Evasc prlng admn rx agnt add,,,237.94,15039.8,71
CPT,61651,HC ENDOVASC INTRACRAN PRLNG ADMN RX AGNT W/IMG ADDL,31900.7,23925.52,382.81,28710.63,119
CPT,61680,Intracranial vessel surgery,,,347.24,21184.26,107
CPT,61682,Intracranial vessel surgery,,,643.61,38722.26,107
CPT,61684,Intracranial vessel surgery,,,441.06,26650.9,107
CPT,61686,Intracranial vessel surgery,,,695.44,41984.07,107
CPT,61690,Intracranial vessel surgery,,,338.7,22336.05,107
CPT,61692,Intracranial vessel surgery,,,565.36,35186.73,107
CPT,61697,Brain aneurysm repr complx,,,654.62,39450.47,107
CPT,61698,Brain aneurysm repr complx,,,716.23,43227.32,107
CPT,61700,Brain aneurysm repr simple,,,525.72,33063.33,107
CPT,61702,Inner skull vessel surgery,,,622.8,37604.18,107
CPT,61703,Clamp neck artery,,,211.68,26746.64,107
CPT,61705,Revise circulation to head,,,403.91,31515.96,107
CPT,61708,Revise circulation to head,,,395.09,23880.97,107
CPT,61710,Revise circulation to head,,,1583.44,20456.63,71
CPT,61711,Fusion of skull arteries,,,399.06,24458.78,107
CPT,61715,Mrgfus strtctc ablt trgt icr,,,11282.26,13879.51,19
CPT,61720,Incise skull/brain surgery,,,940.78,20498.84,71
CPT,61735,Incise skull/brain surgery,,,1179.78,15039.8,71
CPT,61736,Litt icr 1 traj 1 smpl les,,,872.23,15039.8,70
CPT,61737,Litt icr mlt trj mlt/cplx ls,,,1561.53,15039.8,70
CPT,61750,Incise skull/brain biopsy,,,1040.28,15039.8,71
CPT,61751,Brain biopsy w/ct/mr guide,,,1025.54,15039.8,71
CPT,61760,Implant brain electrodes,,,956.65,15039.8,107
CPT,61770,Incise skull for treatment,,,1198.27,10961.61,71
CPT,61781,Scan proc cranial intra,,,227.82,12513.03,52
CPT,61782,Scan proc cranial extra,,,168.31,6815.79,52
CPT,61783,Scan proc spinal,,,223.51,2151.9,52
CPT,61790,Treat trigeminal nerve,,,653.97,2618.2,107
CPT,61791,Treat trigeminal tract,,,834.24,3278.17,107
CPT,61796,Srs cranial lesion simple,,,158.53,9619.36,89
CPT,61797,Srs cran les simple addl,,,33.77,2194.23,53
CPT,61798,Srs cranial lesion complex,,,214.64,12994.51,89
CPT,61799,Srs cran les complex addl,,,46.73,2813.39,53
CPT,61800,Apply srs headframe add-on,,,23.3,10890.66,53
CPT,61850,Implant neuroelectrodes,,,153.69,15039.8,107
CPT,61860,Implant neuroelectrodes,,,243.28,15039.8,107
CPT,61863,Implant neuroelectrode,,,234.14,15039.8,143
CPT,61864,Implant neuroelectrde addl,,,43.63,15039.8,71
CPT,61867,Implant neuroelectrode,,,354.3,21414.19,143
CPT,61868,Implant neuroelectrde addl,,,76.98,15039.8,71
CPT,61880,Revise/remove neuroelectrode,,,91.38,17947.17,143
CPT,61885,Insrt/redo neurostim 1 array,,,389.17,31244.22,107
CPT,61886,Implant neurostim arrays,,,647.5,33917.23,71
CPT,61888,Revise/remove neuroreceiver,,,310.12,26141.99,107
CPT,61889,Ins sk-mnt crnl nstm pg/rcvr,,,3037.09,26141.99,35
CPT,61891,Rev/rplcmt sk-mnt crnl nstm,,,1435.56,31244.22,35
CPT,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,1993.41,9863.73,35
CPT,62000,Treat skull fracture,,,766.05,4662.35,71
CPT,62005,Treat skull fracture,,,198.21,15039.8,107
CPT,62010,Treatment of head injury,,,239.35,15039.8,107
CPT,62100,Repair brain fluid leakage,,,244.65,15039.8,107
CPT,62115,Reduction of skull defect,,,262.38,15895.91,107
CPT,62117,Reduction of skull defect,,,305.51,18454.84,107
CPT,62120,Repair skull cavity lesion,,,322.23,19306.93,107
CPT,62121,Incise skull repair,,,243.18,15466.95,107
CPT,62140,Crnop skull defect<5 cm diam,,,159.15,16181.08,107
CPT,62141,Crnop skull defect>5 cm diam,,,177.78,15039.8,107
CPT,62142,Rmvl b1 flp/prostc plate skl,,,138.87,15039.8,107
CPT,62143,Rpl b1 flp/prostc plate skl,,,162.84,15039.8,107
CPT,62145,Repair of skull & brain,,,220.37,15039.8,107
CPT,62146,Crnop w/autograft<5 cm diam,,,194.76,15039.8,107
CPT,62147,Crnop w/autograft>5 cm diam,,,220.54,15039.8,107
CPT,62148,Retr bone flap to fix skull,,,121.35,15039.8,71
CPT,62160,Neuroendoscopy add-on,,,181.71,11261.85,52
CPT,62161,Dissect brain w/scope,,,236.65,15039.8,107
CPT,62162,Remove colloid cyst w/scope,,,293.8,17773.93,107
CPT,62164,Remove brain tumor w/scope,,,325.63,19705.77,107
CPT,62165,Remove pituit tumor w/scope,,,1124.44,15039.8,71
CPT,62180,Establish brain cavity shunt,,,248.84,16515.35,107
CPT,62190,Establish brain cavity shunt,,,688.47,15039.8,71
CPT,62192,Establish brain cavity shunt,,,151.99,15039.8,107
CPT,62194,Replace/irrigate catheter,,,385.26,7372.94,71
CPT,62200,Establish brain cavity shunt,,,214.32,15039.8,107
CPT,62201,Brain cavity shunt w/scope,,,900.14,15039.8,71
CPT,62220,Establish brain cavity shunt,,,150.92,15039.8,107
CPT,62223,Establish brain cavity shunt,,,161.39,15039.8,107
CPT,62225,Replace/irrigate catheter,,,395.94,8132.71,71
CPT,62230,Replace/revise brain shunt,,,131.03,8885.77,107
CPT,62252,Csf shunt reprogram,,,36.07,6815.79,107
CPT,62256,Remove brain cavity shunt,,,95.02,15039.8,107
CPT,62258,Replace brain cavity shunt,,,173.36,15039.8,107
CPT,62263,Epidural lysis mult sessions,,,245.48,4833.49,71
CPT,62264,Epidural lysis on single day,,,189.38,8760.4,71
CPT,62267,HC PERC INTERVERTEBRAL DISC ASPIRATION,3665.16,2748.87,43.98,3298.64,119
CPT,62267,Interdiscal perq aspir dx,,,149.7,1146.24,71
CPT,62268,Drain spinal cord cyst,,,248.04,1367.71,71
CPT,62268,HC PERC CYST ASPIRATE SPINAL CORD,1564.11,1173.08,18.77,1407.7,119
CPT,62269,Needle biopsy spinal cord,,,252.96,2091.8,71
CPT,62270,Dx lmbr spi pnxr,,,60.95,1146.24,71
CPT,62270,HC LUMBAR PUNCTURE DIAGNOSTIC,1500.0,1125.0,18.0,1350.0,119
CPT,62272,HC SPINAL PUNCTURE THERAPEUTIC,1388.85,1041.64,16.67,1249.96,119
CPT,62272,Ther spi pnxr drg csf,,,87.8,1753.08,71
CPT,62273,HC INJ EPIDURAL BLOOD OR CLOT PATCH,2209.9,1657.42,26.52,1988.91,119
CPT,62273,Inject epidural patch,,,109.74,1126.35,71
CPT,62280,Treat spinal cord lesion,,,122.82,1367.71,71
CPT,62281,Treat spinal cord lesion,,,123.16,1367.71,71
CPT,62282,Treat spinal canal lesion,,,109.53,1367.71,71
CPT,62284,HC SPINAL MYELOGRAM INJECTION NOT C1-C2,1400.84,1050.63,16.81,1260.76,119
CPT,62284,Injection for myelogram,,,81.62,1668.6,52
CPT,62287,Dcmprn pq nuc pul 1/mlt lmbr,,,416.21,3234.24,71
CPT,62287,HC DCMPRN PERQ NUCLEUS PULPOSUS 1/MLT LEVELS LUMBAR,6892.94,5169.7,82.72,6203.65,119
CPT,62290,HC INJ DISKOGRPHY LUMBAR EA LEVEL,5511.46,4133.6,66.14,4960.31,119
CPT,62290,Njx px discography lumbar,,,152.88,3073.77,52
CPT,62291,HC INJ DISKOGRHY CERVICAL EA LEVEL,4992.95,3744.71,59.92,4493.66,119
CPT,62291,Njx px discography crv/thrc,,,142.03,2765.5,52
CPT,62292,Njx chemonucleolysis lmbr,,,424.64,2618.2,71
CPT,62294,Injection into spinal artery,,,705.31,2776.42,71
CPT,62302,HC MYELOGRAM CERVICAL INCLUD LUMBAR INJECTION,2668.57,2001.43,32.02,2401.71,119
CPT,62302,Myelography lumbar injection,,,115.74,2270.46,71
CPT,62303,HC MYELOGRAM THORACIC INCLUDE LUMBAR  INJECTION,2918.94,2189.2,35.03,2627.05,119
CPT,62303,Myelography lumbar injection,,,115.74,2309.2,71
CPT,62304,HC MYELOGRAM LUMBOSACRAL INCL LUMBAR INJECTION,3016.17,2262.13,36.19,2714.55,119
CPT,62304,Myelography lumbar injection,,,114.07,2254.79,71
CPT,62305,HC MYELOGRAM MULT SITES INCL LUMB INJECTION,3269.47,2452.1,39.23,2942.52,119
CPT,62305,Myelography lumbar injection,,,118.72,2459.09,71
CPT,62320,Njx interlaminar crv/thrc,,,97.49,1889.74,71
CPT,62321,HC NJX INTERLAMINAR CRV/THRC,2537.98,1903.48,30.46,2284.18,119
CPT,62321,Njx interlaminar crv/thrc,,,103.34,2060.96,71
CPT,62322,Njx interlaminar lmbr/sac,,,78.2,1367.71,71
CPT,62323,HC INJ DX/THER INTRALAMINAR LUMBAR/SACRAL W/IMAGING,2785.15,2088.86,33.42,2506.64,119
CPT,62323,Njx interlaminar lmbr/sac,,,95.77,1126.35,71
CPT,62324,Njx interlaminar crv/thrc,,,87.23,1367.71,71
CPT,62325,Njx interlaminar crv/thrc,,,108.03,1367.71,71
CPT,62326,Njx interlaminar lmbr/sac,,,83.82,1367.71,71
CPT,62327,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMAGING,2425.25,1818.94,29.1,2182.72,119
CPT,62327,Njx interlaminar lmbr/sac,,,102.28,1367.71,71
CPT,62328,Dx lmbr spi pnxr w/fluor/ct,,,83.96,1146.24,71
CPT,62328,HC LMBR SPI PNXR W/FLUOR/CT,1994.99,1496.24,23.94,1795.49,119
CPT,62329,HC SPINAL PUNCTURE THERAPEUTIC W/FLUORO OR CT,1388.85,1041.64,16.67,1249.96,119
CPT,62329,Ther spi pnxr csf fluor/ct,,,105.03,1146.24,71
CPT,62330,Dcmprn prq rmv lig flv 1lmbr,,,7347.11,7347.11,9
CPT,62331,Dcmprn prq rmv lig flv addl,,,,,0
CPT,62350,Implant spinal canal cath,,,308.94,11033.64,71
CPT,62351,Implant spinal canal cath,,,140.43,11309.48,143
CPT,62355,Remove spinal canal catheter,,,213.12,9246.98,71
CPT,62360,Insert spine infusion device,,,246.99,31193.03,71
CPT,62361,Implant spine infusion pump,,,337.3,28480.59,71
CPT,62362,Implant spine infusion pump,,,299.06,27808.68,71
CPT,62365,Remove spine infusion device,,,229.7,23868.77,71
CPT,62367,Analyze spine infus pump,,,23.99,23305.66,71
CPT,62368,Analyze sp inf pump w/reprog,,,33.52,6815.79,71
CPT,62369,Anal sp inf pmp w/reprg&fill,,,33.84,333.8,71
CPT,62370,Anl sp inf pmp w/mdreprg&fil,,,44.73,333.8,71
CPT,62370,HC NR PUMP REFILL/ADJ-DONE BY DR,1081.06,810.8,12.97,972.95,119
CPT,62380,Ndsc dcmprn 1 ntrspc lumbar,,,215.76,9254.47,27
CPT,63001,Remove spine lamina 1/2 crvl,,,184.94,9254.47,143
CPT,63003,Remove spine lamina 1/2 thrc,,,191.95,11309.48,143
CPT,63005,Remove spine lamina 1/2 lmbr,,,186.36,9254.47,143
CPT,63011,Remove spine lamina 1/2 scrl,,,170.08,9478.16,143
CPT,63012,Remove lamina/facets lumbar,,,185.94,9254.47,143
CPT,63015,Remove spine lamina >2 crvcl,,,230.16,9254.47,143
CPT,63016,Remove spine lamina >2 thrc,,,237.7,9254.47,143
CPT,63017,Remove spine lamina >2 lmbr,,,196.72,9254.47,143
CPT,63020,Lamot dcmprn nrv rt 1 cerv,,,170.35,9254.47,179
CPT,63030,Lamot dcmprn nrv rt 1 lmbr,,,141.79,9254.47,179
CPT,63032,Lamot rpr anulr dfct 1 lmbr,,,,,0
CPT,63035,Lamot dcmprn nrv rt ea addl,,,36.15,8755.39,124
CPT,63040,Laminotomy single cervical,,,214.63,9254.47,179
CPT,63042,Laminotomy single lumbar,,,201.18,9254.47,179
CPT,63043,Laminotomy addl cervical,,,1595.48,7755.91,16
CPT,63044,Laminotomy addl lumbar,,,1595.48,7755.91,16
CPT,63045,Lam facetec & foramot crv,,,200.14,9254.47,143
CPT,63046,Lam facetec & foramot thrc,,,190.98,9254.47,143
CPT,63047,Lam facetec & foramot lumbar,,,171.87,9254.47,143
CPT,63048,Lam facetec &foramot ea addl,,,32.47,13082.91,88
CPT,63050,Cervical laminoplsty 2/> seg,,,229.17,15039.8,143
CPT,63051,C-laminoplasty w/graft/plate,,,263.04,15828.4,143
CPT,63052,Lam facetc/frmt arthrd lum 1,,,39.88,11673.27,88
CPT,63053,Lam factc/frmt arthrd lum ea,,,35.33,13265.74,88
CPT,63055,Decompress spinal cord thrc,,,252.66,9254.47,107
CPT,63056,Decompress spinal cord lmbr,,,231.85,9254.47,107
CPT,63057,Decompress spine cord add-on,,,49.63,7755.91,52
CPT,63064,Decompress spinal cord thrc,,,276.92,9254.47,107
CPT,63066,Decompress spine cord add-on,,,31.75,2507.98,52
CPT,63075,Neck spine disk surgery,,,210.85,9254.47,143
CPT,63076,Neck spine disk surgery,,,37.53,2265.24,88
CPT,63077,Spine disk surgery thorax,,,237.15,15039.8,143
CPT,63078,Spine disk surgery thorax,,,31.91,15039.8,107
CPT,63081,Remove vert body dcmprn crvl,,,273.05,16512.06,143
CPT,63082,Remove vertebral body add-on,,,40.91,15039.8,107
CPT,63085,Remove vert body dcmprn thrc,,,299.01,18052.54,143
CPT,63086,Remove vertebral body add-on,,,29.24,15039.8,107
CPT,63087,Remov vertbr dcmprn thrclmbr,,,374.37,22686.6,143
CPT,63088,Remove vertebral body add-on,,,39.89,15039.8,107
CPT,63090,Remove vert body dcmprn lmbr,,,302.04,19013.58,143
CPT,63091,Remove vertebral body add-on,,,27.21,15039.8,107
CPT,63101,Remove vert body dcmprn thrc,,,360.88,21724.14,107
CPT,63102,Remove vert body dcmprn lmbr,,,355.19,21501.7,107
CPT,63103,Remove vertebral body add-on,,,45.5,18206.94,71
CPT,63170,Incise spinal cord tract(s),,,248.04,18020.52,107
CPT,63172,Drainage of spinal cyst,,,220.02,15039.8,107
CPT,63173,Drainage of spinal cyst,,,268.48,16252.47,107
CPT,63185,Incise spine nrv half segmnt,,,177.71,15039.8,107
CPT,63190,Incise spine nrv >2 segmnts,,,192.55,15039.8,107
CPT,63191,Incise spine accessory nerve,,,215.18,15039.8,143
CPT,63197,Lam w/cordotomy 1stg thrc,,,266.26,16125.64,107
CPT,63200,Release spinal cord lumbar,,,237.32,15039.8,107
CPT,63250,Revise spinal cord vsls crvl,,,459.98,27786.03,107
CPT,63251,Revise spinal cord vsls thrc,,,470.27,28406.13,107
CPT,63252,Revise spine cord vsl thrlmb,,,470.12,28402.97,107
CPT,63265,Excise intraspinl lesion crv,,,259.72,23807.1,107
CPT,63266,Excise intrspinl lesion thrc,,,267.13,23804.46,107
CPT,63267,Excise intrspinl lesion lmbr,,,213.39,13107.24,107
CPT,63268,Excise intrspinl lesion scrl,,,217.85,13794.96,107
CPT,63270,Excise intrspinl lesion crvl,,,323.12,19532.12,107
CPT,63271,Excise intrspinl lesion thrc,,,322.97,19511.03,107
CPT,63272,Excise intrspinl lesion lmbr,,,290.48,17718.45,107
CPT,63273,Excise intrspinl lesion scrl,,,290.69,17579.59,107
CPT,63275,Bx/exc xdrl spine lesn crvl,,,281.13,16904.3,107
CPT,63276,Bx/exc xdrl spine lesn thrc,,,277.94,16796.68,107
CPT,63277,Bx/exc xdrl spine lesn lmbr,,,243.2,15039.8,107
CPT,63278,Bx/exc xdrl spine lesn scrl,,,248.27,15039.8,107
CPT,63280,Bx/exc idrl spine lesn crvl,,,329.37,19869.86,107
CPT,63281,Bx/exc idrl spine lesn thrc,,,326.2,19723.71,107
CPT,63282,Bx/exc idrl spine lesn lmbr,,,308.09,18658.94,107
CPT,63283,Bx/exc idrl spine lesn scrl,,,296.14,17921.76,107
CPT,63285,Bx/exc idrl imed lesn cervl,,,406.01,24547.19,107
CPT,63286,Bx/exc idrl imed lesn thrc,,,401.97,24267.59,107
CPT,63287,Bx/exc idrl imed lesn thrlmb,,,425.78,25731.89,107
CPT,63290,Bx/exc xdrl/idrl lsn any lvl,,,433.01,26166.71,107
CPT,63295,Repair laminectomy defect,,,51.07,21565.83,107
CPT,63300,Remove vert xdrl body crvcl,,,282.22,21930.25,107
CPT,63301,Remove vert xdrl body thrc,,,342.97,19915.79,107
CPT,63302,Remove vert xdrl body thrlmb,,,338.8,20494.39,107
CPT,63303,Remov vert xdrl bdy lmbr/sac,,,359.61,21734.39,107
CPT,63304,Remove vert idrl body crvcl,,,365.12,22076.76,107
CPT,63305,Remove vert idrl body thrc,,,388.4,23477.2,107
CPT,63306,Remov vert idrl bdy thrclmbr,,,381.74,23079.04,107
CPT,63307,Remov vert idrl bdy lmbr/sac,,,373.76,22593.77,107
CPT,63308,Remove vertebral body add-on,,,49.36,19342.48,71
CPT,63600,Remove spinal cord lesion,,,809.08,18935.78,71
CPT,63610,Stimulation of spinal cord,,,560.26,3677.88,71
CPT,63620,Srs spinal lesion,,,175.28,10623.91,89
CPT,63621,Srs spinal lesion addl,,,38.93,3082.33,53
CPT,63650,HC COM CON PERC IMPLNT NEUROSTI,19796.38,14847.28,237.56,17816.74,119
CPT,63650,HC PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,19796.38,14847.28,237.56,17816.74,119
CPT,63650,Implant neuroelectrodes,,,321.06,12412.85,71
CPT,63655,Implant neuroelectrodes,,,130.27,31193.03,107
CPT,63661,HC RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,3533.3,2649.98,42.4,3179.97,119
CPT,63661,Remove spine eltrd perq aray,,,50.92,10402.86,107
CPT,63662,Remove spine eltrd plate,,,131.79,26141.99,107
CPT,63663,Revise spine eltrd perq aray,,,70.07,12412.85,107
CPT,63664,Revise spine eltrd plate,,,137.44,20343.28,107
CPT,63685,Ins/rplc spi npg/rcvr pocket,,,56.14,50189.96,107
CPT,63688,Rev/rmv imp sp npg/r dtch cn,,,290.08,17049.12,71
CPT,63700,Repair of spinal herniation,,,204.5,42062.77,107
CPT,63702,Repair of spinal herniation,,,223.34,15039.8,107
CPT,63704,Repair of spinal herniation,,,259.64,15728.17,107
CPT,63706,Repair of spinal herniation,,,288.14,17440.14,107
CPT,63707,Repair spinal fluid leakage,,,146.27,15039.8,107
CPT,63709,Repair spinal fluid leakage,,,173.48,15039.8,107
CPT,63710,Graft repair of spine defect,,,168.01,15039.8,107
CPT,63740,Install spinal shunt,,,153.75,15039.8,107
CPT,63741,Install spinal shunt,,,107.16,10095.79,107
CPT,63744,Revision of spinal shunt,,,106.12,10376.22,107
CPT,63746,Removal of spinal shunt,,,452.18,8460.99,71
CPT,64400,HC INJECTION OF ANESTH AGENT; TRIGEMINAL NERVE,719.31,539.48,8.63,647.38,119
CPT,64400,Njx aa&/strd trigeminal nrv,,,72.84,8696.02,71
CPT,64405,"HC INJECTION, GREATER OCCIPITAL NERVE BILATERAL",1615.38,1211.54,19.38,1453.84,119
CPT,64405,"HC INJECTION, GREATER OCCIPITAL NERVE UNILATERAL",807.69,605.77,9.69,726.92,119
CPT,64405,Njx aa&/strd gr ocpl nrv,,,76.76,2194.23,71
CPT,64408,HC NERVE BLOCK (VAGUS),750.98,563.24,9.01,675.88,119
CPT,64408,Njx aa&/strd vagus nrv,,,65.55,328.55,71
CPT,64415,HC INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,750.98,563.24,9.01,675.88,119
CPT,64415,Njx aa&/strd brch plxs img,,,101.76,1367.71,71
CPT,64416,Njx aa&/strd brch pl nfs img,,,114.98,1367.71,71
CPT,64417,HC INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,750.98,563.24,9.01,675.88,119
CPT,64417,Njx aa&/strd ax nerve img,,,92.58,1367.71,71
CPT,64418,HC INJECTION AA&/STRD SUPRASCAPULAR NERVE,1230.6,922.95,14.77,1107.54,119
CPT,64418,Njx aa&/strd sprscap nrv,,,81.44,1146.24,71
CPT,64420,HC INJECTION ANESTHETIC STEROID INTERCOSTAL 1 LEVEL,1315.67,986.75,15.79,1184.1,119
CPT,64420,Njx aa&/strd ntrcost nrv 1,,,85.19,1146.24,71
CPT,64421,HC INJECTION ANESTHETIC STEROID INTERCOSTAL EA ADD LEVEL,1639.74,1229.8,19.68,1475.77,119
CPT,64421,Njx aa&/strd ntrcost nrv ea,,,35.64,1367.71,71
CPT,64425,HC ILIOHYPOGASTRIC NERVE BLOCK,1234.68,926.01,14.82,1111.21,119
CPT,64425,Njx aa&/strd ii ih nerves,,,79.71,943.96,71
CPT,64430,HC  INJECTION AA&/STRD PUDENDAL NERVE,750.98,563.24,9.01,675.88,119
CPT,64430,Njx aa&/strd pudendal nerve,,,79.64,1367.71,71
CPT,64435,HC INJECTION AA&/STRD PARACERVICAL NERVE BILAT,998.8,749.1,11.99,898.92,119
CPT,64435,HC INJECTION AA&/STRD PARACERVICAL NERVE UNILAT,998.8,749.1,11.99,898.92,119
CPT,64435,Njx aa&/strd paracrv nrv,,,63.17,770.78,71
CPT,64445,HC INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,998.8,749.1,11.99,898.92,119
CPT,64445,Njx aa&/strd sciatic nrv img,,,106.85,1146.24,71
CPT,64446,Njx aa&/strd sc nrv nfs img,,,112.43,1367.71,71
CPT,64447,HC IN FEMORAL NERVE SINGLE,998.8,749.1,11.99,898.92,119
CPT,64447,Njx aa&/strd femoral nrv img,,,92.25,770.78,71
CPT,64448,Njx aa&/strd fem nrv nfs img,,,106.14,1850.43,71
CPT,64449,Njx aa&/strd lmbr plex nfs,,,90.54,1367.71,71
CPT,64450,HC INJ OTHR PERIPHRAL NERVE/BRANC,1994.99,1496.24,23.94,1795.49,119
CPT,64450,HC INJ OTHR PERIPHRAL NERVE/BRANCH BILATERAL,2206.07,1654.55,26.47,1985.46,119
CPT,64450,HC TARSAL TUNNEL INJECTION BILATERAL,2205.96,1654.47,26.47,1985.36,119
CPT,64450,HC TARSAL TUNNEL INJECTION UNILATERAL,1103.04,827.28,13.24,992.74,119
CPT,64450,Njx aa&/strd other pn/branch,,,60.95,1550.8,71
CPT,64450,PBB INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,186.84,140.13,2.24,168.16,119
CPT,64451,Njx aa&/strd nrv nrvtg si jt,,,118.73,1146.24,71
CPT,64454,Njx aa&/strd gnclr nrv brnch,,,119.19,1126.35,70
CPT,64455,Njx aa&/strd pltr com dg nrv,,,49.23,943.96,71
CPT,64461,HC PARAVERTEBRAL BLOCK THORACIC SINGLE INJ W/IMG,583.94,437.96,7.01,525.55,119
CPT,64461,Pvb thoracic single inj site,,,114.78,1126.35,71
CPT,64462,HC PARAVERTEBRAL BLOCK THORACIC 2ND AND ADDL SITES W/IMG,583.94,437.96,7.01,525.55,119
CPT,64462,Pvb thoracic 2nd+ inj site,,,71.61,650.94,52
CPT,64463,Pvb thoracic cont infusion,,,120.53,1126.35,71
CPT,64466,HC THRC FASCIAL PLN BLK UNILATERIAL NJX,1120.91,840.68,13.45,1008.82,119
CPT,64466,Thrc fascial pln blk uni njx,,,292.98,1135.33,16
CPT,64467,Thrc fascial pln blk uni nfs,,,536.08,2077.4,16
CPT,64468,Thrc fascial pln blk bi njx,,,337.66,1308.49,16
CPT,64469,Thrc fascial pln blk bi nfs,,,813.65,3153.01,16
CPT,64473,HC LWR XTR FSCL PLN BLK UNILATERIAL NJX,1120.91,840.68,13.45,1008.82,119
CPT,64473,Lwr xtr fscl pln blk uni njx,,,275.99,1096.64,16
CPT,64474,Lwr xtr fscl pln blk uni nfs,,,529.55,2642.53,16
CPT,64479,HC NJX AA&/STRD TFRM EPI C/T 1,2123.57,1592.68,25.48,1911.21,119
CPT,64479,Njx aa&/strd tfrm epi c/t 1,,,189.15,1367.71,71
CPT,64480,HC NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,467.63,350.72,5.61,420.87,119
CPT,64480,Njx aa&/strd tfrm epi c/t ea,,,89.34,1719.83,52
CPT,64483,HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL,1909.87,1432.4,22.92,1718.88,119
CPT,64483,Njx aa&/strd tfrm epi l/s 1,,,160.5,1367.71,71
CPT,64484,HC INJ ANES/STRD W/IMG TFRML EDRL LMBR/SAC EA ADDL LVL,781.01,585.76,9.37,702.91,119
CPT,64484,Njx aa&/strd tfrm epi l/s ea,,,75.0,1020.98,52
CPT,64486,HC TAP BLOCK UNILATERAL BY INJECTION(S),1315.67,986.75,15.79,1184.1,119
CPT,64486,Tap block unil by injection,,,81.17,1146.24,52
CPT,64487,Tap block uni by infusion,,,93.21,1849.84,52
CPT,64488,Tap block bi injection,,,67.15,1154.06,52
CPT,64489,Tap block bi by infusion,,,76.65,3005.57,52
CPT,64490,HC INJ PARAVERT F JNT C/T 1 LEV,2251.2,1688.4,27.01,2026.08,119
CPT,64490,HC INJ PARAVERT F JNT C/T 1 LEV BILATERAL,4156.14,3117.1,49.87,3740.53,119
CPT,64490,Inj paravert f jnt c/t 1 lev,,,16.24,1367.71,107
CPT,64491,HC INJ PARAVERT F JNT C/T 2 LEV,1508.32,1131.24,18.1,1357.49,119
CPT,64491,HC INJ PARAVERT F JNT C/T 2 LEV BILATERAL,3016.63,2262.47,36.2,2714.97,119
CPT,64491,Inj paravert f jnt c/t 2 lev,,,9.21,2518.96,88
CPT,64492,HC INJ PARAVERT F JNT C/T 3 LEV,1397.77,1048.33,16.77,1257.99,119
CPT,64492,Inj paravert f jnt c/t 3 lev,,,9.36,1146.24,88
CPT,64493,HC INJ PARAVERT F JNT L/S 1 LEV,2878.88,2159.16,34.55,2590.99,119
CPT,64493,HC INJ PARAVERT F JNT L/S 1 LEV BILATERAL,5758.09,4318.57,69.1,5182.28,119
CPT,64493,Inj paravert f jnt l/s 1 lev,,,13.96,1367.71,107
CPT,64494,HC INJ PARAVERT F JNT L/S 2 LEV,833.31,624.98,10.0,749.98,119
CPT,64494,HC INJ PARAVERT F JNT L/S 2 LEV BILATERAL,1628.1,1221.08,19.54,1465.29,119
CPT,64494,Inj paravert f jnt l/s 2 lev,,,7.95,830.31,88
CPT,64495,HC  INJ PARAVERT F JNT L/S 3 LEV,456.67,342.5,5.48,411.0,119
CPT,64495,Inj paravert f jnt l/s 3 lev,,,8.05,1146.24,88
CPT,64505,HC INJECTION OF ANESTH AGENT; SPHENOPALATINE NERVE,675.26,506.44,8.1,607.73,119
CPT,64505,N block spenopalatine gangl,,,150.39,695.88,71
CPT,64510,HC NJX ANES STELLATE GANGLION CRV SYMPATHETIC,1725.28,1293.96,20.7,1552.75,119
CPT,64510,N block stellate ganglion,,,111.09,1367.71,71
CPT,64517,HC INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,1940.77,1455.58,23.29,1746.69,119
CPT,64517,N block inj hypogas plxs,,,122.17,1367.71,71
CPT,64520,HC INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,1952.31,1464.23,23.43,1757.08,119
CPT,64520,N block lumbar/thoracic,,,121.91,1367.71,71
CPT,64530,HC CELIAC PLEXUS W/WO RAD MONITOR,1255.21,941.41,15.06,1129.69,119
CPT,64530,N block inj celiac pelus,,,91.47,1367.71,71
CPT,64553,Implant neuroelectrodes,,,304.18,21699.51,71
CPT,64555,Implant neuroelectrodes,,,252.74,15171.26,71
CPT,64561,Implant neuroelectrodes,,,235.15,18185.73,107
CPT,64566,Neuroeltrd stim post tibial,,,29.27,12714.6,71
CPT,64567,Perq elec nrv field stimj cn,,,918.34,918.34,9
CPT,64568,Opn impltj crnl nrv nea&pg,,,443.58,44598.19,107
CPT,64569,Revise/repl vagus n eltrd,,,277.41,24411.94,107
CPT,64570,Remove vagus n eltrd,,,544.08,26141.99,107
CPT,64575,Opn impltj nea perph nerve,,,225.71,23055.72,71
CPT,64580,Opn impltj nea neuromuscular,,,48.83,31193.03,107
CPT,64581,Opn impltj nea sacral nerve,,,484.55,19322.34,71
CPT,64582,Opn mpltj hpglsl nstm ary pg,,,636.55,49339.55,107
CPT,64583,Rev/rplct hpglsl nstm ary pg,,,640.39,20343.28,107
CPT,64584,Rmvl hpglsl nstim ary pg,,,539.63,41350.06,107
CPT,64585,Rev/rmv perph nstim eltrd ra,,,110.7,17049.12,71
CPT,64590,Ins/rpl prph sac/gstr npg/r,,,124.58,37788.85,71
CPT,64595,Rev/rmv prph sac/gstr npg/r,,,98.3,5315.69,71
CPT,64596,Ins/rplcmt prq eltrd ra pn 1,,,11282.26,31669.76,27
CPT,64597,Ins/rplcm prq eltrd ra pn ea,,,4454.93,4803.39,8
CPT,64598,Revj/rmvl nea pn w/int nstim,,,3296.84,19322.34,27
CPT,64600,Injection treatment of nerve,,,179.28,4025.58,71
CPT,64605,Injection treatment of nerve,,,272.8,4454.93,107
CPT,64610,Injection treatment of nerve,,,373.98,2618.2,107
CPT,64611,Chemodenerv saliv glands,,,85.03,2194.23,71
CPT,64612,Destroy nerve face muscle,,,91.22,2194.23,107
CPT,64615,Chemodenerv musc migraine,,,95.02,433.24,71
CPT,64616,Chemodenerv musc neck dyston,,,83.82,393.63,107
CPT,64616,HC CHEMODENERV MUSC NECK DYSTON BILATERAL,1321.09,990.82,15.85,1188.98,119
CPT,64616,HC CHEMODENERV MUSC NECK DYSTON UNILATERAL,457.86,343.4,5.49,412.07,119
CPT,64617,Chemodener muscle larynx emg,,,84.45,770.78,107
CPT,64620,Injection treatment of nerve,,,137.28,1367.71,71
CPT,64624,Dstrj nulyt agt gnclr nrv,,,112.83,2618.2,106
CPT,64624,HC DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,3673.63,2755.22,44.08,3306.27,119
CPT,64625,Rf abltj nrv nrvtg si jt,,,150.65,2618.2,106
CPT,64628,Trml dstrj ios bvn 1st 2 l/s,,,353.82,24411.94,71
CPT,64629,Trml dstrj ios bvn ea addl,,,206.02,2194.23,52
CPT,64630,Injection treatment of nerve,,,148.37,20458.95,71
CPT,64632,N block inj common digit,,,52.01,1517.89,107
CPT,64633,Destroy cerv/thor facet jnt,,,148.0,2618.2,107
CPT,64633,HC CT FACET RHIZOTOMY C OR T SPINE BILATERAL SINGLE LEVEL,6084.12,4563.09,73.01,5475.71,119
CPT,64633,HC CT FACET RHIZOTOMY C OR T SPINE UNILATERAL SINGLE LEVEL,3042.06,2281.54,36.5,2737.85,119
CPT,64634,Destroy c/th facet jnt addl,,,97.32,2246.91,52
CPT,64634,HC CT FACET RHIZOTOMY C OR T SPINE EACH ADDL BILATERAL LEVEL,5205.81,3904.36,62.47,4685.23,119
CPT,64634,HC CT FACET RHIZOTOMY C OR T SPINE SINGLE LEVEL EACH ADDL UNILATERAL LEVEL,2602.9,1952.18,31.23,2342.61,119
CPT,64635,Destroy lumb/sac facet jnt,,,148.25,2618.2,107
CPT,64635,HC CT FACET RHIZOTOMY L OR SACRAL SPINE BILATERAL SINGLE LEVEL,7565.82,5674.36,90.79,6809.24,119
CPT,64635,HC CT FACET RHIZOTOMY L OR SACRAL SPINE UNILATERAL SINGLE LEVEL,3782.91,2837.18,45.39,3404.62,119
CPT,64636,Destroy l/s facet jnt addl,,,85.92,2106.67,52
CPT,64636,HC CT FACET RHIZOTOMY L OR SACRAL SPINE EACH ADDL BILATERAL LEVEL,5838.8,4379.1,70.07,5254.92,119
CPT,64636,HC CT FACET RHIZOTOMY L OR SACRAL SPINE EACH ADDL UNILATERAL SINGLE LEVEL,2919.4,2189.55,35.03,2627.46,119
CPT,64640,HC DESTROY PERIPH NEVER W/LYTIC,1788.11,1341.08,21.46,1609.3,119
CPT,64640,Injection treatment of nerve,,,91.52,2194.23,107
CPT,64642,Chemodenerv 1 extremity 1-4,,,102.51,1765.59,71
CPT,64643,Chemodenerv 1 extrem 1-4 ea,,,68.13,861.65,52
CPT,64644,Chemodenerv 1 extrem 5/> mus,,,111.98,770.78,71
CPT,64645,Chemodenerv 1 extrem 5/> ea,,,79.04,1109.02,52
CPT,64646,Chemodenerv trunk musc 1-5,,,111.76,770.78,71
CPT,64647,Chemodenerv trunk musc 6/>,,,128.96,929.46,71
CPT,64650,Chemodenerv eccrine glands,,,39.48,328.55,71
CPT,64653,Chemodenerv eccrine glands,,,50.16,328.55,71
CPT,64654,1st opn implt bat modulj sys,,,44598.19,44598.19,9
CPT,64655,Revj/rplcmt bat mod sys lead,,,3539.9,3539.9,9
CPT,64656,Revj/rplcmt bat mod sys pg,,,31244.22,31244.22,9
CPT,64657,Rmvl bat modulj sys tot sys,,,3458.94,3458.94,9
CPT,64658,Rmvl bat modul sys lead only,,,3539.9,3539.9,9
CPT,64659,Rmvl bat modulj sys pg only,,,3539.9,3539.9,9
CPT,64680,HC CT CELIAC PLEXIS NEUROLYSIS,1308.0,981.0,15.7,1177.2,119
CPT,64680,Injection treatment of nerve,,,125.18,1367.71,71
CPT,64681,Injection treatment of nerve,,,172.38,1367.71,71
CPT,64702,Revise finger/toe nerve,,,379.61,2618.2,71
CPT,64704,Revise hand/foot nerve,,,50.45,2618.2,107
CPT,64708,Revise arm/leg nerve,,,77.86,2618.2,107
CPT,64712,Revision of sciatic nerve,,,92.47,2618.2,143
CPT,64713,Revision of arm nerve(s),,,123.75,2618.2,143
CPT,64714,Revise low back nerve(s),,,118.1,2618.2,143
CPT,64716,Revision of cranial nerve,,,79.65,2618.2,107
CPT,64718,Revise ulnar nerve at elbow,,,445.6,2618.2,107
CPT,64719,Revise ulnar nerve at wrist,,,301.81,2618.2,107
CPT,64721,Carpal tunnel surgery,,,322.75,2618.2,107
CPT,64722,Decompression unspec nerve,,,56.83,2618.2,107
CPT,64726,Dcmprn plantar digital nerve,,,199.76,2618.2,71
CPT,64727,Internal neurolysis,,,173.84,2194.23,52
CPT,64728,Dcmprn median nrv carpl tunl,,,1977.19,1977.19,9
CPT,64732,Incision of brow nerve,,,70.55,2618.2,143
CPT,64734,Incision of cheek nerve,,,378.82,2618.2,107
CPT,64736,Incision of chin nerve,,,51.59,2618.2,143
CPT,64738,Incision of jaw nerve,,,69.97,2618.2,143
CPT,64740,Incision of tongue nerve,,,71.52,2618.2,143
CPT,64742,Incision of facial nerve,,,76.13,2618.2,143
CPT,64744,Incise nerve back of head,,,373.81,2618.2,107
CPT,64746,Incise diaphragm nerve,,,66.73,2618.2,143
CPT,64755,Incision of stomach nerves,,,143.16,15039.8,107
CPT,64760,Incision of vagus nerve,,,81.04,15039.8,107
CPT,64763,Incise hip/thigh nerve,,,80.22,7211.05,143
CPT,64766,Incise hip/thigh nerve,,,98.96,4092.76,143
CPT,64771,Sever cranial nerve,,,90.07,2618.2,107
CPT,64772,Incision of spinal nerve,,,87.24,2618.2,107
CPT,64774,Remove skin nerve lesion,,,315.52,2618.2,71
CPT,64776,Remove digit nerve lesion,,,294.76,2618.2,71
CPT,64778,Digit nerve surgery add-on,,,174.67,2194.23,52
CPT,64782,Remove limb nerve lesion,,,336.89,2618.2,71
CPT,64783,Limb nerve surgery add-on,,,207.95,1990.97,52
CPT,64784,Remove nerve lesion,,,536.03,2618.2,71
CPT,64786,Remove sciatic nerve lesion,,,156.25,8132.71,143
CPT,64787,Implant nerve end,,,228.61,2194.23,52
CPT,64788,Remove skin nerve lesion,,,298.79,6815.79,71
CPT,64790,Removal of nerve lesion,,,625.13,2618.2,71
CPT,64792,Removal of nerve lesion,,,165.29,8132.71,107
CPT,64795,Biopsy of nerve,,,187.27,2618.2,71
CPT,64802,Sympathectomy cervical,,,131.65,6815.79,143
CPT,64804,Sympathectomy cervicothorac,,,185.7,3462.73,143
CPT,64809,Sympathectomy thoracolumbar,,,169.76,15039.8,143
CPT,64818,Sympathectomy lumbar,,,121.08,15039.8,143
CPT,64820,Sympathectomy digital artery,,,565.31,8619.08,71
CPT,64821,Sympathectomy radial artery,,,513.32,6113.83,107
CPT,64822,Sympathectomy ulnar artery,,,516.84,4266.34,107
CPT,64823,Sympathectomy supfc palmar,,,585.22,4266.34,107
CPT,64831,Repair of digit nerve,,,512.55,3575.5,107
CPT,64832,Repair nerve add-on,,,321.15,3575.5,52
CPT,64834,Repair of hand or foot nerve,,,543.42,11585.33,107
CPT,64835,Repair of hand or foot nerve,,,126.93,8132.71,143
CPT,64836,Repair of hand or foot nerve,,,126.93,10376.22,143
CPT,64837,Repair nerve add-on,,,56.06,6815.79,52
CPT,64840,Repair of leg nerve,,,149.49,8885.77,143
CPT,64856,Repair/transpose nerve,,,746.11,8885.77,71
CPT,64857,Repair arm/leg nerve,,,163.56,8132.71,107
CPT,64858,Repair sciatic nerve,,,182.24,6815.79,143
CPT,64859,Nerve surgery,,,38.12,6815.79,52
CPT,64861,Repair of arm nerves,,,236.84,4415.26,143
CPT,64862,Repair of low back nerves,,,212.81,8132.71,143
CPT,64864,Repair of facial nerve,,,134.2,8885.77,107
CPT,64865,Repair of facial nerve,,,169.27,10095.79,107
CPT,64866,Fusion of facial/other nerve,,,192.92,15039.8,107
CPT,64868,Fusion of facial/other nerve,,,155.25,15039.8,107
CPT,64872,Subsequent repair of nerve,,,17.84,9629.08,52
CPT,64874,Repair & revise nerve add-on,,,26.66,7698.29,52
CPT,64876,Repair nerve/shorten bone,,,30.2,1808.25,52
CPT,64885,Nerve graft head/neck <4 cm,,,167.41,8885.77,107
CPT,64886,Nerve graft head/neck >4 cm,,,200.94,10095.79,107
CPT,64890,Nrv grf 1strnd hnd/foot <4cm,,,167.45,10095.79,107
CPT,64891,Nrv grf 1strnd hnd/foot >4cm,,,178.02,10095.79,107
CPT,64892,Nrv grf 1strnd arm/leg <4cm,,,163.01,12412.85,107
CPT,64893,Nrv grf 1strnd arm/leg >4 cm,,,173.74,8460.99,107
CPT,64895,Nrv grf mltst hnd/foot <4 cm,,,205.39,10402.86,107
CPT,64896,Nrv grf mltst hnd/foot >4 cm,,,221.24,8885.77,107
CPT,64897,Nrv grf mltst arm/leg <4 cm,,,196.22,8885.77,107
CPT,64898,Nrv grf mltst arm/leg >4 cm,,,212.42,8885.77,107
CPT,64901,Nerve graft add-on,,,91.48,6815.79,52
CPT,64902,Nerve graft add-on,,,105.97,6815.79,52
CPT,64905,Nerve pedicle transfer,,,156.1,8885.77,107
CPT,64907,Nerve pedicle transfer,,,201.41,8885.77,107
CPT,64910,Nerve repair w/allograft,,,118.01,10656.66,107
CPT,64911,Neurorraphy w/vein autograft,,,158.62,10376.22,107
CPT,64912,Nrv rpr w/nrv algrft 1st,,,138.57,11585.33,107
CPT,64913,Nrv rpr w/nrv algrft ea addl,,,26.78,8696.02,52
CPT,64999,HC COM CON UNLISTED PROCEDURE NERVOUS SYSTEM,3586.72,2690.04,43.04,3228.05,119
CPT,64999,HC CT FACET JOINT ASPIRATION,4423.69,3317.77,53.08,3981.32,119
CPT,64999,HC DISC BLOCK / INJECTION,3586.72,2690.04,43.04,3228.05,119
CPT,64999,HC GUIDED TISSEEL INJECTION,1255.21,941.41,15.06,1129.69,119
CPT,64999,HC RENAL PLEXUS BLOCK,1255.21,941.41,15.06,1129.69,119
CPT,64999,HC RENAL PLEXUS NERVE BLOCK W/ GUIDANCE,1255.21,941.41,15.06,1129.69,119
CPT,64999,HC SPINAL CYST ASPIRATION / INJECTION,3586.72,2690.04,43.04,3228.05,119
CPT,64999,Unlisted px nervous system,,,282.99,328.55,19
CPT,65091,Revise eye,,,500.02,9709.33,107
CPT,65093,Revise eye with implant,,,495.91,4413.46,107
CPT,65101,Removal of eye,,,571.77,4413.46,107
CPT,65103,Remove eye/insert implant,,,589.17,4413.46,107
CPT,65105,Remove eye/attach implant,,,146.82,4413.46,143
CPT,65110,Removal of eye,,,202.82,4413.46,143
CPT,65112,Remove eye/revise socket,,,232.24,4413.46,143
CPT,65114,Remove eye/revise socket,,,242.6,4413.46,143
CPT,65125,Revise ocular implant,,,195.6,3698.79,107
CPT,65130,Insert ocular implant,,,573.75,4413.46,107
CPT,65135,Insert ocular implant,,,580.64,4413.46,107
CPT,65140,Attach ocular implant,,,623.79,4413.46,107
CPT,65150,Revise ocular implant,,,472.06,4413.46,107
CPT,65155,Reinsert ocular implant,,,649.22,4413.46,107
CPT,65175,Removal of ocular implant,,,524.39,4413.46,107
CPT,65205,HC REM FOREIGN BDY EXT EYE CONJUN,643.27,482.45,7.72,578.94,119
CPT,65205,Remove foreign body from eye,,,42.2,3698.79,71
CPT,65210,HC REMOVE FOREIGN BODY FROM EYE BILAT,583.94,437.96,7.01,525.55,119
CPT,65210,HC REMOVE FOREIGN BODY FROM EYE UNILAT,583.94,437.96,7.01,525.55,119
CPT,65210,Remove foreign body from eye,,,52.07,3698.79,71
CPT,65220,HC REM FOREGN BDY CORNEA W/O LAMP,643.27,482.45,7.72,578.94,119
CPT,65220,Remove foreign body from eye,,,60.26,553.47,71
CPT,65222,HC REM FOREIGN BODY CORNEA W/LAMP,643.27,482.45,7.72,578.94,119
CPT,65222,Remove foreign body from eye,,,72.23,618.72,71
CPT,65235,Remove foreign body from eye,,,463.86,3157.23,107
CPT,65260,Remove foreign body from eye,,,150.06,3157.23,143
CPT,65265,Remove foreign body from eye,,,168.96,3157.23,143
CPT,65270,Repair of eye wound,,,108.31,2926.22,107
CPT,65272,Repair of eye wound,,,235.83,2926.22,107
CPT,65273,Repair of eye wound,,,254.06,15039.8,107
CPT,65275,Repair of eye wound,,,308.19,4413.46,107
CPT,65280,Repair of eye wound,,,448.33,6896.03,107
CPT,65285,Repair of eye wound,,,738.91,6896.03,107
CPT,65286,Repair of eye wound,,,331.16,5779.37,107
CPT,65290,Repair of eye socket wound,,,327.48,5779.37,107
CPT,65400,Removal of eye lesion,,,402.22,1937.5,107
CPT,65410,Biopsy of cornea,,,145.92,3698.79,71
CPT,65420,Removal of eye lesion,,,252.96,2926.22,107
CPT,65426,Removal of eye lesion,,,318.82,2926.22,107
CPT,65430,Corneal smear,,,144.99,2452.38,71
CPT,65435,Curette/treat cornea,,,98.79,2452.38,71
CPT,65436,Curette/treat cornea,,,246.69,2596.59,107
CPT,65450,Treatment of corneal lesion,,,154.12,928.46,107
CPT,65600,Revision of cornea,,,226.6,2596.59,107
CPT,65710,Corneal transplant,,,174.38,6896.03,143
CPT,65730,Corneal transplant,,,191.41,5603.02,143
CPT,65750,Corneal transplant,,,192.78,6896.03,143
CPT,65755,Corneal transplant,,,192.08,5603.02,143
CPT,65756,Corneal trnspl endothelial,,,180.2,5779.37,143
CPT,65757,Prep corneal endo allograft,,,272.96,4695.73,16
CPT,65760,Keratomileusis,,,,,0
CPT,65765,Keratophakia,,,,,0
CPT,65767,Epikeratoplasty,,,,,0
CPT,65770,Keratoprosthesis,,,215.17,28480.59,143
CPT,65771,Radial keratotomy,,,,,0
CPT,65772,Correction of astigmatism,,,270.0,1528.62,107
CPT,65775,Correction of astigmatism,,,383.46,23868.77,107
CPT,65778,Cover eye w/membrane,,,76.59,11212.97,71
CPT,65779,Cover eye w/membrane suture,,,211.68,9846.33,71
CPT,65780,Ocular reconst transplant,,,445.8,9397.56,107
CPT,65781,Ocular reconst transplant,,,202.38,10095.79,143
CPT,65782,Ocular reconst transplant,,,764.3,4413.46,107
CPT,65785,Impltj ntrstrml crnl rng seg,,,295.52,8693.6,107
CPT,65800,Drainage of eye,,,128.24,3698.79,71
CPT,65810,Drainage of eye,,,309.41,7285.85,107
CPT,65815,Drainage of eye,,,317.63,3157.23,107
CPT,65820,Goniotomy,,,550.85,5603.02,107
CPT,65850,Trabeculotomy ab externo,,,564.35,3157.23,107
CPT,65855,Trabeculoplasty laser surg,,,157.26,4695.73,107
CPT,65860,Severing ads ant sgm laser,,,166.04,2645.99,107
CPT,65865,Incise inner eye adhesions,,,319.43,3157.23,107
CPT,65870,Incise inner eye adhesions,,,397.22,3157.23,107
CPT,65875,Incise inner eye adhesions,,,423.61,3157.23,107
CPT,65880,Incise inner eye adhesions,,,445.36,5603.02,107
CPT,65900,Remove eye lesion,,,151.56,3157.23,143
CPT,65920,Remove implant of eye,,,528.88,4695.73,107
CPT,65930,Remove blood clot from eye,,,429.6,3157.23,107
CPT,66020,Injection treatment of eye,,,99.99,3157.23,107
CPT,66030,Injection treatment of eye,,,84.78,3157.23,107
CPT,66130,Remove eye lesion,,,377.3,2926.22,107
CPT,66150,Glaucoma surgery,,,585.14,5603.02,107
CPT,66155,Glaucoma surgery,,,584.68,5603.02,107
CPT,66160,Glaucoma surgery,,,658.26,4695.73,107
CPT,66170,Glaucoma surgery,,,166.76,4695.73,143
CPT,66172,Incision of eye,,,181.96,3342.8,143
CPT,66174,Trluml dil aq o/f can w/o st,,,95.05,5603.02,143
CPT,66175,Trluml dil aq o/f can w/st,,,110.55,9534.91,143
CPT,66179,Aqueous shunt eye w/o graft,,,164.77,8974.03,143
CPT,66180,Aqueous shunt eye w/graft,,,173.79,8693.6,143
CPT,66183,Insert ant drainage device,,,156.99,8132.71,143
CPT,66184,Revision of aqueous shunt,,,120.69,7285.85,142
CPT,66185,Revise aqueous shunt eye,,,129.74,6815.79,143
CPT,66225,Repair/graft eye lesion,,,625.06,6896.03,107
CPT,66250,Follow-up surgery of eye,,,371.03,2926.22,107
CPT,66500,Incision of iris,,,263.96,5779.37,107
CPT,66505,Incision of iris,,,286.58,3157.23,107
CPT,66600,Remove iris and lesion,,,606.42,5603.02,107
CPT,66605,Removal of iris,,,729.34,3157.23,107
CPT,66625,Removal of iris,,,286.14,4695.73,107
CPT,66630,Removal of iris,,,378.15,3157.23,107
CPT,66635,Removal of iris,,,381.59,3157.23,107
CPT,66680,Repair iris & ciliary body,,,348.12,3157.23,107
CPT,66682,Repair iris & ciliary body,,,477.07,3157.23,107
CPT,66683,Implantation iris prosthesis,,,1835.42,18271.57,35
CPT,66700,Destruction ciliary body,,,261.08,3157.23,107
CPT,66710,Ciliary transsleral therapy,,,261.08,5961.03,107
CPT,66711,Ecp ciliary body destruction,,,336.75,3157.23,107
CPT,66720,Destruction ciliary body,,,273.39,2926.22,107
CPT,66740,Destruction ciliary body,,,261.08,3677.88,107
CPT,66761,Revision of iris,,,180.11,2452.38,107
CPT,66762,Revision of iris,,,283.2,3082.33,107
CPT,66770,Removal of inner eye lesion,,,320.91,1482.54,107
CPT,66820,Incision secondary cataract,,,314.13,3157.23,107
CPT,66821,After cataract laser surgery,,,207.51,928.14,107
CPT,66821,HC AFTER CATARACT LASER SURGERY,1676.66,1257.49,20.12,1508.99,119
CPT,66825,Reposition intraocular lens,,,557.59,3157.23,107
CPT,66830,Removal of lens lesion,,,473.13,3157.23,107
CPT,66840,Removal of lens material,,,462.53,3157.23,107
CPT,66850,Removal of lens material,,,526.09,3157.23,107
CPT,66852,Removal of lens material,,,559.99,5603.02,107
CPT,66920,Extraction of lens,,,500.12,3157.23,107
CPT,66930,Extraction of lens,,,572.4,5603.02,107
CPT,66940,Extraction of lens,,,523.37,3157.23,107
CPT,66982,Xcapsl ctrc rmvl cplx wo ecp,,,497.71,4695.73,124
CPT,66983,Cataract surg w/iol 1 stage,,,2186.44,4182.0,52
CPT,66984,Xcapsl ctrc rmvl w/o ecp,,,363.34,4182.0,120
CPT,66985,Insert lens prosthesis,,,513.08,3157.23,107
CPT,66986,Exchange lens prosthesis,,,602.72,3157.23,107
CPT,66987,Xcapsl ctrc rmvl cplx w/ecp,,,2208.95,7291.4,35
CPT,66988,Xcapsl ctrc rmvl w/ecp,,,1797.89,7291.4,35
CPT,66989,Xcpsl ctrc rmvl cplx insj 1+,,,571.31,9815.35,107
CPT,66990,Ophthalmic endoscope add-on,,,84.5,6110.72,52
CPT,66991,Xcapsl ctrc rmvl insj 1+,,,455.86,9815.35,107
CPT,66999,Unlisted px ant segment eye,,,2186.44,2538.46,19
CPT,67005,Partial removal of eye fluid,,,317.22,3157.23,107
CPT,67010,Partial removal of eye fluid,,,363.71,8225.96,107
CPT,67015,Release of eye fluid,,,404.26,3157.23,107
CPT,67025,Replace eye fluid,,,421.21,3157.23,107
CPT,67027,Implant eye drug system,,,129.33,17101.12,143
CPT,67028,HC INJECTION EYE DRUG,1090.27,817.7,13.08,981.24,119
CPT,67028,Injection eye drug,,,131.69,2645.99,71
CPT,67030,Incise inner eye strands,,,372.06,4334.52,107
CPT,67031,Laser surgery eye strands,,,184.94,1083.38,107
CPT,67036,Removal of inner eye fluid,,,136.61,5603.02,143
CPT,67039,Laser treatment of retina,,,146.35,5603.02,143
CPT,67040,Laser treatment of retina,,,158.03,5603.02,143
CPT,67041,Vit for macular pucker,,,174.48,5603.02,143
CPT,67042,Vit for macular hole,,,174.43,5603.02,143
CPT,67043,Vit for membrane dissect,,,183.93,5603.02,143
CPT,67101,Repair detached retina crtx,,,216.94,4695.73,107
CPT,67105,Repair detached retina pc,,,209.46,4695.73,107
CPT,67107,Repair detached retina,,,171.4,5603.02,143
CPT,67108,Repair detached retina,,,181.51,5603.02,143
CPT,67110,Repair detached retina,,,542.27,4695.73,107
CPT,67113,Repair retinal detach cplx,,,202.94,6896.03,143
CPT,67115,Release encircling material,,,332.3,5603.02,107
CPT,67120,Remove eye implant material,,,369.93,5779.37,107
CPT,67121,Remove eye implant material,,,137.71,4695.73,143
CPT,67141,Proph rta dtchmnt crtx dthrm,,,164.67,2645.99,107
CPT,67145,Proph rta dtchmnt pc,,,164.67,2645.99,107
CPT,67208,Treatment of retinal lesion,,,286.57,1686.64,107
CPT,67210,Treatment of retinal lesion,,,332.46,1440.99,107
CPT,67218,Treatment of retinal lesion,,,462.35,4413.46,107
CPT,67220,Treatment of choroid lesion,,,332.26,1480.38,107
CPT,67221,Ocular photodynamic ther,,,199.84,3698.79,71
CPT,67225,Eye photodynamic ther add-on,,,26.51,751.32,52
CPT,67227,Dstrj extensive retinopathy,,,194.1,4197.14,107
CPT,67228,Treatment x10sv retinopathy,,,225.24,950.99,107
CPT,67229,HC TR RETINAL LES PRETERM INF,3859.52,2894.64,46.31,3473.57,238
CPT,67229,Tr retinal les preterm inf,,,462.35,3240.67,107
CPT,67250,Reinforce eye wall,,,491.25,2926.22,107
CPT,67255,Reinforce/graft eye wall,,,104.97,5603.02,143
CPT,67299,Unlisted px posterior segmnt,,,2186.44,2538.46,19
CPT,67311,Revise eye muscle,,,303.89,2926.22,107
CPT,67312,Revise two eye muscles,,,444.39,4695.73,107
CPT,67314,Revise eye muscle,,,303.89,2926.22,107
CPT,67316,Revise two eye muscles,,,476.69,3698.79,107
CPT,67318,Revise eye muscle(s),,,459.82,2926.22,107
CPT,67320,Revise eye muscle(s) add-on,,,194.7,2452.38,52
CPT,67331,Eye surgery follow-up add-on,,,274.82,2452.38,52
CPT,67332,Rerevise eye muscles add-on,,,302.28,1865.02,52
CPT,67334,Revise eye muscle w/suture,,,271.28,1138.39,52
CPT,67335,Eye suture during surgery,,,270.26,1713.54,52
CPT,67340,Revise eye muscle add-on,,,44.76,2670.19,52
CPT,67343,Release eye tissue,,,447.91,2926.22,107
CPT,67345,Destroy nerve of eye muscle,,,165.0,2237.88,107
CPT,67346,Biopsy eye muscle,,,274.65,4413.46,71
CPT,67399,Unlisted px extraocular musc,,,286.57,332.71,19
CPT,67400,Explore/biopsy eye socket,,,369.88,4413.46,107
CPT,67405,Explore/drain eye socket,,,607.6,3698.79,107
CPT,67412,Explore/treat eye socket,,,666.18,3698.79,107
CPT,67413,Explore/treat eye socket,,,148.45,2926.22,143
CPT,67414,Explr/decompress eye socket,,,223.75,4413.46,143
CPT,67415,Aspiration orbital contents,,,147.87,2926.22,71
CPT,67420,Explore/treat eye socket,,,269.27,4831.17,143
CPT,67430,Explore/treat eye socket,,,212.75,4413.46,143
CPT,67440,Explore/drain eye socket,,,206.41,5603.02,143
CPT,67445,Explr/decompress eye socket,,,234.96,4413.46,143
CPT,67450,Explore/biopsy eye socket,,,213.85,4695.73,143
CPT,67500,Inject/treat eye socket,,,92.63,3698.79,71
CPT,67505,Inject/treat eye socket,,,104.39,3698.79,71
CPT,67515,Inject/treat eye socket,,,68.06,332.71,71
CPT,67516,Sprchoroidal spc njx rx agt,,,123.29,369.17,35
CPT,67550,Insert eye socket implant,,,92.47,4413.46,107
CPT,67560,Revise eye socket implant,,,184.94,4413.46,107
CPT,67570,Decompress optic nerve,,,195.65,4413.46,143
CPT,67599,Unlisted procedure orbit,,,286.57,332.71,19
CPT,67700,Blepharotomy drg absc eyelid,,,88.74,3698.79,107
CPT,67700,HC DRAINAGE OF EYELID ABSCESS BILAT,726.31,544.73,8.72,653.68,119
CPT,67700,HC DRAINAGE OF EYELID ABSCESS UNILAT,968.79,726.59,11.63,871.91,119
CPT,67710,Severing tarsorrhaphy,,,74.78,3698.79,107
CPT,67715,Canthotomy,,,82.83,2926.22,107
CPT,67800,Remove eyelid lesion,,,78.21,520.14,71
CPT,67801,Remove eyelid lesions,,,101.2,2452.38,71
CPT,67805,Remove eyelid lesions,,,125.26,571.67,71
CPT,67808,Remove eyelid lesion(s),,,245.44,2926.22,71
CPT,67810,Incal bx eyelid skn lid mrgn,,,98.7,503.18,71
CPT,67820,Revise eyelashes,,,27.98,2452.38,71
CPT,67825,Revise eyelashes,,,92.81,400.7,107
CPT,67830,Revise eyelashes,,,104.95,1528.62,107
CPT,67835,Revise eyelashes,,,246.59,2926.22,107
CPT,67840,Remove eyelid lesion,,,120.38,1281.1,107
CPT,67850,Dstrj lesion lid margin <1cm,,,100.86,2452.38,107
CPT,67875,Closure of eyelid by suture,,,136.5,1528.62,71
CPT,67880,Revision of eyelid,,,245.43,2926.22,107
CPT,67882,Revision of eyelid,,,314.11,2926.22,107
CPT,67900,Repair brow defect,,,337.74,2926.22,107
CPT,67901,Repair eyelid defect,,,394.38,2926.22,107
CPT,67902,Repair eyelid defect,,,484.9,4413.46,107
CPT,67903,Repair eyelid defect,,,320.63,2926.22,107
CPT,67904,Repair eyelid defect,,,397.43,3698.79,107
CPT,67906,Repair eyelid defect,,,337.35,4413.46,107
CPT,67908,Repair eyelid defect,,,288.33,2926.22,107
CPT,67909,Revise eyelid defect,,,292.64,3698.79,107
CPT,67911,Revise eyelid defect,,,373.21,2926.22,107
CPT,67912,Correction eyelid w/implant,,,325.42,2926.22,107
CPT,67914,Repair eyelid defect,,,218.54,2926.22,107
CPT,67915,Repair eyelid defect,,,132.48,2596.59,107
CPT,67916,Repair eyelid defect,,,286.41,2926.22,107
CPT,67917,Repair eyelid defect,,,304.48,2926.22,107
CPT,67921,Repair eyelid defect,,,207.56,2926.22,107
CPT,67922,Repair eyelid defect,,,132.69,2596.59,107
CPT,67923,Repair eyelid defect,,,286.63,2926.22,107
CPT,67924,Repair eyelid defect,,,304.29,2926.22,107
CPT,67930,"HC SUTURE EYELID WOUND,PARTIAL THICK BILAT",998.8,749.1,11.99,898.92,119
CPT,67930,"HC SUTURE EYELID WOUND,PARTIAL THICK UNILAT",998.8,749.1,11.99,898.92,119
CPT,67930,Repair eyelid wound,,,180.79,2596.59,107
CPT,67935,"HC SUTURE EYELID WOUND,FULL THICK BILAT",125.29,93.97,1.5,112.76,119
CPT,67935,"HC SUTURE EYELID WOUND,FULL THICK UNILAT",125.29,93.97,1.5,112.76,119
CPT,67935,Repair eyelid wound,,,293.93,2926.22,107
CPT,67938,HC REMOVE EYELID FOREIGN BODY BILAT,643.27,482.45,7.72,578.94,119
CPT,67938,HC REMOVE EYELID FOREIGN BODY UNILAT,643.27,482.45,7.72,578.94,119
CPT,67938,Remove eyelid foreign body,,,90.22,713.29,107
CPT,67950,Revision of eyelid,,,308.7,2926.22,107
CPT,67961,Revision of eyelid,,,302.65,2926.22,107
CPT,67966,Revision of eyelid,,,436.65,2926.22,107
CPT,67971,Reconstruction of eyelid,,,480.52,2926.22,107
CPT,67973,Reconstruction of eyelid,,,141.18,2926.22,143
CPT,67974,Reconstruction of eyelid,,,140.83,4413.46,143
CPT,67975,Reconstruction of eyelid,,,455.05,2926.22,107
CPT,67999,Unlisted procedure eyelids,,,286.57,332.71,19
CPT,68020,HC INCISE/DRAIN CONJUNCTIVA BILAT,726.31,544.73,8.72,653.68,119
CPT,68020,HC INCISE/DRAIN CONJUNCTIVA UNILAT,726.31,544.73,8.72,653.68,119
CPT,68020,Incise/drain eyelid lining,,,84.27,3698.79,107
CPT,68040,Treatment of eyelid lesions,,,68.51,2452.38,71
CPT,68100,Biopsy conjunctiva,,,136.53,2596.59,71
CPT,68110,Exc les conjunctiva <1 cm,,,92.47,2596.59,107
CPT,68115,Exc les conjunctiva >1 cm,,,139.58,2926.22,107
CPT,68130,Exc les conjunctiva adj scl,,,274.19,2926.22,107
CPT,68135,Destruction les conjunctiva,,,114.47,2596.59,107
CPT,68200,Treat eyelid by injection,,,48.8,2452.38,71
CPT,68320,Revise/graft eyelid lining,,,277.41,2926.22,107
CPT,68325,Revise/graft eyelid lining,,,317.83,4413.46,107
CPT,68326,Revise/graft eyelid lining,,,429.42,4413.46,107
CPT,68328,Revise/graft eyelid lining,,,470.58,3698.79,107
CPT,68330,Revise eyelid lining,,,306.49,3698.79,107
CPT,68335,Revise/graft eyelid lining,,,430.6,4413.46,107
CPT,68340,Separate eyelid adhesions,,,265.54,2926.22,107
CPT,68360,Revise eyelid lining,,,273.41,4413.46,107
CPT,68362,Revise eyelid lining,,,436.77,2926.22,107
CPT,68371,Harvest eye tissue alograft,,,313.58,3698.79,107
CPT,68399,Unlisted px conjunctiva,,,286.57,332.71,19
CPT,68400,I&d lacrimal gland,,,100.16,2452.38,107
CPT,68420,I&d lacrimal sac,,,127.16,2596.59,107
CPT,68440,Snip inc lacrimal punctum,,,75.91,606.83,107
CPT,68500,Removal of tear gland,,,635.73,4413.46,107
CPT,68505,Partial removal tear gland,,,215.76,4413.46,107
CPT,68510,Biopsy of tear gland,,,412.07,3698.79,71
CPT,68520,Removal of tear sac,,,495.19,4413.46,107
CPT,68525,Biopsy of tear sac,,,371.33,2926.22,71
CPT,68530,Clearance of tear duct,,,193.97,3698.79,107
CPT,68540,Remove tear gland lesion,,,658.81,2926.22,107
CPT,68550,Remove tear gland lesion,,,462.35,4413.46,107
CPT,68700,Repair tear ducts,,,401.52,2926.22,107
CPT,68705,Revise tear duct opening,,,126.44,3698.79,107
CPT,68720,Create tear sac drain,,,124.23,4413.46,143
CPT,68745,Create tear duct drain,,,124.77,4413.46,143
CPT,68750,Create tear duct drain,,,131.6,4413.46,143
CPT,68760,Close tear duct opening,,,111.03,3698.79,107
CPT,68761,Close tear duct opening,,,89.55,3698.79,107
CPT,68770,Close tear system fistula,,,418.66,2926.22,107
CPT,68801,Dilate tear duct opening,,,60.07,862.14,107
CPT,68810,Probe nasolacrimal duct,,,97.53,2452.38,107
CPT,68811,Probe nasolacrimal duct,,,102.92,2926.22,107
CPT,68815,Probe nasolacrimal duct,,,169.23,2926.22,107
CPT,68816,Probe nl duct w/balloon,,,120.14,2926.22,107
CPT,68840,Explore/irrigate tear ducts,,,89.3,2452.38,107
CPT,68841,Insj rx elut implt lac canal,,,46.91,2596.59,71
CPT,68850,Injection for tear sac x-ray,,,74.81,531.59,52
CPT,68899,Unlisted px lacrimal system,,,286.57,332.71,19
CPT,69000,Drg xtrnl ear absc/hem smpl,,,96.78,783.1,107
CPT,69000,"HC I&D ABSCESS EAR, EXTERNAL  SIMPLE",643.27,482.45,7.72,578.94,119
CPT,69005,Drg xtrnl ear absc/hem comp,,,124.58,1803.33,107
CPT,69005,"HC I&D ABSCESS EAR, EXTERNAL COMPLICATED",5251.0,3938.25,63.01,4725.9,119
CPT,69020,Drg xtrnl aud canal abscess,,,111.9,783.1,107
CPT,69020,HC DRAN EXTRNL AUDITRY CANAL ABSC,726.31,544.73,8.72,653.68,119
CPT,69090,Ear piercing,,,,,0
CPT,69100,Biopsy of external ear,,,45.44,400.7,71
CPT,69105,Biopsy of external ear canal,,,92.25,1648.68,71
CPT,69110,Remove external ear partial,,,184.94,3236.54,107
CPT,69120,Removal of external ear,,,298.27,7571.84,71
CPT,69140,Remove ear canal lesion(s),,,691.03,7571.84,107
CPT,69145,Remove ear canal lesion(s),,,197.59,6345.74,107
CPT,69150,Extensive ear canal surgery,,,777.54,7571.84,71
CPT,69155,Extensive ear/neck surgery,,,254.04,15039.8,107
CPT,69200,Clear outer ear canal,,,68.93,6345.74,71
CPT,69200,HC REM FB EXT AUDTR CANL W/O ANES,643.27,482.45,7.72,578.94,119
CPT,69205,Clear outer ear canal,,,74.43,12587.2,107
CPT,69209,HC REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE BILATERAL,445.39,334.04,5.34,400.85,119
CPT,69209,HC REMOVAL IMPACTED CERUMEN IRRIGATION/LAVAGE UNILATERAL,167.44,125.58,2.01,150.7,119
CPT,69209,Remove impacted ear wax uni,,,21.62,616.92,71
CPT,69210,HC REMOVAL IMPACTED CERUMEN REQ INSTR; BILATERAL,342.73,257.05,4.11,308.46,119
CPT,69210,HC REMOVAL IMPACTED CERUMEN REQ INSTR; UNILATERAL,128.66,96.5,1.54,115.79,119
CPT,69210,Remove impacted ear wax uni,,,31.8,1753.08,71
CPT,69220,Clean out mastoid cavity,,,74.76,725.45,71
CPT,69222,Clean out mastoid cavity,,,105.75,598.31,107
CPT,69300,Revise external ear,,,608.0,3825.0,71
CPT,69310,Rebuild outer ear canal,,,462.35,7571.84,107
CPT,69320,Rebuild outer ear canal,,,242.96,7571.84,143
CPT,69399,Unlisted px external ear,,,222.62,258.46,19
CPT,69420,Incision of eardrum,,,93.33,6345.74,107
CPT,69421,Incision of eardrum,,,118.14,6345.74,107
CPT,69424,Remove ventilating tube,,,87.62,3609.55,71
CPT,69433,Create eardrum opening,,,102.7,3205.62,107
CPT,69436,Create eardrum opening,,,124.08,1850.43,107
CPT,69440,Exploration of middle ear,,,400.7,3825.0,107
CPT,69450,Eardrum revision,,,421.2,3825.0,107
CPT,69501,Mastoidectomy,,,548.59,7571.84,107
CPT,69502,Mastoidectomy,,,728.74,7571.84,107
CPT,69505,Remove mastoid structures,,,944.95,7571.84,107
CPT,69511,Extensive mastoid surgery,,,966.98,7571.84,107
CPT,69530,Extensive mastoid surgery,,,261.22,7571.84,143
CPT,69535,Remove part of temporal bone,,,2054.12,24576.36,107
CPT,69540,Excision aural polyp,,,101.1,6345.74,107
CPT,69550,Exc aurl glomus tum trnscanl,,,165.56,20597.38,143
CPT,69552,Exc aurl glomus tum trnsmstd,,,247.56,7571.84,143
CPT,69554,Exc aurl glomus tum extended,,,395.12,23361.69,143
CPT,69601,Revj mstdc rsltg compl mstdc,,,786.03,7571.84,107
CPT,69602,Rev mstdc rslt mod rad mstdc,,,839.64,19579.37,107
CPT,69603,Revj mstdc rsltg rad mstdc,,,987.92,7571.84,107
CPT,69604,Revj mstdc rsltg tympanplsty,,,858.02,7571.84,107
CPT,69610,Tympanic membrane repair,,,224.54,6345.74,107
CPT,69620,Myringoplasty,,,380.41,6345.74,107
CPT,69631,Repair eardrum structures,,,549.04,7571.84,107
CPT,69632,Rebuild eardrum structures,,,834.97,7571.84,107
CPT,69633,Rebuild eardrum structures,,,809.75,7571.84,107
CPT,69635,Repair eardrum structures,,,983.23,7571.84,107
CPT,69636,Rebuild eardrum structures,,,1083.29,7571.84,107
CPT,69637,Rebuild eardrum structures,,,1078.41,7571.84,107
CPT,69641,Revise middle ear & mastoid,,,804.39,7571.84,107
CPT,69642,Revise middle ear & mastoid,,,1032.1,7571.84,107
CPT,69643,Revise middle ear & mastoid,,,944.68,7571.84,107
CPT,69644,Revise middle ear & mastoid,,,1159.51,7571.84,107
CPT,69645,Revise middle ear & mastoid,,,1137.32,7571.84,107
CPT,69646,Revise middle ear & mastoid,,,1208.56,7571.84,107
CPT,69650,Stapes mobilization,,,619.3,6345.74,107
CPT,69660,Revise middle ear bone,,,713.87,7571.84,107
CPT,69661,Revise middle ear bone,,,930.16,7571.84,107
CPT,69662,Revise middle ear bone,,,891.82,7571.84,107
CPT,69666,Repair middle ear structures,,,622.94,6345.74,107
CPT,69667,Repair middle ear structures,,,623.21,6345.74,107
CPT,69670,Remove mastoid air cells,,,147.4,7571.84,143
CPT,69676,Remove middle ear nerve,,,642.4,3825.0,107
CPT,69700,Close mastoid fistula,,,513.41,6345.74,107
CPT,69705,Nps surg dilat eust tube uni,,,169.49,10656.66,71
CPT,69706,Nps surg dilat eust tube bi,,,236.34,10656.66,71
CPT,69710,Implant/replace hearing aid,,,,,0
CPT,69711,Remove/repair hearing aid,,,131.03,8931.05,143
CPT,69714,Impl oi implt skull perq esp,,,379.56,25768.16,107
CPT,69716,Impl oi implt sk tc esp<100,,,477.63,25768.16,107
CPT,69717,Rplcmt oi implt skl prq esp,,,431.04,21595.56,107
CPT,69719,Rplcm oi implt sk tc esp<100,,,495.26,25768.16,107
CPT,69720,Release facial nerve,,,916.95,11327.55,107
CPT,69725,Release facial nerve,,,291.9,21595.56,143
CPT,69726,Rmv ntr oi implt skl prq esp,,,366.35,6345.74,107
CPT,69727,Rmv ntr oi imp sk tc esp<100,,,409.03,6345.74,107
CPT,69728,Rmv ntr oi imp sk tc>100,,,577.62,4266.34,71
CPT,69729,Impl oi implt sk tc esp>100,,,654.95,25768.16,71
CPT,69730,Rplc oi implt sk tc esp>100,,,670.28,23055.72,71
CPT,69740,Repair facial nerve,,,181.39,21595.56,143
CPT,69745,Repair facial nerve,,,193.3,19322.34,143
CPT,69799,Unlisted px middle ear,,,222.62,258.46,19
CPT,69801,Incise inner ear,,,181.47,6345.74,71
CPT,69805,Explore inner ear,,,160.71,7571.84,143
CPT,69806,Explore inner ear,,,400.7,7571.84,107
CPT,69905,Remove inner ear,,,708.11,7571.84,107
CPT,69910,Remove inner ear & mastoid,,,764.56,7571.84,107
CPT,69915,Incise inner ear nerve,,,234.9,6345.74,143
CPT,69930,Implant cochlear device,,,938.31,35402.24,107
CPT,69949,Unlisted px inner ear,,,222.62,258.46,19
CPT,69950,Incise inner ear nerve,,,272.72,16162.49,143
CPT,69955,Release facial nerve,,,307.09,26141.99,143
CPT,69960,Release inner ear canal,,,294.39,13545.74,143
CPT,69970,Remove inner ear lesion,,,332.16,7571.84,143
CPT,69979,Unlisted px temporal bone,,,222.62,258.46,19
CPT,69990,Microsurgery add-on,,,33.52,6345.74,52
CPT,70010,Contrast x-ray of brain,,,57.36,397.49,63
CPT,70015,Contrast x-ray of brain,,,55.89,879.33,99
CPT,70030,HC DI EYE FOREIGN BODY,34.61,25.96,0.42,31.15,119
CPT,70030,X-ray eye for foreign body,,,8.59,98.0,135
CPT,70100,HC DI MANDIBLE LESS THAN 4 VWS,484.8,363.6,5.82,436.32,119
CPT,70100,X-ray exam of jaw <4views,,,8.59,242.0,112
CPT,70110,HC DI MANDIBLE MIN 4 VIEWS,635.02,476.26,7.62,571.52,119
CPT,70110,X-ray exam of jaw 4/> views,,,11.59,361.0,120
CPT,70120,X-ray exam of mastoids,,,8.59,118.36,127
CPT,70130,HC DI MASTOIDS MIN 3 VIEWS,340.52,255.39,4.09,306.47,119
CPT,70130,X-ray exam of mastoids,,,16.19,118.36,135
CPT,70134,X-ray exam of middle ear,,,16.84,610.26,91
CPT,70140,HC DI FACIAL BONES <3 VIEWS,519.68,389.76,6.24,467.71,119
CPT,70140,X-ray exam of facial bones,,,9.56,237.0,120
CPT,70150,HC DI FACIAL BONES MIN 3 VIEWS,631.87,473.9,7.58,568.68,119
CPT,70150,X-ray exam of facial bones,,,12.24,362.0,112
CPT,70160,HC DI NASAL BONES MIN 3 VIEWS,458.99,344.24,5.51,413.09,119
CPT,70160,X-ray exam of nasal bones,,,8.25,235.0,120
CPT,70170,X-ray exam of tear duct,,,14.2,269.03,55
CPT,70190,X-ray exam of eye sockets,,,10.55,149.02,135
CPT,70200,HC DI ORBITS COMPLETE 4 OR MORE VIEWS,784.21,588.16,9.41,705.79,119
CPT,70200,"HC DI ORBITS LESS THAN 4 VIEW,  LIMITED",871.3,653.48,10.46,784.17,119
CPT,70200,X-ray exam of eye sockets,,,13.23,388.0,112
CPT,70210,HC DI SINUSES <3 VIEWS,442.99,332.24,5.32,398.69,119
CPT,70210,X-ray exam of sinuses,,,8.25,230.0,120
CPT,70220,HC DI SINUSES COMPLETE 3 OR MORE VIEWS,636.7,477.52,7.64,573.03,119
CPT,70220,X-ray exam of sinuses,,,10.26,290.0,112
CPT,70240,HC DI SELLA TURCICA,207.96,155.97,2.5,187.16,119
CPT,70240,X-ray exam pituitary saddle,,,8.93,113.39,99
CPT,70250,HC DI SKULL <4 VIEWS,554.71,416.03,6.66,499.24,119
CPT,70250,X-ray exam of skull,,,8.59,313.0,112
CPT,70260,HC DI SKULL ROUTINE MIN 4 VIEWS,629.37,472.03,7.55,566.43,119
CPT,70260,X-ray exam of skull,,,13.23,350.0,120
CPT,70300,X-ray exam of teeth,,,4.94,98.0,91
CPT,70310,X-ray exam of teeth,,,3.66,269.03,99
CPT,70320,Full mouth x-ray of teeth,,,10.57,269.03,91
CPT,70328,X-ray exam of jaw joint,,,8.59,98.0,99
CPT,70330,HC DI TEMPOROMANDIBULAR JOINTS,571.38,428.54,6.86,514.24,119
CPT,70330,X-ray exam of jaw joints,,,11.25,98.0,91
CPT,70332,HC DI TMJ ARTHROGRAM UNILATERAL,1163.32,872.49,13.96,1046.99,119
CPT,70332,X-ray exam of jaw joint,,,25.75,269.03,135
CPT,70336,HC MRI TMJ UNILATERAL,3532.7,2649.52,42.39,3179.43,119
CPT,70336,Magnetic image jaw joint,,,68.82,269.03,127
CPT,70350,X-ray head for orthodontia,,,7.51,98.0,99
CPT,70355,HC DI ORTHOPANTOGRAM,214.85,161.14,2.58,193.36,119
CPT,70355,Panoramic x-ray of jaws,,,7.82,98.0,91
CPT,70360,HC DI NECK SOFT TISSUE,378.84,284.13,4.55,340.96,119
CPT,70360,X-ray exam of neck,,,8.59,214.0,120
CPT,70370,Throat x-ray & fluoroscopy,,,14.57,98.0,91
CPT,70371,Speech evaluation complex,,,40.31,269.03,99
CPT,70380,X-ray exam of salivary gland,,,7.94,98.0,91
CPT,70390,HC SIALOGRAM UNILATERAL,724.16,543.12,8.69,651.74,119
CPT,70390,HC SIALOGRAPHY BILATERAL,1609.21,1206.91,19.31,1448.29,119
CPT,70390,X-ray exam of salivary duct,,,17.86,269.03,99
CPT,70450,Ct head/brain w/o dye,,,39.7,533.0,122
CPT,70450,HC CT HEAD/BRAIN W/O CONTRAST,1806.74,1355.06,21.68,1626.07,119
CPT,70460,Ct head/brain w/dye,,,52.92,805.0,122
CPT,70460,HC CT HEAD/BRAIN W/CONTRAST,2098.84,1574.13,25.19,1888.96,119
CPT,70470,Ct head/brain w/o & w/dye,,,59.52,948.0,122
CPT,70470,HC CT HEAD/BRAIN W/WO CONTRAST,2679.5,2009.62,32.15,2411.55,119
CPT,70471,Cta h&n c+ w/noncontrast img,,,353.24,353.24,9
CPT,70473,Ct cere prfu aly c+wo ct/cta,,,177.6,177.6,9
CPT,70480,Ct orbit/ear/fossa w/o dye,,,27.28,564.0,120
CPT,70480,HC CT ORBIT/SELLA/IAC W/O CONTRAST,1758.29,1318.72,21.1,1582.46,119
CPT,70481,Ct orbit/ear/fossa w/dye,,,52.92,525.0,112
CPT,70481,HC CT ORBIT/SELLA/IAC W/CONTRAST,2017.18,1512.88,24.21,1815.46,119
CPT,70482,Ct orbit/ear/fossa w/o&w/dye,,,59.21,198.13,99
CPT,70482,HC CT ORBIT/SELLA/IAC W/WO CONTRAST,2097.16,1572.87,25.17,1887.44,119
CPT,70486,Ct maxillofacial w/o dye,,,40.02,573.0,122
CPT,70486,HC CT MAXILLOFACIAL W/O CONTRAST,2062.6,1546.95,24.75,1856.34,119
CPT,70487,Ct maxillofacial w/dye,,,52.92,854.0,122
CPT,70487,HC CT MAXILLOFACIAL W/CONTRAST,2824.71,2118.53,33.9,2542.24,119
CPT,70488,Ct maxillofacial w/o & w/dye,,,59.52,805.0,120
CPT,70488,HC CT MAXILLOFACIAL W/WO CONTRAST,2939.4,2204.55,35.27,2645.46,119
CPT,70490,Ct soft tissue neck w/o dye,,,60.18,805.0,122
CPT,70490,HC CT NECK SOFT TISSUE W/O CONTRAST,2001.18,1500.88,24.01,1801.06,119
CPT,70491,Ct soft tissue neck w/dye,,,64.82,878.0,122
CPT,70491,HC CT NECK SOFT TISSUE W/CONTRAST,2441.63,1831.22,29.3,2197.47,119
CPT,70492,Ct sft tsue nck w/o & w/dye,,,75.44,1073.0,120
CPT,70492,HC CT NECK SOFT TISS W/WO CONTRAST,2904.71,2178.53,34.86,2614.24,119
CPT,70496,Ct angiography head,,,82.0,1150.0,122
CPT,70496,HC CTA HEAD W/WO CONTRAST,3013.86,2260.4,36.17,2712.47,119
CPT,70498,Ct angiography neck,,,82.0,1245.0,122
CPT,70498,HC CTA NECK W/WO CONTRAST,2964.87,2223.65,35.58,2668.38,119
CPT,70540,HC MRI NECK/ORBIT/FACE W/O CONTRAST,4383.44,3287.58,52.6,3945.1,119
CPT,70540,Mri orbit/face/neck w/o dye,,,62.86,1289.0,122
CPT,70542,HC MRI NECK/ORBIT/FACE W/CONTRAST,5431.71,4073.78,65.18,4888.54,119
CPT,70542,Mri orbit/face/neck w/dye,,,75.76,1401.0,120
CPT,70543,HC MRI NECK/ORBIT/FACE W/WO CONTRAST,6599.79,4949.84,79.2,5939.81,119
CPT,70543,Mri orbt/fac/nck w/o &w/dye,,,100.24,2155.0,122
CPT,70544,HC MRA HEAD W/O CONTRAST,3964.88,2973.66,47.58,3568.39,119
CPT,70544,Mr angiography head w/o dye,,,56.23,1179.0,122
CPT,70545,HC MRA HEAD W/CONTRAST,3464.86,2598.64,41.58,3118.37,119
CPT,70545,Mr angiography head w/dye,,,55.92,397.49,91
CPT,70546,HC MRA HEAD W/WO CONTRAST,5450.62,4087.96,65.41,4905.56,119
CPT,70546,Mr angiograph head w/o&w/dye,,,39.13,2312.0,120
CPT,70547,HC MRA NECK W/O CONTRAST,3901.43,2926.07,46.82,3511.29,119
CPT,70547,Mr angiography neck w/o dye,,,56.23,1201.0,122
CPT,70548,HC MRA NECK W/CONTRAST,4553.22,3414.92,54.64,4097.9,119
CPT,70548,Mr angiography neck w/dye,,,70.12,1963.0,122
CPT,70549,HC MRA NECK W/WO CONTRAST,6166.95,4625.21,74.0,5550.26,119
CPT,70549,Mr angiograph neck w/o&w/dye,,,84.32,1982.0,122
CPT,70551,HC MRI BRAIN LIMITED W/O CONTRAST,4729.11,3546.83,56.75,4256.2,119
CPT,70551,HC MRI BRAIN W/O CONTRAST,4026.95,3020.21,48.32,3624.26,119
CPT,70551,Mri brain stem w/o dye,,,69.44,1179.0,122
CPT,70552,HC MRI BRAIN LIMITED W/CONTRAST,4542.87,3407.15,54.51,4088.58,119
CPT,70552,HC MRI BRAIN W/CONTRAST,4693.84,3520.38,56.33,4224.46,119
CPT,70552,Mri brain stem w/dye,,,83.65,1517.0,122
CPT,70553,HC MRI BRAIN W/WO CONTRAST,5833.02,4374.77,70.0,5249.72,119
CPT,70553,HC MRI IAC'S W AND W/O CONTRAST LIMITED,5833.02,4374.77,70.0,5249.72,119
CPT,70553,Mri brain stem w/o & w/dye,,,107.16,2212.0,122
CPT,70554,Fmri brain by tech,,,98.87,377.12,127
CPT,70554,HC MRI FUNCTIONAL BRAIN IMAGING,4878.06,3658.54,58.54,4390.25,119
CPT,70555,Fmri brain by phys/psych,,,75.85,269.03,99
CPT,70555,HC MRI FUNCTIONAL BRAIN  IMAGING W PHYSICIAN,5280.23,3960.17,63.36,4752.21,119
CPT,70557,Mri brain w/o dye,,,154.69,610.26,55
CPT,70558,Mri brain w/dye,,,162.44,273.16,63
CPT,70559,Mri brain w/o & w/dye,,,155.83,198.13,55
CPT,71045,HC DI CHEST 1 VIEW,403.62,302.71,4.84,363.26,119
CPT,71045,X-ray exam chest 1 view,,,8.59,197.0,122
CPT,71046,HC DI CHEST 2 VIEWS,477.12,357.84,5.73,429.41,119
CPT,71046,X-ray exam chest 2 views,,,10.26,220.0,122
CPT,71047,HC DI CHEST 3 VIEWS,467.96,350.97,5.62,421.16,119
CPT,71047,X-ray exam chest 3 views,,,12.89,241.0,122
CPT,71048,HC DI CHEST 4 VIEWS,570.02,427.52,6.84,513.02,119
CPT,71048,X-ray exam chest 4+ views,,,14.56,288.0,122
CPT,71100,HC DI RIBS 2 VIEWS UNILATERAL,413.48,310.11,4.96,372.13,119
CPT,71100,X-ray exam ribs uni 2 views,,,10.57,429.31,120
CPT,71101,HC DI X-RAY EXAM OF RIBS/CHEST,523.0,392.25,6.28,470.7,119
CPT,71101,X-ray exam unilat ribs/chest,,,12.58,325.0,112
CPT,71110,HC DI RIBS 3 VIEWS BILATERAL,661.64,496.23,7.94,595.48,119
CPT,71110,X-ray exam ribs bil 3 views,,,13.57,394.19,120
CPT,71111,HC DI RIBS PA CHEST 4 VIEWS BILATERAL,736.19,552.14,8.83,662.57,119
CPT,71111,X-ray exam ribs/chest4/> vws,,,15.2,344.0,112
CPT,71120,HC DI STERNUM MIN 2 VIEWS,500.68,375.51,6.01,450.61,119
CPT,71120,X-ray exam breastbone 2/>vws,,,9.27,445.32,120
CPT,71130,HC DI STERNO-CLAVICULAR JOINTS,549.02,411.76,6.59,494.12,119
CPT,71130,X-ray strenoclavic jt 3/>vws,,,10.26,98.0,91
CPT,71250,Ct thorax dx c-,,,50.59,608.0,122
CPT,71250,HC CT THORAX DX W/O CONTRAST,2192.76,1644.57,26.31,1973.48,119
CPT,71260,Ct thorax dx c+,,,54.56,917.0,122
CPT,71260,HC CT THORAX DX W/CONTRAST,3530.67,2648.0,42.37,3177.6,119
CPT,71270,Ct thorax dx c-/c+,,,58.24,1150.0,122
CPT,71270,HC CT THORAX DX W/WO CONTRAST,4287.61,3215.71,51.45,3858.85,119
CPT,71271,Ct thorax lung cancer scr c-,,,50.59,118.36,91
CPT,71271,HC CT LOW DOSE LUNG CA SCREEN W/O,2392.59,1794.44,28.71,2153.33,119
CPT,71275,Ct angiography chest,,,85.0,1169.0,122
CPT,71275,HC CTA PULMONARY W/WO CONTRAST,3517.15,2637.86,42.21,3165.44,119
CPT,71550,HC MRI CHEST W/O CONTRAST,4153.45,3115.09,49.84,3738.1,119
CPT,71550,Mri chest w/o dye,,,68.45,1282.0,112
CPT,71551,HC MRI CHEST W/CONTRAST,3974.76,2981.07,47.7,3577.28,119
CPT,71551,Mri chest w/dye,,,81.01,879.33,99
CPT,71552,HC MRI CHEST W/WO CONTRAST,6010.14,4507.6,72.12,5409.13,119
CPT,71552,Mri chest w/o & w/dye,,,105.83,2595.0,112
CPT,71555,HC MRA CHEST W/CONTRAST,3731.3,2798.48,44.78,3358.17,119
CPT,71555,HC MRA CHEST W/O CONTRAST,4094.16,3070.62,49.13,3684.74,119
CPT,71555,HC MRA CHEST W/WO CONTRAST,6332.62,4749.46,75.99,5699.36,119
CPT,71555,Mri angio chest w or w/o dye,,,84.04,372.63,81
CPT,72020,HC SPINE SINGLE VIEW,422.02,316.52,5.06,379.82,119
CPT,72020,X-ray exam of spine 1 view,,,7.6,204.0,112
CPT,72040,HC DI CERVICAL SPINE 2 OR 3 VIEWS,497.92,373.44,5.98,448.13,119
CPT,72040,X-ray exam neck spine 2-3 vw,,,10.57,455.53,120
CPT,72050,HC DI CERVICAL SPINE 4 OR 5 VIEWS,596.69,447.52,7.16,537.02,119
CPT,72050,X-ray exam neck spine 4/5vws,,,12.89,338.0,112
CPT,72052,HC DI CERVICAL SPINE 6 OR MORE VIEWS,900.73,675.55,10.81,810.66,119
CPT,72052,X-ray exam neck spine 6/>vws,,,14.2,546.44,120
CPT,72070,HC DI THORACIC SPINE 2 VIEWS,483.98,362.98,5.81,435.58,119
CPT,72070,X-ray exam thorac spine 2vws,,,9.58,298.0,112
CPT,72072,HC DI THORACIC SPINE 3 VIEWS,495.95,371.96,5.95,446.36,119
CPT,72072,X-ray exam thorac spine 3vws,,,10.6,683.06,120
CPT,72074,HC THORACIC SPINE 4 VIEW MIN,512.5,384.38,6.15,461.25,119
CPT,72074,X-ray exam thorac spine4/>vw,,,11.59,318.0,112
CPT,72080,HC DI THORACOLUMAR MINIMUM 2 VIEWS,597.09,447.82,7.17,537.38,119
CPT,72080,X-ray exam thoracolmb 2/> vw,,,9.92,682.26,120
CPT,72081,HC DI SCOLIOSIS SPINE 1 VIEW,381.54,286.15,4.58,343.39,119
CPT,72081,X-ray exam entire spi 1 vw,,,12.24,275.0,112
CPT,72082,HC DI SCOLIOSIS SPINE 2 OR 3 VIEWS,602.78,452.08,7.23,542.5,119
CPT,72082,X-ray exam entire spi 2/3 vw,,,14.86,556.88,120
CPT,72083,HC DI SCOLIOSIS SPINE 4 OR 5 VIEWS,612.52,459.39,7.35,551.27,119
CPT,72083,X-ray exam entire spi 4/5 vw,,,16.86,118.36,91
CPT,72084,HC DI SCOLIOSIS SPINE MIN 6 VIEWS,1069.78,802.34,12.84,962.8,119
CPT,72084,X-ray exam entire spi 6/> vw,,,19.81,659.14,99
CPT,72100,HC DI LUMBAR SPINE 2 OR 3 VIEWS,494.76,371.07,5.94,445.28,119
CPT,72100,X-ray exam l-s spine 2/3 vws,,,10.57,318.0,112
CPT,72110,HC DI L SPINE AP/LAT/OBL/OR FLEX/EXT,617.99,463.49,7.42,556.19,119
CPT,72110,X-ray exam l-2 spine 4/>vws,,,12.24,836.41,120
CPT,72114,HC DI L SPINE AP/LAT/OBL AND FLEX/EXT,659.09,494.32,7.91,593.18,119
CPT,72114,X-ray exam l-s spine bending,,,14.52,378.0,112
CPT,72120,HC LUMBAR SPINE FLEX/EXT ONLY,526.29,394.72,6.32,473.66,119
CPT,72120,X-ray bend only l-s spine,,,10.57,531.24,120
CPT,72125,Ct neck spine w/o dye,,,46.36,612.0,122
CPT,72125,HC CT CERVICAL SPINE W/O CONTRAST,2191.67,1643.75,26.3,1972.5,119
CPT,72126,Ct neck spine w/dye,,,56.91,805.0,120
CPT,72126,HC CT CERVICAL SPINE W/CONTRAST,2918.84,2189.13,35.03,2626.96,119
CPT,72127,Ct neck spine w/o & w/dye,,,59.21,805.0,120
CPT,72127,HC CT CERVICALSPINE W/WO CONTRAST,3142.53,2356.9,37.71,2828.28,119
CPT,72128,Ct chest spine w/o dye,,,46.36,650.0,122
CPT,72128,HC CT THORACIC SPINE  W/O CONTRAST,2139.85,1604.89,25.68,1925.86,119
CPT,72129,Ct chest spine w/dye,,,57.2,853.0,122
CPT,72129,HC CT THORACIC SPINE W/CONTRAST,3039.98,2279.98,36.48,2735.98,119
CPT,72130,Ct chest spine w/o & w/dye,,,59.52,805.0,120
CPT,72130,HC CT THORACIC SPINE W/WO CONTRAST,3749.04,2811.78,44.99,3374.14,119
CPT,72131,Ct lumbar spine w/o dye,,,46.36,618.0,122
CPT,72131,HC CT LUMBAR SPINE W/O CONTRAST,2483.62,1862.72,29.8,2235.26,119
CPT,72132,Ct lumbar spine w/dye,,,56.91,1415.0,122
CPT,72132,HC CT LUMBAR SPINE W/CONTRAST,2946.67,2210.0,35.36,2652.0,119
CPT,72133,Ct lumbar spine w/o & w/dye,,,59.52,979.0,122
CPT,72133,HC CT LUMBAR SPINE W/WO CONTRAST,3220.86,2415.64,38.65,2898.77,119
CPT,72141,HC MRI CERVICAL SPINE W/O CONTRAST,4759.14,3569.36,57.11,4283.23,119
CPT,72141,HC MRI CERVICAL SPINE W/O CONTRAST-LIMITED,4759.14,3569.36,57.11,4283.23,119
CPT,72141,Mri neck spine w/o dye,,,69.44,1206.0,122
CPT,72142,HC MRI CERVICAL SPINE W/CONTRAST,4865.15,3648.86,58.38,4378.64,119
CPT,72142,Mri neck spine w/dye,,,83.96,1815.0,122
CPT,72146,HC MRI THORACIC SPINE W/O CONTRAST,4399.05,3299.29,52.79,3959.15,119
CPT,72146,HC MRI THORACIC SPINE W/O CONTRAST-LIMITED,4399.05,3299.29,52.79,3959.15,119
CPT,72146,Mri chest spine w/o dye,,,69.44,1239.0,122
CPT,72147,HC MRI THORACIC SPINE W/CONTRAST,4709.44,3532.08,56.51,4238.5,119
CPT,72147,Mri chest spine w/dye,,,83.65,1701.0,122
CPT,72148,HC MRI LUMBAR SPINE W/O CONTRAST,4126.6,3094.95,49.52,3713.94,119
CPT,72148,Mri lumbar spine w/o dye,,,69.44,1269.0,122
CPT,72149,HC MRI LUMBAR SPINE W/CONTRAST,5042.43,3781.82,60.51,4538.19,119
CPT,72149,Mri lumbar spine w/dye,,,83.65,1599.0,122
CPT,72156,HC MRI CERVICAL SPINE W/WO CONTRAST,6666.24,4999.68,79.99,5999.62,119
CPT,72156,HC MRI CERVICAL SPINE W/WO CONTRAST-LIMITED,6666.24,4999.68,79.99,5999.62,119
CPT,72156,Mri neck spine w/o & w/dye,,,107.16,2260.0,122
CPT,72157,HC MRI THORACIC SPINE W/WO CONTRAST,6346.7,4760.02,76.16,5712.03,119
CPT,72157,HC MRI THORACIC SPINE W/WO CONTRAST-LIMITED,6346.7,4760.02,76.16,5712.03,119
CPT,72157,Mri chest spine w/o & w/dye,,,107.16,2028.0,122
CPT,72158,HC MRI LUMBAR SPINE W/WO CONTRAST,6639.88,4979.91,79.68,5975.89,119
CPT,72158,HC MRI LUMBAR SPINE W/WO CONTRAST -LIMITED,5517.92,4138.44,66.22,4966.13,119
CPT,72158,Mri lumbar spine w/o & w/dye,,,107.16,2005.0,122
CPT,72159,Mr angio spine w/o&w/dye,,,84.64,259.43,72
CPT,72170,HC DI PELVIS 1 OR 2 VIEWS,410.42,307.82,4.93,369.38,119
CPT,72170,X-ray exam of pelvis,,,8.25,1198.8,120
CPT,72190,HC DI PELVIS MIN 3 VIEWS,535.75,401.81,6.43,482.18,119
CPT,72190,X-ray exam of pelvis,,,11.9,118.36,91
CPT,72191,Ct angiograph pelv w/o&w/dye,,,83.72,1154.0,112
CPT,72191,HC CTA PELVIS W/WO CONTRAST,2860.78,2145.58,34.33,2574.7,119
CPT,72192,Ct pelvis w/o dye,,,50.93,597.0,122
CPT,72192,HC CT PELVIS W/O CONTRAST,2431.42,1823.56,29.18,2188.28,119
CPT,72193,Ct pelvis w/dye,,,54.25,917.0,122
CPT,72193,HC CT PELVIS W/CONTRAST,3141.76,2356.32,37.7,2827.58,119
CPT,72194,Ct pelvis w/o & w/dye,,,56.91,1069.0,122
CPT,72194,HC CT PELVIS W/WO CONTRAST,3505.3,2628.98,42.06,3154.77,119
CPT,72195,HC MRI PELVIS W/O CONTRAST,4225.77,3169.33,50.71,3803.19,119
CPT,72195,Mri pelvis w/o dye,,,68.45,1321.0,122
CPT,72196,HC MRI PELVIS W/CONTRAST,4070.62,3052.96,48.85,3663.56,119
CPT,72196,Mri pelvis w/dye,,,81.33,1519.0,122
CPT,72197,HC MRI PELVIS W/WO CONTRAST,4154.42,3115.82,49.85,3738.98,119
CPT,72197,Mri pelvis w/o & w/dye,,,102.57,2048.0,122
CPT,72198,HC MRA PELVIS W/CONTRAST,3933.07,2949.8,47.2,3539.76,119
CPT,72198,HC MRA PELVIS W/O CONTRAST,5168.77,3876.58,62.03,4651.89,119
CPT,72198,HC MRA PELVIS W/WO CONTRAST,5168.77,3876.58,62.03,4651.89,119
CPT,72198,Mr angio pelvis w/o & w/dye,,,83.7,252.21,81
CPT,72200,HC DI SACRO-ILIAC JOINTS<3 VIEWS,525.86,394.4,6.31,473.27,119
CPT,72200,X-ray exam si joints,,,7.94,388.0,112
CPT,72202,HC DI SACRO-ILIAC JOINTS 3> VIEWS,593.54,445.16,7.12,534.19,119
CPT,72202,X-ray exam si joints 3/> vws,,,10.6,341.0,120
CPT,72220,HC DI SACRUM/COCCYX MIN 2 VIEWS,538.42,403.82,6.46,484.58,119
CPT,72220,X-ray exam sacrum tailbone,,,8.25,255.0,112
CPT,72240,HC DI CERVICAL MYELOGRAM,1195.16,896.37,14.34,1075.64,119
CPT,72240,Myelography neck spine,,,43.56,879.33,99
CPT,72255,HC DI THORACIC MYELOGRAM,1897.38,1423.04,22.77,1707.64,119
CPT,72255,Myelography thoracic spine,,,45.69,879.33,91
CPT,72265,HC LUMBAR MYELOGRAM,1696.43,1272.32,20.36,1526.79,119
CPT,72265,Myelography l-s spine,,,39.03,879.33,120
CPT,72270,HC DI MULTIPLE SITES MYELOGRAM,2455.7,1841.78,29.47,2210.13,119
CPT,72270,Myelogphy 2/> spine regions,,,64.69,879.33,91
CPT,72285,Discography cerv/thor spine,,,54.6,3078.0,120
CPT,72295,X-ray of lower spine disk,,,39.03,3078.0,112
CPT,73000,HC CLAVICLE 1 VIEW UNILATERAL-LIMITED,444.68,333.51,5.34,400.21,119
CPT,73000,HC CLAVICLE COMPLETE UNILATERAL,390.44,292.83,4.69,351.4,119
CPT,73000,X-ray exam of collar bone,,,7.91,212.0,156
CPT,73010,HC DI SCAPULA COMPLETE,475.17,356.38,5.7,427.65,119
CPT,73010,X-ray exam of shoulder blade,,,8.56,246.0,148
CPT,73020,HC DI SHOULDER ONE VIEW UNILATERAL,371.64,278.73,4.46,334.48,119
CPT,73020,X-ray exam of shoulder,,,7.26,204.0,156
CPT,73030,HC DI SHOULDER MIN 2 VIEWS UNILATERAL,548.92,411.69,6.59,494.03,119
CPT,73030,X-ray exam of shoulder,,,8.9,246.0,148
CPT,73040,Contrast x-ray of shoulder,,,26.38,676.0,156
CPT,73040,HC DI ARTHROGRAM SHOULDER UNILATERAL S&I,1014.02,760.52,12.17,912.62,119
CPT,73050,HC DI A-C JOINTS W/WO WEIGHT,525.01,393.76,6.3,472.51,119
CPT,73050,X-ray exam of shoulders,,,8.9,240.0,112
CPT,73060,HC DI HUMERUS 1 VIEW UNILATERAL-LIMITED,504.24,378.18,6.05,453.82,119
CPT,73060,HC DI HUMERUS MIN 2 VIEWS UNILATERAL,442.75,332.06,5.31,398.48,119
CPT,73060,X-ray exam of humerus,,,7.91,329.91,120
CPT,73070,HC DI ELBOW 1 VIEW-LIMITED,327.55,245.66,3.93,294.8,119
CPT,73070,HC DI ELBOW 2 VIEW UNILATERAL,287.6,215.7,3.45,258.84,119
CPT,73070,X-ray exam of elbow,,,7.91,128.0,148
CPT,73080,HC DI ELBOW 3 VIEW UNILATERAL,557.37,418.03,6.69,501.63,119
CPT,73080,X-ray exam of elbow,,,8.25,412.71,156
CPT,73085,Contrast x-ray of elbow,,,26.69,397.49,127
CPT,73085,HC DI ARTHROGRAM ELBOW S&I UNILATERAL,677.54,508.16,8.13,609.79,119
CPT,73090,HC DI FOREARM 1 VIEW LIMITED,429.28,321.96,5.15,386.35,119
CPT,73090,HC DI FOREARM MIN 2 VIEW UNILATERAL,429.28,321.96,5.15,386.35,119
CPT,73090,X-ray exam of forearm,,,7.6,484.35,156
CPT,73092,HC DI UPPER EXTRMTY UNILATERAL <12MO 1 VIEW LIMITED,360.91,270.68,4.33,324.82,119
CPT,73092,HC DI UPPER EXTRMTY UNILATERAL <12MO MIN 2 VIEW,324.85,243.64,3.9,292.36,119
CPT,73092,X-ray exam of arm infant,,,7.6,118.36,127
CPT,73100,HC DI WRIST 1 VIEW UNILATERAL-LIMITED,344.12,258.09,4.13,309.71,119
CPT,73100,HC DI WRIST 2 VIEW UNILATERAL,309.71,232.28,3.72,278.74,119
CPT,73100,X-ray exam of wrist,,,7.91,341.11,156
CPT,73110,HC DI WRIST MIN 3 VIEW UNILAT,491.08,368.31,5.89,441.97,119
CPT,73110,X-ray exam of wrist,,,8.25,241.0,148
CPT,73115,Contrast x-ray of wrist,,,26.69,697.04,135
CPT,73115,HC DI ARTHROGRAM WRIST 1 INJ S&I UNILATERAL,994.71,746.03,11.94,895.24,119
CPT,73120,HC DI HAND 1 VIEW UNILATERAL-LIMITED,326.59,244.94,3.92,293.93,119
CPT,73120,HC DI HAND 2 VIEW UNILATERAL,326.59,244.94,3.92,293.93,119
CPT,73120,X-ray exam of hand,,,7.91,261.0,148
CPT,73130,HC DI HAND MIN 3 VIEW UNILATERAL,468.52,351.39,5.62,421.67,119
CPT,73130,X-ray exam of hand,,,8.25,822.87,156
CPT,73140,HC DI FINGERS 1 VIEW UNILATERAL LIMITED,408.17,306.13,4.9,367.35,119
CPT,73140,HC DI FINGERS MIN 2 VIEWS UNILATERAL,367.35,275.51,4.41,330.62,119
CPT,73140,X-ray exam of finger(s),,,6.58,207.0,148
CPT,73200,Ct upper extremity w/o dye,,,46.36,592.0,158
CPT,73200,HC CT UPPER EXTREMITY W/O CONTRAST,1972.19,1479.14,23.67,1774.97,119
CPT,73201,Ct upper extremity w/dye,,,54.25,805.0,156
CPT,73201,HC CT UPPER EXTREMITY W/CONTRAST,2374.85,1781.14,28.5,2137.36,119
CPT,73202,Ct uppr extremity w/o&w/dye,,,56.91,805.0,156
CPT,73202,HC UPPR EXTR W/WO CONTRAST UNILATERAL,2688.95,2016.71,32.27,2420.05,119
CPT,73206,Ct angio upr extrm w/o&w/dye,,,83.72,198.13,91
CPT,73206,HC CTA UPPER EXTREMITY W/WO CONTRAST UNILATERAL,2974.23,2230.67,35.69,2676.81,119
CPT,73218,HC MRI UPPER EXTREMITY W/O CONTRAST,3995.56,2996.67,47.95,3596.0,119
CPT,73218,Mri upper extremity w/o dye,,,63.49,1315.0,158
CPT,73219,HC MRI UPPER EXTREMITY W/CONTRAST UNILATERAL,4181.43,3136.07,50.18,3763.29,119
CPT,73219,Mri upper extremity w/dye,,,75.76,1401.0,156
CPT,73220,HC MRI UPPER EXTREM W/WO CONTRAST UNILATERAL,5932.97,4449.73,71.2,5339.67,119
CPT,73220,Mri uppr extremity w/o&w/dye,,,100.56,2037.0,158
CPT,73221,HC MRI UPPER EXTREM 1 JOINT W/O CONTRAST,3663.7,2747.78,43.96,3297.33,119
CPT,73221,Mri joint upr extrem w/o dye,,,63.8,1257.0,158
CPT,73222,HC MRI UPPER JOINT UNILATERAL W/CONTRAST,4434.21,3325.66,53.21,3990.79,119
CPT,73222,Mri joint upr extrem w/dye,,,76.07,2011.0,158
CPT,73223,HC MRI UPPER JOINT UNILATERAL W/WO CONTRAST,5313.11,3984.83,63.76,4781.8,119
CPT,73223,Mri joint upr extr w/o&w/dye,,,100.87,2053.0,158
CPT,73225,HC MRA UPPER EXTREMITY W/ CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CPT,73225,HC MRA UPPER EXTREMITY W/O CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CPT,73225,HC MRA UPPER EXTREMITY W/WO CONTRAST UNILATERAL,3613.15,2709.86,43.36,3251.84,119
CPT,73225,Mr angio upr extr w/o&w/dye,,,81.33,259.43,80
CPT,73501,HC DI HIP UNILATERAL +/- PELVIS 1 VIEW,476.96,357.72,5.72,429.26,119
CPT,73501,X-ray exam hip uni 1 view,,,8.9,275.0,112
CPT,73502,HC DI HIP UNILATERAL +/- PELVIS 2 OR 3 VIEW,1099.69,824.77,13.2,989.72,119
CPT,73502,X-ray exam hip uni 2-3 views,,,10.57,275.0,120
CPT,73503,HC DI HIP UNILATERAL +/- PELVIS MIN 4 VIEW,1338.39,1003.79,16.06,1204.55,119
CPT,73503,X-ray exam hip uni 4/> views,,,12.89,118.36,91
CPT,73521,HC DI HIP BILATERAL +/- PELVIS 2 VIEW,1111.37,833.53,13.34,1000.23,119
CPT,73521,X-ray exam hips bi 2 views,,,10.57,515.0,120
CPT,73522,HC DI HIP BILATERAL +/- PELVIS 3 OR 4 VIEW,1160.51,870.38,13.93,1044.46,119
CPT,73522,X-ray exam hips bi 3-4 views,,,13.89,515.0,112
CPT,73523,HC DI HIP BILATERAL +/- PELVIS MIN 5 VIEW,1937.29,1452.97,23.25,1743.56,119
CPT,73523,X-ray exam hips bi 5/> views,,,14.86,118.36,99
CPT,73525,Contrast x-ray of hip,,,27.32,397.49,127
CPT,73525,HC DI ARTHROGRAM HIP S&I,956.99,717.74,11.48,861.29,119
CPT,73551,HC DI FEMUR 1 VIEW,327.74,245.8,3.93,294.97,119
CPT,73551,X-ray exam of femur 1,,,7.91,108.54,135
CPT,73552,HC DI FEMUR MIN 2 VIEW UNILATERAL,443.6,332.7,5.32,399.24,119
CPT,73552,X-ray exam of femur 2/>,,,8.59,275.0,148
CPT,73560,HC DI KNEE 1-2 VIEWS UNILATERAL,338.96,254.22,4.07,305.06,119
CPT,73560,X-ray exam of knee 1 or 2,,,7.91,204.0,156
CPT,73562,HC DI KNEE 3 VIEWS UNILATERAL,482.58,361.94,5.79,434.32,119
CPT,73562,X-ray exam of knee 3,,,8.9,249.0,148
CPT,73564,HC DI KNEE MIN 4 VIEW UNILATERAL,513.3,384.98,6.16,461.97,119
CPT,73564,X-ray exam knee 4 or more,,,10.89,304.0,156
CPT,73565,HC DI KNEES STANDING AP BILATERAL,403.98,302.98,4.85,363.58,119
CPT,73565,X-ray exam of knees,,,8.23,213.0,112
CPT,73580,Contrast x-ray of knee joint,,,29.6,397.49,135
CPT,73580,HC ARTHROGRAPHY KNEE UNILATERAL S&I,746.35,559.76,8.96,671.72,119
CPT,73590,HC DI TIBIA/FIBULA 1 VIEW UNILATERAL-LIMITED,435.25,326.44,5.22,391.72,119
CPT,73590,HC DI TIBIA/FIBULA 2 VIEW UNILATERAL,382.15,286.61,4.59,343.94,119
CPT,73590,X-ray exam of lower leg,,,7.6,216.0,148
CPT,73592,HC LWER EXTRMTY <12 MO 1 VIEW UNILATERAL LIMITED,381.49,286.12,4.58,343.34,119
CPT,73592,HC LWER EXTRMTY <12 MO 2 VIEWS UNILATERAL,338.04,253.53,4.06,304.24,119
CPT,73592,X-ray exam of leg infant,,,7.6,193.85,135
CPT,73600,HC DI ANKLE 1 VIEW-LIMITED,328.35,246.26,3.94,295.52,119
CPT,73600,HC DI ANKLE 2 VIEW UNILATERAL,295.52,221.64,3.55,265.97,119
CPT,73600,X-ray exam of ankle,,,7.91,185.0,148
CPT,73610,HC DI ANKLE MIN 3 VIEW UNILATERAL,534.41,400.81,6.41,480.97,119
CPT,73610,X-ray exam of ankle,,,8.25,238.14,156
CPT,73615,Contrast x-ray of ankle,,,26.69,397.49,127
CPT,73615,HC ARTHROGRAM ANKLE S/I UNILATERAL,903.19,677.39,10.84,812.87,119
CPT,73620,HC DI FOOT 1 VIEW-LIMITED,325.08,243.81,3.9,292.57,119
CPT,73620,HC DI FOOT 2 VIEW UNILATERAL,325.08,243.81,3.9,292.57,119
CPT,73620,X-ray exam of foot,,,7.28,184.0,156
CPT,73630,HC DI FOOT MIN 3 VIEW UNILATERAL,533.95,400.46,6.41,480.56,119
CPT,73630,X-ray exam of foot,,,7.94,233.0,148
CPT,73650,HC DI OS CALCIS 1 VIEW UNILATERAL-LIMITED,394.63,295.97,4.74,355.17,119
CPT,73650,HC DI OS CALCIS MIN 2 VIEW UNILATERAL,438.49,328.87,5.26,394.64,119
CPT,73650,X-ray exam of heel,,,7.6,222.0,156
CPT,73660,HC DI TOES 1 VIEW UNLATERAL-LIMITED,438.17,328.63,5.26,394.35,119
CPT,73660,HC DI TOES MIN 2 VIEWS UNLATERAL,438.17,328.63,5.26,394.35,119
CPT,73660,X-ray exam of toe(s),,,6.27,215.0,148
CPT,73700,Ct lower extremity w/o dye,,,46.36,603.0,158
CPT,73700,HC CT LOWER EXTREMITY W/O CONTRAST UNILATERAL,2113.28,1584.96,25.36,1901.95,119
CPT,73701,Ct lower extremity w/dye,,,54.25,991.0,158
CPT,73701,HC CT LOWER EXTREMITY W/CONTRAST UNILATERAL,2601.29,1950.97,31.22,2341.16,119
CPT,73702,Ct lwr extremity w/o&w/dye,,,56.59,883.0,158
CPT,73702,HC CT LWR EXTR W/WO CONTRAST UNILATERAL,2797.29,2097.97,33.57,2517.56,119
CPT,73706,Ct angio lwr extr w/o&w/dye,,,88.03,254.9,127
CPT,73706,HC CTA LOWER EXTREMITY W/WO CONTRAST UNILATERAL,3363.19,2522.39,40.36,3026.87,119
CPT,73718,HC MRI LOWER EXTREM UNILATERAL W/O CONTRAST,3733.92,2800.44,44.81,3360.53,119
CPT,73718,Mri lower extremity w/o dye,,,63.18,1223.0,158
CPT,73719,HC MRI LOWER EXTREM UNILATERAL W/CONTRAST,3539.36,2654.52,42.47,3185.42,119
CPT,73719,Mri lower extremity w/dye,,,75.76,1401.0,156
CPT,73720,HC MRI LOWER EXTREM UNILATERAL W/WO CONTRAST,5019.66,3764.74,60.24,4517.69,119
CPT,73720,Mri lwr extremity w/o&w/dye,,,100.56,1968.0,158
CPT,73721,HC MRI LOWER JOINT UNILATERAL W/O CONTRAST,3464.36,2598.27,41.57,3117.92,119
CPT,73721,Mri jnt of lwr extre w/o dye,,,63.49,1268.0,158
CPT,73722,HC MRI LOWER JOINT UNILATERAL W/CONTRAST,4468.4,3351.3,53.62,4021.56,119
CPT,73722,Mri joint of lwr extr w/dye,,,76.07,1868.0,158
CPT,73723,HC MRI LOWER JOINT UNILATERAL W/WO CONTRAST,5079.75,3809.81,60.96,4571.78,119
CPT,73723,Mri joint lwr extr w/o&w/dye,,,100.56,2111.0,158
CPT,73725,HC MRA LOWER EXTREM UNILATERAL W/CONTRAST,4255.43,3191.57,51.07,3829.89,119
CPT,73725,HC MRA LOWER EXTREM UNILATERAL W/O CONTRAST,4255.19,3191.39,51.06,3829.67,119
CPT,73725,HC MRA LOWER EXTREM UNILATERAL W/WO CONTRAST,4255.19,3191.39,51.06,3829.67,119
CPT,73725,Mr ang lwr ext w or w/o dye,,,84.06,1775.0,138
CPT,74018,HC ABDOMEN 1 VIEW,407.53,305.65,4.89,366.78,119
CPT,74018,Radex abdomen 1 view,,,8.59,200.0,112
CPT,74019,HC DI ABDOMEN 2 VIEWS,480.57,360.43,5.77,432.51,119
CPT,74019,Radex abdomen 2 views,,,10.91,421.03,120
CPT,74021,HC DI ABDOMEN 3  OR MORE VIEWS,443.01,332.26,5.32,398.71,119
CPT,74021,Radex abdomen 3+ views,,,12.58,224.0,112
CPT,74022,HC DI ABDOMEN COMPLETE W/PA CHEST,644.79,483.59,7.74,580.31,119
CPT,74022,Radex compl aqt abd series,,,15.2,490.86,120
CPT,74150,Ct abdomen w/o contrast,,,55.58,576.0,122
CPT,74150,HC CT ABDOMEN W/O CONTRAST,2379.04,1784.28,28.55,2141.14,119
CPT,74160,Ct abdomen w/contrast,,,59.52,940.0,122
CPT,74160,HC CT ABDOMEN W/CONTRAST,3117.03,2337.77,37.4,2805.33,119
CPT,74170,Ct abd wo cntrst flwd cntrst,,,65.18,1099.0,122
CPT,74170,HC CT ABDOMEN W/WO CONTRAST,3270.73,2453.05,39.25,2943.66,119
CPT,74174,Cta abd&plvs w/contrast,,,102.23,1135.0,122
CPT,74174,HC CTA ABDOMEN AND PELVIS,3534.94,2651.2,42.42,3181.45,119
CPT,74175,Cta abdomen w/contrast,,,84.69,1069.0,122
CPT,74175,HC CTA ABDOMEN W/WO CONTRAST,2848.33,2136.25,34.18,2563.5,119
CPT,74176,Ct abd & pelvis w/o contrast,,,81.66,934.0,122
CPT,74176,HC CT ABD & PELVIS W/O CONTRAST,3744.58,2808.44,44.93,3370.12,119
CPT,74177,Ct abd & pelvis w/contrast,,,85.32,1325.0,122
CPT,74177,HC CT ABDOMEN & PELVIS W/CONTRAST,4761.83,3571.37,57.14,4285.65,119
CPT,74178,Ct abd&plv wo cntr flwd cntr,,,93.64,1576.0,122
CPT,74178,HC CT ABD & PELVIS W/WO CONTRAST,6392.67,4794.5,76.71,5753.4,119
CPT,74181,HC MRI ABDOMEN W/O CONTRAST,4130.78,3098.08,49.57,3717.7,119
CPT,74181,Mri abdomen w/o contrast,,,68.45,1159.0,122
CPT,74182,HC MRI ABDOMEN W/CONTRAST,4758.93,3569.2,57.11,4283.04,119
CPT,74182,Mri abdomen w/contrast,,,81.01,1401.0,120
CPT,74183,HC MRI ABDOMEN W/WO CONTRAST,5905.57,4429.18,70.87,5315.01,119
CPT,74183,HC MRI ABDOMEN W/WO LIMITED METS,5905.57,4429.18,70.87,5315.01,119
CPT,74183,Mri abd w/o cntr flwd cntr,,,102.57,1939.0,122
CPT,74185,HC MRA ABDOMEN W/CONTRAST,3204.49,2403.37,38.45,2884.04,119
CPT,74185,HC MRA ABDOMEN W/O CONTRAST,3971.46,2978.6,47.66,3574.31,119
CPT,74185,HC MRA ABDOMEN W/WO CONTRAST,6039.69,4529.77,72.48,5435.72,119
CPT,74185,Mra abd w or w/o cntrst,,,83.7,1390.0,102
CPT,74190,HC PERITONEOGRAM,504.49,378.37,6.05,454.04,119
CPT,74190,Peritoneogram rs&i,,,21.83,610.26,55
CPT,74210,X-ray xm phrnx&/crv esoph c+,,,27.76,672.83,99
CPT,74220,HC DI ESOPHAGRAM,818.62,613.96,9.82,736.76,119
CPT,74220,X-ray xm esophagus 1cntrst,,,28.41,198.13,91
CPT,74221,HC X-RAY XM ESOPHAGUS 2CNTRST,773.61,580.21,9.28,696.25,119
CPT,74221,X-ray xm esophagus 2cntrst,,,32.74,473.68,99
CPT,74230,HC DI SWALLOWING EVAL W/VIDEO,1042.57,781.93,12.51,938.31,119
CPT,74230,X-ray xm swlng funcj c+,,,25.09,198.13,91
CPT,74235,Remove esophagus obstruction,,,55.89,668.03,44
CPT,74240,HC DI X-RAY UPPER GI DELAY W/KUB,676.53,507.4,8.12,608.88,119
CPT,74240,HC DI X-RAY UPPER GI DELAY W/KUB (W/SM BOWEL),1521.54,1141.16,18.26,1369.39,119
CPT,74240,X-ray xm upr gi trc 1cntrst,,,37.7,521.0,112
CPT,74246,HC DI X-RAY XM UPR GI TRC 2CNTRST,1610.03,1207.52,19.32,1449.03,119
CPT,74246,HC DI X-RAY XM UPR GI TRC 2CNTRST (W/SM BOWEL),1521.45,1141.09,18.26,1369.3,119
CPT,74246,X-ray xm upr gi trc 2cntrst,,,41.71,791.65,120
CPT,74248,HC DI X-RAY SM INT F-THRU STD,1319.71,989.78,15.84,1187.74,119
CPT,74248,X-ray sm int f-thru std,,,32.74,47.68,72
CPT,74250,HC X-RAY XM SM INT 1CNTRST STD,1115.55,836.66,13.39,1004.0,119
CPT,74250,X-ray xm sm int 1cntrst std,,,37.72,793.26,120
CPT,74251,HC X-RAY XM SM INT 2CNTRST STD,1228.9,921.68,14.75,1106.01,119
CPT,74251,X-ray xm sm int 2cntrst std,,,54.9,198.13,91
CPT,74261,Ct colonography dx,,,98.82,790.06,120
CPT,74261,HC CT DIAGNOSTIC COLONOGRAPHY W/O CONTRAST,2916.87,2187.65,35.0,2625.18,119
CPT,74262,Ct colonography dx w/dye,,,116.79,198.13,91
CPT,74263,Ct colonography screening,,,231.73,840.01,27
CPT,74263,HC CT SCREENING COLONOGRAPHY,410.97,308.23,4.93,369.87,119
CPT,74270,HC X-RAY XM COLON 1CNTRST STD,1218.99,914.24,14.63,1097.09,119
CPT,74270,X-ray xm colon 1cntrst std,,,48.34,515.0,112
CPT,74280,HC X-RAY XM COLON 2CNTRST STD,1295.31,971.48,15.54,1165.78,119
CPT,74280,X-ray xm colon 2cntrst std,,,57.09,198.13,99
CPT,74283,HC DI THERAPEUTIC ENEMA,921.55,691.16,11.06,829.4,119
CPT,74283,Ther nma rdctj intus/obstrcj,,,97.72,198.13,91
CPT,74290,Contrast x-ray gallbladder,,,15.2,198.13,99
CPT,74300,HC DI OR CHOLANGIOGRAM,920.54,690.4,11.05,828.49,119
CPT,74300,X-ray bile ducts/pancreas,,,12.87,353.0,57
CPT,74301,HC XR CHOLANGIOGRAM INTRAOPERATIVE ADDED,585.65,439.24,7.03,527.08,119
CPT,74301,X-rays at surgery add-on,,,9.92,751.34,44
CPT,74328,HC BILIARY ERCP IMAGING,1085.11,813.83,13.02,976.6,119
CPT,74328,X-ray bile duct endoscopy,,,22.48,22.48,36
CPT,74329,HC DI ERCP PANCRATC DUCT SYST IMG,1056.89,792.67,12.68,951.2,119
CPT,74329,X-ray for pancreas endoscopy,,,22.79,329.96,44
CPT,74330,HC BILIARY AND PANCREATIC ERCP IMAGING,1128.35,846.26,13.54,1015.52,119
CPT,74330,X-ray bile/panc endoscopy,,,27.05,27.05,36
CPT,74340,HC INTRO LONG GI TUBE INCL FLUORO W IMG S&I,1350.87,1013.15,16.21,1215.78,119
CPT,74340,X-ray guide for gi tube,,,25.43,680.0,65
CPT,74355,X-ray guide intestinal tube,,,35.71,35.71,36
CPT,74360,HC INTRALUMINAL DILATION,5241.5,3931.12,62.9,4717.35,119
CPT,74360,X-ray guide gi dilation,,,26.06,616.07,44
CPT,74363,HC PERC BILIARY DILATION W/WO STENT,2335.07,1751.3,28.02,2101.56,119
CPT,74363,X-ray bile duct dilation,,,40.72,40.72,36
CPT,74400,HC IVP W/WO TOMOS,1059.46,794.6,12.71,953.51,119
CPT,74400,Urography iv +-kub tomog,,,23.11,664.0,120
CPT,74410,Urography nfs drip&/bolus,,,22.53,198.13,91
CPT,74415,HC NEPHROTOMOGRAM,1618.54,1213.9,19.42,1456.69,119
CPT,74415,Urography nfs drip&/bls w/nf,,,22.84,662.95,99
CPT,74420,HC DI PYELOGRAM RETROGRADE,955.24,716.43,11.46,859.72,119
CPT,74420,Urography rtrgr +-kub,,,23.86,397.49,91
CPT,74425,HC UROGRAPHY ANTEGRADE RS&I,863.21,647.41,10.36,776.89,119
CPT,74425,Urography antegrade rs&i,,,23.52,831.12,99
CPT,74430,Contrast x-ray bladder,,,14.88,456.0,112
CPT,74430,HC CYSTOGRAM 3 VIEWS,659.04,494.28,7.91,593.14,119
CPT,74440,X-ray male genital tract,,,17.25,833.61,99
CPT,74445,X-ray exam of penis,,,52.04,118.36,55
CPT,74450,HC URETHROGRAM RETROGRADE,790.78,593.08,9.49,711.7,119
CPT,74450,X-ray urethra/bladder,,,15.53,269.03,63
CPT,74455,HC DI CYSTOURETHROGRAM VOIDNG,727.25,545.44,8.73,654.52,119
CPT,74455,X-ray urethra/bladder,,,15.24,269.03,91
CPT,74470,X-ray exam of kidney lesion,,,24.81,610.26,63
CPT,74485,Dilation urtr/urt rs&i,,,38.4,2280.0,91
CPT,74485,HC URETERAL DILATION UNILATERAL,3408.26,2556.2,40.9,3067.43,119
CPT,74710,N/A,,,15.87,79.3,80
CPT,74712,Mri fetal sngl/1st gestation,,,140.85,269.03,91
CPT,74713,Mri fetal ea addl gestation,,,86.96,271.38,80
CPT,74740,HC HYSTEROSALPINGOGRAM,897.85,673.39,10.77,808.06,119
CPT,74740,X-ray female genital tract,,,17.86,269.03,91
CPT,74742,X-ray fallopian tube,,,28.75,259.4,44
CPT,74775,HC PERINEOGRAM,1197.62,898.22,14.37,1077.86,119
CPT,74775,X-ray exam of perineum,,,29.4,269.03,55
CPT,75557,Cardiac mri for morph,,,108.61,1196.0,120
CPT,75557,HC MRI CARDIAC FOR MORPH,2556.49,1917.37,30.68,2300.84,119
CPT,75557,HC MRI CARDIAC FOR MORPH LIMITED,2556.49,1917.37,30.68,2300.84,119
CPT,75559,Cardiac mri w/stress img,,,134.28,610.26,91
CPT,75559,HC CARDIAC MRI W/STRESS IMG,4296.4,3222.3,51.56,3866.76,119
CPT,75561,Cardiac mri for morph w/dye,,,120.2,1471.0,120
CPT,75561,HC MRI CARDIAC MORPH W/WO CONTRAST,4442.73,3332.05,53.31,3998.46,119
CPT,75563,Card mri w/stress img & dye,,,136.6,879.33,91
CPT,75563,HC CARD MRI W/STRESS IMG & DYE,5888.36,4416.27,70.66,5299.52,119
CPT,75565,Card mri veloc flow mapping,,,11.59,322.39,80
CPT,75565,HC MRI CARDIAC FLOW MAP,3658.12,2743.59,43.9,3292.31,119
CPT,75571,Ct hrt w/o dye w/ca test,,,27.42,258.0,112
CPT,75571,HC CT HEART QUAN CALCIUM W/O CONTRAST,426.26,319.7,5.12,383.63,119
CPT,75572,Ct hrt w/3d image,,,81.1,397.49,99
CPT,75572,HC CT HEART W/CONTRAST STRUCTURE,6799.72,5099.79,81.6,6119.75,119
CPT,75573,Ct hrt c+ strux cgen hrt ds,,,118.17,397.49,91
CPT,75573,HC CCTA W/CONTRAST CONGENITAL,6529.72,4897.29,78.36,5876.75,119
CPT,75574,Ct angio hrt w/3d image,,,66.41,1135.0,120
CPT,75574,HC CTA CORONARY ARTERIES W/CONTRAST,3697.75,2773.31,44.37,3327.98,119
CPT,75577,Quan&char c athrosclrtc plaq,,,942.0,942.0,9
CPT,75580,N-invas est c ffr sw aly cta,,,869.49,1132.36,19
CPT,75600,Contrast exam thoracic aorta,,,23.03,3503.18,99
CPT,75600,HC AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,2803.81,2102.86,33.65,2523.43,119
CPT,75605,Contrast exam thoracic aorta,,,51.9,6016.57,91
CPT,75605,HC THORACIC AORTOGRAM,16365.54,12274.16,196.39,14728.99,119
CPT,75625,Contrast exam abdominl aorta,,,44.26,3503.18,99
CPT,75625,HC ABDOMINAL AORTOGRAPHY,3965.45,2974.09,47.59,3568.9,119
CPT,75630,HC ABDOMEN AORTOGRAPHY RUNOFF,5946.92,4460.19,71.36,5352.23,119
CPT,75630,X-ray aorta leg arteries,,,60.54,3503.18,91
CPT,75635,Ct angio abdominal arteries,,,70.52,1151.0,120
CPT,75635,HC CTA ABD ILEO/FEMORAL RUNOFF W/WO CONTRAST,2565.1,1923.82,30.78,2308.59,119
CPT,75705,Artery x-rays spine,,,112.52,6016.57,91
CPT,75705,HC ANGIOGRAPHY SPINAL,4041.84,3031.38,48.5,3637.66,119
CPT,75710,Artery x-rays arm/leg,,,64.91,3503.18,99
CPT,75710,HC ANGIO EXTREMITY UNILATERAL,3680.03,2760.02,44.16,3312.03,119
CPT,75716,Artery x-rays arms/legs,,,67.42,3503.18,91
CPT,75716,HC ANGIO EXTREMITY BILATERAL,4155.49,3116.62,49.87,3739.94,119
CPT,75726,Artery x-rays abdomen,,,59.14,6016.57,99
CPT,75726,HC ANGIO VISCERAL SELECT,2062.84,1547.13,24.75,1856.56,119
CPT,75731,Artery x-rays adrenal gland,,,53.57,3503.18,91
CPT,75731,HC ANGIO ADRENAL UNILATERAL,3248.91,2436.68,38.99,2924.02,119
CPT,75733,Artery x-rays adrenals,,,59.69,3503.18,99
CPT,75733,HC ANGIO ADRENAL BILATERAL,7380.81,5535.61,88.57,6642.73,119
CPT,75736,Artery x-rays pelvis,,,51.29,6016.57,91
CPT,75736,HC ANGIO PELVIC SELECTIVE,3926.52,2944.89,47.12,3533.87,119
CPT,75741,Artery x-rays lung,,,59.25,3503.18,99
CPT,75741,HC ANGIO PULMONARY UNILATERAL,3782.97,2837.23,45.4,3404.67,119
CPT,75743,Artery x-rays lungs,,,68.05,3503.18,91
CPT,75743,HC ANGIO PULMONARY BILATERAL,4188.13,3141.1,50.26,3769.32,119
CPT,75746,Artery x-rays lung,,,51.96,3503.18,99
CPT,75746,HC ANGIO PULM VENOUS  NONSELECT,3493.95,2620.46,41.93,3144.56,119
CPT,75756,Artery x-rays chest,,,53.76,3503.18,91
CPT,75756,HC ANGIO INTERNAL MAMMARY,7603.99,5702.99,91.25,6843.59,119
CPT,75774,Artery x-ray each vessel,,,45.36,238.09,80
CPT,75774,HC ANGIO SELECTIVE VESSEL ADDL,2361.05,1770.79,28.33,2124.95,119
CPT,75801,Lymph vessel x-ray arm/leg,,,41.01,688.13,55
CPT,75803,Lymph vessel x-ray arms/legs,,,54.9,1728.99,63
CPT,75805,HC LYMPHANGIOGRAPHY PEL/ABD UNILATERAL,2474.75,1856.06,29.7,2227.28,119
CPT,75805,Lymph vessel x-ray trunk,,,38.03,3503.18,55
CPT,75807,HC LYMPHANGIOGRAPHY PEL/ABD BILATERAL,4273.01,3204.76,51.28,3845.71,119
CPT,75807,Lymph vessel x-ray trunk,,,51.72,3503.18,63
CPT,75809,HC SHUNTOGRAM NON VASCULAR,836.91,627.68,10.04,753.22,119
CPT,75809,Nonvascular shunt x-ray,,,22.75,118.36,91
CPT,75810,HC SPLENOPORTOGRAPHY,3037.07,2277.8,36.44,2733.36,119
CPT,75810,Vein x-ray spleen/liver,,,47.52,3503.18,63
CPT,75820,HC VENOGRAM EXTREMITY UNILATERAL,1850.05,1387.54,22.2,1665.04,119
CPT,75820,Vein x-ray arm/leg,,,48.28,1728.99,91
CPT,75822,HC VENOGRAM EXTREMITY BILATERAL,2392.83,1794.62,28.71,2153.55,119
CPT,75822,Vein x-ray arms/legs,,,61.48,1728.99,99
CPT,75825,HC INFERIOR VENACAVAGRAM,8007.17,6005.38,96.09,7206.45,119
CPT,75825,Vein x-ray trunk,,,51.84,3503.18,91
CPT,75827,HC SUPERIOR VENACAVAGRAM,2178.22,1633.66,26.14,1960.4,119
CPT,75827,Vein x-ray chest,,,52.46,1728.99,99
CPT,75831,HC VENOGRAM RENAL UNILATERAL,3839.16,2879.37,46.07,3455.24,119
CPT,75831,Vein x-ray kidney,,,50.98,3503.18,91
CPT,75833,HC VENOGRAM RENAL BILATERAL,3694.2,2770.65,44.33,3324.78,119
CPT,75833,Vein x-ray kidneys,,,63.73,3503.18,99
CPT,75840,HC VENOGRAM ADRENAL UNILATERAL,2692.26,2019.2,32.31,2423.03,119
CPT,75840,Vein x-ray adrenal gland,,,53.57,3503.18,91
CPT,75842,HCD VENOGRAM ADRENAL BILATERAL,2601.94,1951.46,31.22,2341.75,119
CPT,75842,Vein x-ray adrenal glands,,,70.1,6016.57,90
CPT,75860,HC SINUS/JUGULAR CATH VENOGRAM,1949.63,1462.22,23.4,1754.67,119
CPT,75860,Vein x-ray neck,,,52.55,3503.18,91
CPT,75870,HC SUPERIOR SAGITTAL SINUS VENOGRAM,2745.55,2059.16,32.95,2471.0,119
CPT,75870,Vein x-ray skull,,,57.4,3503.18,99
CPT,75872,Vein x-ray skull epidural,,,53.57,688.13,91
CPT,75880,Vein x-ray eye socket,,,33.05,688.13,99
CPT,75885,HC PORTOGRAPHY LIVER  W/HEMO EVAL,3519.44,2639.58,42.23,3167.5,119
CPT,75885,Vein x-ray liver w/hemodynam,,,63.65,3503.18,91
CPT,75887,HC PORTOGRAPHY W/O PRESSURE,3068.85,2301.64,36.83,2761.96,119
CPT,75887,Vein x-ray liver w/o hemodyn,,,64.59,3503.18,99
CPT,75889,HC VENOGRAPHY HEPATIC W/PRESSURE,3635.88,2726.91,43.63,3272.29,119
CPT,75889,Vein x-ray liver w/hemodynam,,,50.7,3503.18,99
CPT,75891,HC VENOGRAPHY HEPATIC WO /PRESSURE,2947.08,2210.31,35.36,2652.37,119
CPT,75891,Vein x-ray liver,,,51.04,3503.18,99
CPT,75893,HC VENOUS SAMPLING THROUGH CATH,1795.6,1346.7,21.55,1616.04,119
CPT,75893,Venous sampling by catheter,,,24.49,6016.57,99
CPT,75894,HC TRANSCATH EMBOLIZATION S&I,4622.68,3467.01,55.47,4160.41,119
CPT,75894,X-rays transcath therapy,,,68.64,733.75,44
CPT,75898,Follow-up angiography,,,87.2,3503.18,63
CPT,75898,HC ANGIO POST EMBOLIZATION,2062.84,1547.13,24.75,1856.56,119
CPT,75901,Remove cva device obstruct,,,22.17,739.92,80
CPT,75902,HC MECH REMV INTRALUM CV S&I,1112.65,834.49,13.35,1001.39,119
CPT,75902,Remove cva lumen obstruct,,,18.15,91.8,80
CPT,75956,HC TAA REPAIR COVERING LT SUB,1671.1,1253.32,20.05,1503.99,119
CPT,75956,Xray endovasc thor ao repr,,,321.74,15039.8,54
CPT,75957,Xray endovasc thor ao repr,,,3.66,15039.8,54
CPT,75958,Xray place prox ext thor ao,,,182.95,15039.8,54
CPT,75959,Xray place dist ext thor ao,,,160.25,15039.8,54
CPT,75970,HC TRANSCATHETER BIOPSY S&I,3369.1,2526.82,40.43,3032.19,119
CPT,75970,Vascular biopsy,,,37.1,503.32,44
CPT,75984,HC CHANGE CATHETER W/CONTRAST,1056.05,792.04,12.67,950.44,119
CPT,75984,Xray control catheter change,,,36.83,367.0,101
CPT,75989,Abscess drainage under x-ray,,,54.28,764.66,80
CPT,75989,HC GUIDANCE FOR PERCUTANEOUS DRAINAGE,1180.6,885.45,14.17,1062.54,119
CPT,76000,Fluoroscopy <1 hr phys/qhp,,,15.1,269.03,91
CPT,76000,HC FLUOROSCOPY UP TO 1 HR,739.55,554.66,8.87,665.6,119
CPT,76010,HC FOREIGN BODY XRAY PEDS,307.62,230.72,3.69,276.86,119
CPT,76010,X-ray nose to rectum,,,8.59,947.52,120
CPT,76014,Mr sfty implt&/fb asmt stf 1,,,23.47,29.28,19
CPT,76016,Mr safety deter phys/qhp,,,84.41,262.19,27
CPT,76017,Mr sfty med physics xm cstmz,,,84.55,269.03,27
CPT,76018,Mr safety implant elec prepj,,,88.0,337.56,27
CPT,76019,Mr safety implt pos&/immoblj,,,56.94,332.83,27
CPT,76080,HC ABSCESS FISTULA SINUS S/I,1108.34,831.26,13.3,997.51,119
CPT,76080,X-ray exam of fistula,,,24.49,610.26,91
CPT,76098,HC SPECIMEN RADIOGRAPHY EXAM,362.13,271.6,4.35,325.92,119
CPT,76098,X-ray exam surgical specimen,,,14.86,802.03,100
CPT,76100,X-ray exam of body section,,,27.73,118.36,99
CPT,76120,Cine/video x-rays,,,18.76,118.36,99
CPT,76125,Cine/video x-rays add-on,,,12.58,230.96,44
CPT,76140,X-ray consultation,,,279.49,279.49,1
CPT,76145,Med physic dos eval rad exps,,,377.83,855.61,55
CPT,76376,3d render w/intrp postproces,,,9.27,115.56,80
CPT,76376,HC 3-D RECONSTRUCT W/O WORKSTATION,830.01,622.51,9.96,747.01,119
CPT,76377,3d render w/intrp postproces,,,36.07,272.2,80
CPT,76377,HC 3-D RECONSTRUCT W/WORKSTATION,596.0,447.0,7.15,536.4,119
CPT,76380,Cat scan follow-up study,,,44.7,147.02,99
CPT,76390,HC MRI SPECTROSCOPY,1021.46,766.1,12.26,919.31,119
CPT,76390,Mr spectroscopy,,,84.41,749.0,48
CPT,76391,HC MRI ELASTOGRAPHY,1988.37,1491.28,23.86,1789.53,119
CPT,76391,Mr elastography,,,51.59,269.03,99
CPT,76496,HC SELECTIVE HEPATIC VEIN PRESSURES W/O VENOGRAPHY,2601.75,1951.31,31.22,2341.58,119
CPT,76496,HC XR GUB GASTRO CHALLENGE TUBE PLACEMENT,2601.75,1951.31,31.22,2341.58,119
CPT,76496,Unlisted fluoroscopic px,,,59.82,98.0,27
CPT,76497,Unlisted ct procedure,,,84.41,98.0,19
CPT,76498,HC MRI CAD (NON BREAST),5517.04,4137.78,66.2,4965.34,119
CPT,76498,HC MRI LYMPHANGIOGRAM,4572.71,3429.53,54.87,4115.44,119
CPT,76498,HC MRI WHOLE BODY LIMITED W/O CONTRAST,5974.95,4481.21,71.7,5377.46,119
CPT,76498,HC MRI WHOLE BODY LIMITED W/WO CONTRAST 1-4 AREAS,5974.95,4481.21,71.7,5377.46,119
CPT,76498,HC MRI WHOLE BODY WO CONTRAST,5974.95,4481.21,71.7,5377.46,119
CPT,76498,Unlisted mr procedure,,,84.41,98.0,19
CPT,76499,HC NERVE STIMULATOR PLACEMENT VERIFICATION,721.56,541.17,8.66,649.4,119
CPT,76499,HC UNLISTED DIAGNOSTIC RADIOGRAPHY PROCEDURE,577.25,432.94,6.93,519.52,119
CPT,76499,HC WHOLE BODY DXA,122.51,91.88,1.47,110.26,119
CPT,76499,Unlisted dx radiographic px,,,84.41,98.0,19
CPT,76506,Echo exam of head,,,29.74,131.16,99
CPT,76506,HC ECHOENCEPHALOGRAM SONO,945.62,709.22,11.35,851.06,119
CPT,76510,Oph us dx b-scan&quan a-scan,,,28.53,146.97,135
CPT,76511,Oph us dx quan a-scan only,,,20.38,150.44,135
CPT,76512,HC US OPTHALMC DIAG B SCAN UNILATERAL,267.88,200.91,3.21,241.09,119
CPT,76512,Oph us dx b-scan,,,16.61,118.36,135
CPT,76513,Oph us dx ant sgm us uni/bi,,,31.29,302.05,135
CPT,76514,Echo exam of eye thickness,,,3.43,214.36,99
CPT,76516,Echo exam of eye,,,21.69,118.36,99
CPT,76519,Echo exam of eye,,,29.26,265.16,135
CPT,76529,Echo exam of eye,,,30.91,98.0,135
CPT,76536,HC US HEAD/NECK SOFT TISSUE,822.34,616.76,9.87,740.11,119
CPT,76536,Us exam of head and neck,,,26.74,339.0,122
CPT,76604,HC US CHEST WALL LIMITED,709.46,532.1,8.51,638.51,119
CPT,76604,HC US CHEST/THORACIC,709.46,532.1,8.51,638.51,119
CPT,76604,Us exam chest,,,27.13,375.0,120
CPT,76641,HC US BREAST BILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS,2714.54,2035.9,32.57,2443.09,119
CPT,76641,HC US BREAST UNILATERAL COMPLETE INCL AXILLA - 4 QUADRANTS,1357.27,1017.95,16.29,1221.54,119
CPT,76641,Ultrasound breast complete,,,34.38,2361.11,136
CPT,76642,HC US BREAST BILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS,1566.95,1175.21,18.8,1410.26,119
CPT,76642,HC US BREAST UNILATERAL LIMITED INCL AXILLA - 1 OR MORE ELEMENTS,824.81,618.61,9.9,742.33,119
CPT,76642,Ultrasound breast limited,,,32.06,122.9,136
CPT,76700,HC ULTRASOUND ABDOMEN COMPLETE,1093.33,820.0,13.12,984.0,119
CPT,76700,Us exam abdom complete,,,37.72,339.0,122
CPT,76705,Echo exam of abdomen,,,27.76,339.0,120
CPT,76705,HC ULTRASOUND ABDOMEN LIMITED,842.95,632.21,10.12,758.66,119
CPT,76706,HC US ABDL AORTA SCREEN AAA,424.57,318.43,5.09,382.11,119
CPT,76706,Us abdl aorta screen aaa,,,25.77,118.36,91
CPT,76770,HC US RETROPERITONEAL COMPLETE,916.88,687.66,11.0,825.19,119
CPT,76770,Us exam abdo back wall comp,,,34.41,339.0,122
CPT,76775,HC US RETROPERITONEAL LIMITED,706.96,530.22,8.48,636.26,119
CPT,76775,Us exam abdo back wall lim,,,27.1,286.0,112
CPT,76776,HC US KIDNEY TRANSPLANT,890.29,667.72,10.68,801.26,119
CPT,76776,Us exam k transpl w/doppler,,,35.4,326.0,120
CPT,76800,HC US SPINE,1115.32,836.49,13.38,1003.79,119
CPT,76800,Us exam spinal canal,,,58.94,118.36,91
CPT,76801,"HC US, OB < 14 WKS, SINGLE FETUS",855.2,641.4,10.26,769.68,119
CPT,76801,Ob us < 14 wks single fetus,,,46.33,395.0,120
CPT,76802,HC OB US < 14 WKS ADDL FETUS,616.35,462.26,7.4,554.72,119
CPT,76802,Ob us < 14 wks addl fetus,,,20.08,39.34,72
CPT,76805,HC US PREG 2ND/3RD TRIMESTER,1005.63,754.22,12.07,905.07,119
CPT,76805,Ob us >/ 14 wks sngl fetus,,,46.65,356.0,120
CPT,76810,"HC US, OB >/= 14 WKS, ADDL FETUS",593.78,445.34,7.13,534.4,119
CPT,76810,Ob us >/ 14 wks addl fetus,,,39.2,46.31,72
CPT,76811,HC US OB COMPLETE SINGLE GESTATION,1337.41,1003.06,16.05,1203.67,119
CPT,76811,Ob us detailed sngl fetus,,,65.08,269.03,99
CPT,76812,HC US OB COMPLETE EACH ADDL GESTATION,532.88,399.66,6.39,479.59,119
CPT,76812,Ob us detailed addl fetus,,,83.14,101.63,72
CPT,76813,HC OB US NUCHAL MEAS 1 GEST,1402.55,1051.91,16.83,1262.3,119
CPT,76813,Ob us nuchal meas 1 gest,,,55.59,118.36,99
CPT,76814,HC OB US NUCHAL MEAS ADD-ON,568.94,426.7,6.83,512.05,119
CPT,76814,Ob us nuchal meas add-on,,,26.65,46.06,72
CPT,76815,HC ULTRASOUND OB LIMITED,470.82,353.12,5.65,423.74,119
CPT,76815,Ob us limited fetus(s),,,30.73,301.26,99
CPT,76816,HC US OB FOLLOW-UP EACH ADDL FETUS,701.36,526.02,8.42,631.22,119
CPT,76816,HC US OB FOLLOW-UP INITIAL FETUS,701.36,526.02,8.42,631.22,119
CPT,76816,Ob us follow-up per fetus,,,39.75,118.36,91
CPT,76817,HC TRANSVAGINAL ULTRASOUND PREGNANCY,730.43,547.82,8.77,657.39,119
CPT,76817,PBB US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,730.43,547.82,8.77,657.39,119
CPT,76817,Transvaginal us obstetric,,,35.37,339.0,122
CPT,76818,Fetal biophys profile w/nst,,,49.62,118.36,91
CPT,76818,HC BIOPHYSICAL PROFILE W/NST EACH ADDITIONAL,601.28,450.96,7.22,541.15,119
CPT,76818,HC BIOPHYSICAL PROFILE W/NST INITIAL,552.95,414.71,6.64,497.66,119
CPT,76819,Fetal biophys profil w/o nst,,,35.78,118.36,99
CPT,76819,HC BIOPHYSCIAL PROFILE W/O NST INITIAL,487.22,365.42,5.85,438.5,119
CPT,76819,HC BIOPHYSICAL PROFILE W/O NST ADDL,513.96,385.47,6.17,462.56,119
CPT,76820,HC UMBILICAL ARTERY ECHO,636.0,477.0,7.63,572.4,119
CPT,76820,HC UMBILICAL ARTERY ECHO ADDL FETUS,636.0,477.0,7.63,572.4,119
CPT,76820,Umbilical artery echo,,,20.06,118.36,91
CPT,76821,HC FETAL MIDL CEREBRAL ARTERY ECHO,689.73,517.3,8.28,620.76,119
CPT,76821,HC FETAL MIDL CEREBRAL ARTERY ECHO ADDL FETUS,689.73,517.3,8.28,620.76,119
CPT,76821,Middle cerebral artery echo,,,32.78,118.36,99
CPT,76825,Echo exam of fetal heart,,,77.53,610.26,91
CPT,76825,HC US FETAL ECHO W2ND (2D) ULTRASOUND,1207.44,905.58,14.49,1086.7,119
CPT,76826,Echo exam of fetal heart,,,38.44,269.03,99
CPT,76826,HC SONO FETAL HEART F/U,896.67,672.5,10.76,807.0,119
CPT,76827,Echo exam of fetal heart,,,27.14,118.36,91
CPT,76827,HC COMPL FETAL DOPPLER ECHOCARGIOGRAM,819.04,614.28,9.83,737.14,119
CPT,76828,Echo exam of fetal heart,,,21.63,321.47,99
CPT,76828,HC US FETAL DOPPR ECHOCARDGM LIMITED,896.67,672.5,10.76,807.0,119
CPT,76830,HC US TRANSVAGINAL NON-OB S&I,902.71,677.03,10.83,812.44,119
CPT,76830,Transvaginal us non-ob,,,32.71,339.0,122
CPT,76831,Echo exam uterus,,,33.77,411.92,99
CPT,76831,"HC SONO EXAM, HYSTEROSONOGRAPHY",1096.61,822.46,13.16,986.95,119
CPT,76856,HC US PELVIC NON-OB S&I,818.07,613.55,9.82,736.26,119
CPT,76856,Us exam pelvic complete,,,32.4,339.0,122
CPT,76857,"HC US EXAM, PELVIC, LIMITED",771.7,578.78,9.26,694.53,119
CPT,76857,Us exam pelvic limited,,,23.18,481.78,120
CPT,76870,HC US SCROTUM AND CONTENTS,765.36,574.02,9.18,688.82,119
CPT,76870,Us exam scrotum,,,30.08,307.0,112
CPT,76872,HC ULTRASOUND TRANSRECTAL,762.2,571.65,9.15,685.98,119
CPT,76872,Us transrectal,,,31.5,796.62,99
CPT,76873,Echograp trans r pros study,,,74.68,118.36,91
CPT,76873,HC US PROSTATE VOLUME STUDY FOR BRACHYTHERAPY LDR,935.32,701.49,11.22,841.79,119
CPT,76881,HC US COMP JOINT REALTIME W IMAGE,795.75,596.81,9.55,716.18,119
CPT,76881,Us compl joint r-t w/img,,,10.33,548.88,99
CPT,76882,HC US LIMITED JOINT OR NONVASC EXTREM BILATERAL,935.39,701.54,11.22,841.85,119
CPT,76882,HC US LIMITED JOINT OR NONVASC EXTREM UNILATERAL,467.69,350.77,5.61,420.92,119
CPT,76882,Us lmtd jt/fcl evl nvasc xtr,,,8.77,189.0,112
CPT,76883,Us nrv&acc strux 1xtr compre,,,13.79,647.93,99
CPT,76885,HC US HIP BILATERAL,817.75,613.31,9.81,735.98,119
CPT,76885,Us exam infant hips dynamic,,,34.72,98.0,91
CPT,76886,HC US INFANT HIPS W/O MANIPULATIN,44.0,33.0,0.53,39.6,119
CPT,76886,Us exam infant hips static,,,29.4,831.61,99
CPT,76932,Echo guide for heart biopsy,,,34.74,34.74,36
CPT,76932,HC US ENDOMYOCARDIAL BIOPSY,499.15,374.36,5.99,449.24,119
CPT,76936,Echo guide for artery repair,,,91.14,502.52,99
CPT,76936,HC US GUIDED COMPRESSION REPAIR,332.7,249.52,3.99,299.43,119
CPT,76937,HC US GUIDE VASCULAR ACCESS,347.17,260.38,4.17,312.45,119
CPT,76937,Us guide vascular access,,,13.85,23.85,72
CPT,76940,Us guide tissue ablation,,,97.03,768.63,44
CPT,76941,Echo guide for transfusion,,,62.9,62.9,36
CPT,76941,HC US FOR FETAL TRANSF/CORDOCENTESIS,914.24,685.68,10.97,822.82,119
CPT,76942,Echo guide for biopsy,,,26.34,945.14,81
CPT,76942,HC US GUIDED NEEDLE PLACEMENT,1304.95,978.71,15.66,1174.46,119
CPT,76945,Echo guide villus sampling,,,31.16,31.16,36
CPT,76945,HC US CHORINONIC VILLUS SAMPLE,499.64,374.73,6.0,449.68,119
CPT,76946,Echo guide for amniocentesis,,,13.79,829.73,80
CPT,76946,HC US GUIDANCE AMNIOCENTESIS,564.13,423.1,6.77,507.72,119
CPT,76948,Echo guide ova aspiration,,,31.16,46.11,72
CPT,76965,Echo guidance radiotherapy,,,25.4,72.96,80
CPT,76965,HC US GUIDANCE INTERSTITIAL RADIOELEMENT APPLICATION (NEEDLES),631.27,473.45500000000004,6.44,653.36,238
CPT,76975,Gi endoscopic ultrasound,,,39.92,269.03,55
CPT,76977,Us bone density measure,,,2.62,118.36,99
CPT,76978,HC IR TRGT DYNAMIC MICROBUBBLE; 1ST LESION,766.43,574.82,9.2,689.79,119
CPT,76978,Us trgt dyn mbubb 1st les,,,75.76,353.24,91
CPT,76979,Us trgt dyn mbubb ea addl,,,39.7,119.85,80
CPT,76981,HC US ELASTOGRAPHY; PARENCHYMA,1434.15,1075.61,17.21,1290.74,119
CPT,76981,Use parenchyma,,,28.07,118.36,91
CPT,76982,HC US ELASTOGRAPHY; 1ST TARGET LESION,898.03,673.52,10.78,808.23,119
CPT,76982,Use 1st target lesion,,,28.07,121.73,99
CPT,76983,Use ea addl target lesion,,,24.39,34.18,72
CPT,76984,Dx intraop thoracic aorta us,,,283.74,15039.8,27
CPT,76987,Dx intraop epicar car us chd,,,12954.18,15039.8,19
CPT,76988,Dx ntrop epcr us chd img acq,,,476.37,15039.8,27
CPT,76989,Dx intraop epcar us chd i&r,,,12954.18,15039.8,19
CPT,76998,HC ULTRASOUND INTRAOPERATIVE,1092.82,819.62,13.11,983.54,119
CPT,76998,Us guide intraop,,,59.39,638.69,44
CPT,76999,Echo examination procedure,,,84.41,98.0,19
CPT,76999,HC SPECIMEN BREAST TISSUE SURGICAL,471.85,353.89,5.66,424.66,119
CPT,76999,HC US BREAST SCREENING BILATERAL,471.85,353.89,5.66,424.66,119
CPT,76999,HC US GB EJECTION FRACTION CALC,392.12,294.09,4.71,352.91,119
CPT,76999,HC US LYMPH NODES,471.82,353.86,5.66,424.64,119
CPT,77001,Fluoroguide for vein device,,,17.5,78.11,72
CPT,77001,HC FLUORO FOR CVC PROCEDURE,1100.01,825.01,13.2,990.01,119
CPT,77002,HC FLUORO GUIDANCE FOR NEEDLE PLACEMENT,838.57,628.93,10.06,754.71,119
CPT,77002,Needle localization by xray,,,26.38,937.43,101
CPT,77003,Fluoroguide for spine inject,,,28.09,73.09,72
CPT,77003,HC FLUORO GUIDANCE SPINAL INJECT,1052.23,789.17,12.63,947.01,119
CPT,77011,Ct scan for localization,,,60.29,754.59,101
CPT,77011,HC CT STEREOTACTIC LOCALIZATION,3077.54,2308.16,36.93,2769.79,119
CPT,77012,Ct scan for needle biopsy,,,67.76,738.0,93
CPT,77012,HC CT GUIDE NEEDLE BX ASPRTN/INJECT,2248.54,1686.4,26.98,2023.69,119
CPT,77013,Ct guide for tissue ablation,,,178.94,456.78,44
CPT,77013,HC CT GUIDE  FOR TISSUE ABLATION (IE PARENCHYMAL),2132.32,1599.24,25.59,1919.09,119
CPT,77014,Ct scan for therapy guide,,,43.78,71.52,72
CPT,77014,HCD CT GUIDANCE/RAD THERAPY FIELDS,888.49,666.37,10.66,799.64,119
CPT,77021,HC MRI GUIDANCE BX/ASPRTN/INJECT,2620.03,1965.02,31.44,2358.03,119
CPT,77021,Mri guidance ndl plmt rs&i,,,69.2,745.01,80
CPT,77022,Mri gdn parnchyma tiss abltj,,,198.08,198.08,36
CPT,77046,HC MRI BREAST W/O; UNILATERAL,2243.01,1682.26,26.92,2018.71,119
CPT,77046,Mri breast c- unilateral,,,67.51,834.03,100
CPT,77047,HC MRI BREAST W/O; BILATERAL,4279.21,3209.41,51.35,3851.29,119
CPT,77047,Mri breast c- bilateral,,,74.76,269.03,92
CPT,77048,"HC MRI BREAST W & WO, UNILATERAL, INCL CAD",5030.56,3772.92,60.37,4527.5,119
CPT,77048,Mri breast c-+ w/cad uni,,,98.24,483.96,81
CPT,77049,"HC MRI BREAST W & WO, BILATERAL, INCL CAD",6735.05,5051.29,80.82,6061.54,119
CPT,77049,HC MRI BREAST WO/W FAST LTD BILAT SELECT HEALTH,6735.05,5051.29,80.82,6061.54,119
CPT,77049,HC MRI BREAST WO/W FAST LTD BILATERAL,6735.05,5051.29,80.82,6061.54,119
CPT,77049,Mri breast c-+ w/cad bi,,,107.5,333.49,73
CPT,77053,X-ray of mammary duct,,,16.86,744.5,100
CPT,77054,X-ray of mammary ducts,,,20.86,269.03,91
CPT,77061,Breast tomosynthesis uni,,,94.0,99.38,30
CPT,77061,HC DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,165.35,124.01,1.98,148.82,119
CPT,77062,Breast tomosynthesis bi,,,94.0,122.37,30
CPT,77062,HC BREAST TOMOSYNTHESIS BILATERAL,165.35,124.01,1.98,148.82,119
CPT,77063,Breast tomosynthesis bi,,,21.98,94.0,121
CPT,77063,HC BREAST TOMOSYNTHESIS SCREENING BILATERAL,231.7,173.78,2.78,208.53,119
CPT,77063,HC BREAST TOMOSYNTHESIS SCREENING UNILATERAL,115.85,86.89,1.39,104.26,119
CPT,77065,Dx mammo incl cad uni,,,37.72,339.0,121
CPT,77065,"HC DIAG MAMMO, UNILATERAL INCL CAD WHEN PERFORMED",763.67,572.75,9.16,687.3,119
CPT,77066,Dx mammo incl cad bi,,,46.36,339.0,121
CPT,77066,"HC DIAG MAMMO, BILATERAL INCL CAD WHEN PERFORMED",919.39,689.54,11.03,827.45,119
CPT,77067,"HC SCREEN MAMMO, BILATERAL INCL CAD WHEN PERFORMED",1336.04,1002.03,16.03,1202.44,119
CPT,77067,"HC SCREEN MAMMO, UNILATERAL INCL CAD WHEN PERFORMED",723.47,542.6,8.68,651.12,119
CPT,77067,Scr mammo bi incl cad,,,35.71,339.0,121
CPT,77071,Mnl appl strs jt radiography,,,52.35,98.0,55
CPT,77072,Bone age studies,,,4.26,174.0,120
CPT,77072,HC DI BONE AGE STUDY,332.84,249.63,3.99,299.56,119
CPT,77073,Bone length studies,,,12.85,312.0,112
CPT,77073,HC BONE LENGTH STUDY,655.16,491.37,7.86,589.64,119
CPT,77074,HC DI BONE SURVEY LIMITED,793.43,595.07,9.52,714.09,119
CPT,77074,Radex osseous survey lmtd,,,20.52,225.58,99
CPT,77075,HC DI BONE SURVEY COMPLETE,1285.13,963.85,15.42,1156.62,119
CPT,77075,Radex osseous survey compl,,,26.09,544.0,112
CPT,77076,HC DI BONE SURVEY INFANT,1284.04,963.03,15.41,1155.64,119
CPT,77076,Radex osseous survey infant,,,33.05,233.64,99
CPT,77077,HC DI JOINT SURVEY TWO OR >JOINTS,441.06,330.8,5.29,396.95,119
CPT,77077,Joint survey single view,,,16.16,118.36,91
CPT,77078,Ct bone density axial,,,11.59,262.98,99
CPT,77080,Dxa bone density axial,,,9.27,118.36,91
CPT,77080,HC DXA BONE DENSITY AXIAL 1+ SITES,607.61,455.71,7.29,546.85,119
CPT,77081,Dxa bone density appendiculr,,,9.58,294.79,99
CPT,77081,HC DXA BONE DENSITY/PERIPHERAL,504.26,378.2,6.05,453.83,119
CPT,77084,Mri bone marrow blood supply,,,75.08,269.03,91
CPT,77085,Dxa bone density axl vrt fx,,,14.22,286.1,99
CPT,77085,HC DEXA BONE DENSITY INCL VERT FX ASSESSMENT,625.31,468.98,7.5,562.78,119
CPT,77086,Vrt fracture assmt via dxa,,,7.94,293.95,99
CPT,77089,Tbs dxa cal w/i&r fx risk,,,38.41,38.41,36
CPT,77090,HC TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,234.5,175.88,2.81,211.05,119
CPT,77090,Tbs techl prep&transmis data,,,2.49,98.0,55
CPT,77091,HC TBS TECHNICAL CALCULATION ONLY,225.04,168.78,2.7,202.54,119
CPT,77091,Tbs techl calculation only,,,26.34,98.0,55
CPT,77092,Tbs i&r fx rsk qhp,,,9.58,9.58,36
CPT,77261,Ther radiology tx plng smpl,,,68.43,68.99,37
CPT,77262,Ther radiology tx plng intrm,,,104.76,105.45,37
CPT,77263,Ther radiology tx plng cplx,,,162.58,164.88,37
CPT,77280,HC SIMULATION SIMPLE,1638.62,1228.96,19.66,1474.76,119
CPT,77280,Ther rad simulaj field smpl,,,37.13,277.49,99
CPT,77285,Ther rad simulaj field intrm,,,55.58,407.44,99
CPT,77290,HC SIMULATION COMPLEX,2826.27,2119.7,33.92,2543.64,119
CPT,77290,Ther rad simulaj field cplx,,,80.65,407.44,99
CPT,77293,HC RESPIRATORY MOTION MANAGEMENT SIMULATION,1417.89,1063.42,17.01,1276.1,119
CPT,77293,Respirator motion mgmt simul,,,102.75,289.86,80
CPT,77295,3-d radiotherapy plan,,,102.89,1522.88,99
CPT,77295,HC RADIOTHERAPY 3-D PLAN,7025.24,5268.93,84.3,6322.72,119
CPT,77299,Unlisted px ther rad tx plng,,,127.28,147.78,19
CPT,77300,HC BASIC DOSIMETRY,564.57,423.43,6.77,508.11,119
CPT,77300,PBB BASIC RADIATION DOSIMETRY CALCULATION,564.57,423.43,6.77,508.11,119
CPT,77300,Radiation therapy dose plan,,,31.05,292.4,99
CPT,77301,HC IMRT DOSE PLAN,12859.86,9644.9,154.32,11573.87,119
CPT,77301,Radiotherapy dose plan imrt,,,203.38,1522.88,99
CPT,77306,HC TELE ISODOSE PLAN SIMPLE; INCLUDES BASIC DOSE CALC,1951.97,1463.98,23.42,1756.77,119
CPT,77306,Telethx isodose plan simple,,,69.62,845.2,99
CPT,77307,HC TELE ISODOSE PLAN COMPLEX; INCLUDES BASIC DOSE CALC,3256.92,2442.69,39.08,2931.23,119
CPT,77307,Telethx isodose plan cplx,,,125.75,474.77,99
CPT,77316,Brachytx isodose plan simple,,,72.11,1012.91,99
CPT,77316,HC BRACHYTX ISODOSE PLAN SIMPLE; INCLUDES BASIC DOSE CALC,2249.56,1687.17,26.99,2024.6,119
CPT,77317,Brachytx isodose intermed,,,94.17,427.73,99
CPT,77317,PBB BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2366.63,1774.97,28.4,2129.97,119
CPT,77318,Brachytx isodose complex,,,148.86,1137.37,99
CPT,77318,HC BRACHYTX ISODOSE PLAN COMPLEX; INCLUDES BASIC DOSE CALC,4143.33,3107.5,49.72,3729.0,119
CPT,77321,HC SPECIAL TELETHERAPY MEASURES,1481.88,1111.41,17.78,1333.69,119
CPT,77321,Special teletx port plan,,,41.09,407.44,99
CPT,77331,HC SPECIAL DOSIMETRY,575.07,431.3,6.9,517.56,119
CPT,77331,Special radiation dosimetry,,,17.87,1742.82,99
CPT,77332,HC SIMPLE TREATMENT DEVICE (SIMPLE BLOCK; SIMPLE BOLUS),659.15,494.36,7.91,593.24,119
CPT,77332,Radiation treatment aid(s),,,13.47,158.22,99
CPT,77333,"HC INTERMEDIATE TREATMENT DEVICE (STANDARD BLOCKS, STENTS, SP BOLUS, ADJ AIDS)",726.95,545.21,8.72,654.26,119
CPT,77333,Radiation treatment aid(s),,,38.83,367.26,99
CPT,77334,HC COMPLEX TREATMENT DEVICE (CUSTOM),1399.25,1049.44,16.79,1259.32,119
CPT,77334,Radiation treatment aid(s),,,58.97,407.44,99
CPT,77336,HC CONTINUING MEDICAL PHYSICS,596.02,447.02,7.15,536.42,119
CPT,77336,Radiation physics consult,,,80.79,147.78,55
CPT,77338,Design mlc device for imrt,,,220.63,522.78,99
CPT,77338,HC MULTI-LEAF COLLIMATOR MLC,7269.16,5451.87,87.23,6542.24,119
CPT,77370,HC SPECIAL PHYSICS CONSULT,978.2,733.65,11.74,880.38,119
CPT,77370,Radiation physics consult,,,127.28,147.78,55
CPT,77371,HC SRS RAD TX MULTISOURCE,75516.27,56637.2,906.2,67964.64,238
CPT,77371,Srs multisource,,,7328.47,8508.35,19
CPT,77372,HC LINEAR ACLRTR TX 1 SESSION,17713.81,13285.36,212.57,15942.43,119
CPT,77372,Srs linear based,,,907.73,8508.35,55
CPT,77373,HC LINEAR ACCELERATOR MAX 5 FRACTIONS; INCLUDES IMAGE GUIDANCE,5312.31,3984.23,63.75,4781.08,119
CPT,77373,Strtctc bdy rad ther tx dlvr,,,943.11,1954.33,55
CPT,77385,HCD IMRT TREATMENT SIMPLE; INCLUDES GUIDANCE AND TRACKING,2916.3,2187.22,35.0,2624.67,119
CPT,77385,Ntsty modul rad tx dlvr smpl,,,554.55,643.85,10
CPT,77386,HCD IMRT TREATMENT COMPLEX; INCLUDES GUIDANCE AND TRACKING,3253.31,2439.98,39.04,2927.98,119
CPT,77386,Ntsty modul rad tx dlvr cplx,,,554.55,643.85,10
CPT,77387,HC GUIDANCE FOR LOCALIZATION TARGET VOLUME IGRT,462.3,346.72,5.55,416.07,119
CPT,77399,Unlisted px med radj physics,,,127.28,147.78,19
CPT,77401,Radiation tx delivery supfc,,,38.58,121.87,46
CPT,77402,HC RADIATION TREATMENT DELIVERY LEVEL 1,376.57,282.43,4.52,338.91,119
CPT,77402,Radiation tx delivery lvl 1,,,103.31,121.87,19
CPT,77407,HC RADIATION TREATMENT DELIVERY LEVEL 2,325.53,244.15,3.91,292.98,119
CPT,77407,Radiation tx delivery lvl 2,,,252.11,390.53,19
CPT,77412,HC RADIATION TREATMENT DELIVERY LEVEL 3,1036.64,777.48,12.44,932.98,119
CPT,77412,Radiation tx delivery lvl 3,,,252.11,559.46,19
CPT,77417,HC THERAPEUTIC RADIOLOGY PORT FILMS,236.34,177.26,2.84,212.71,119
CPT,77417,Ther radiology port image(s),,,12.84,12.84,36
CPT,77423,Neutron beam tx complex,,,554.55,643.85,19
CPT,77424,Io rad tx delivery by x-ray,,,7328.47,8508.35,19
CPT,77425,Io rad tx deliver by elctrns,,,7328.47,8508.35,19
CPT,77427,Radiation tx management x5,,,184.52,186.46,37
CPT,77431,Radiation therapy management,,,104.03,104.35,37
CPT,77432,Stereotactic radiation trmt,,,411.09,415.26,37
CPT,77435,Sbrt management,,,626.92,626.92,36
CPT,77436,Surf radj ther tx planning,,,37.82,37.82,9
CPT,77437,Surf radj ther supfc<150kv,,,103.31,103.31,9
CPT,77438,Surf rad thr orthvlt>150-500,,,103.31,103.31,9
CPT,77469,Io radiation tx management,,,311.3,311.3,36
CPT,77470,HC SPECIAL TREATMENT PROCEDURE,1797.6,1348.2,21.57,1617.84,119
CPT,77470,Special radiation treatment,,,30.4,643.85,99
CPT,77520,Proton trmt simple w/o comp,,,554.55,643.85,19
CPT,77522,Proton trmt simple w/comp,,,1222.78,1419.65,19
CPT,77523,Proton trmt intermediate,,,1222.78,1419.65,19
CPT,77525,Proton treatment complex,,,1222.78,1419.65,19
CPT,77600,Hyperthermia ext gen supfc,,,69.37,634.24,99
CPT,77605,Hyperthermia ext gen deep,,,97.42,810.72,99
CPT,77610,Hyperthermia ntrstl prb 5/<,,,67.22,643.85,99
CPT,77615,Hyperthermia ntrstl prb>5,,,6.06,924.19,99
CPT,77620,Hyperthermia gen intrcv prb,,,81.03,2234.09,99
CPT,77750,Infuse radioactive materials,,,121.67,628.44,99
CPT,77761,Apply intrcav radiat simple,,,10.28,643.85,99
CPT,77761,HC INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1529.0,1146.75,18.35,1376.1,119
CPT,77762,Apply intrcav radiat interm,,,78.47,643.85,99
CPT,77762,HC INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,2355.73,1766.8,28.27,2120.16,119
CPT,77763,Apply intrcav radiat compl,,,301.0,772.21,99
CPT,77763,HC INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3262.26,2446.7,39.15,2936.03,119
CPT,77767,HC HDR SKIN SURFACE BRACHYTHERAPY 2 CM OR 1 CHANNEL,1302.48,976.86,15.63,1172.23,119
CPT,77767,Hdr rdncl skn surf brachytx,,,10.28,390.53,99
CPT,77768,HC HDR SKIN SURFACE BRACHYTHERAPY 3+ CM / 2+ CHANNEL,1686.69,1265.02,20.24,1518.02,119
CPT,77768,Hdr rdncl skn surf brachytx,,,72.11,1074.84,99
CPT,77770,HC HDR RADIONUCLIDE INTERSTITIAL/INTRACAV; 1 CHANNEL INCL BASIC CALC,4821.46,3616.1,57.86,4339.31,119
CPT,77770,Hdr rdncl ntrstl/icav brchtx,,,8.53,772.21,99
CPT,77771,HC HDR RADIONUCLIDE INTERSTITIAL/INTRAV; 2-12 CHANNELS INCL BASIC CALC,5007.23,3755.42,60.09,4506.51,119
CPT,77771,Hdr rdncl ntrstl/icav brchtx,,,195.89,810.64,99
CPT,77772,HC HDR RADIONUCLIDE INTERSTITIAL/INTRAV; >12 CHANNELS INCL BASIC CALC,6392.6,4794.45,76.71,5753.34,119
CPT,77772,Hdr rdncl ntrstl/icav brchtx,,,8.53,772.21,99
CPT,77778,Apply interstit radiat compl,,,425.47,772.21,91
CPT,77778,HC INTERSTITIAL RADIATION SOURCE APPLICATION; INCL LOAD/HANDLING,5293.22,3969.92,63.52,4763.9,119
CPT,77789,Apply surf ldr radionuclide,,,10.28,121.87,99
CPT,77789,HC SURFACE APPLICATION OF LOW DOSE RADIONUCLIDE SOURCE,611.56,458.67,7.34,550.4,119
CPT,77790,HC SUPERVISION/HANDLING-RADIOELEMENT NON-HDR,881.82,661.36,10.58,793.64,119
CPT,77790,Radiation handling,,,16.28,16.28,36
CPT,77799,PBB RADIUM/RADIOISOTOPE THERAPY UNLIST,1195.34,896.5,14.34,1075.81,119
CPT,77799,Unlisted px clin brachytx,,,103.31,121.87,19
CPT,78012,HC NM THYROID UPTAKE SINGL OR MULT MEASUREMENTS,870.23,652.67,10.44,783.21,119
CPT,78012,Thyroid uptake measurement,,,8.61,2279.38,99
CPT,78013,HC THYROID IMAGING W OR WO BLOOD FLOW,2038.38,1528.78,24.46,1834.54,119
CPT,78013,Thyroid imaging w/blood flow,,,17.2,447.24,99
CPT,78014,HC THYROID IMAGING W SNGL/MULT MEASUREMENTS,2940.62,2205.46,35.29,2646.56,119
CPT,78014,Thyroid imaging w/blood flow,,,22.86,447.24,99
CPT,78015,HC NM THYROID CANCER METS LIMITED,2278.82,1709.12,27.35,2050.94,119
CPT,78015,Thyroid met imaging,,,31.72,447.24,99
CPT,78016,Thyroid met imaging/studies,,,32.47,447.24,99
CPT,78018,HC NM THYROID WHOLE BODY,2789.82,2092.36,33.48,2510.84,119
CPT,78018,Thyroid met imaging body,,,38.47,599.1,99
CPT,78020,HC NM THYROID CANCER METS UPTAKE,535.79,401.84,6.43,482.21,119
CPT,78020,Thyroid met uptake,,,25.94,360.91,80
CPT,78070,HC NM PARATHYROID IMAGING,1873.81,1405.36,22.49,1686.43,119
CPT,78070,Parathyroid planar imaging,,,6.06,447.24,99
CPT,78071,HC PARATHYROID PLANAR IMAGING W SPECT,2342.32,1756.74,28.11,2108.09,119
CPT,78071,Parathyrd planar w/wo subtrj,,,54.98,447.24,99
CPT,78072,HC PARATHYROID PLANAR W SPECT AND CT,3584.68,2688.51,43.02,3226.21,119
CPT,78072,Parathyrd planar w/spect&ct,,,14.99,599.1,99
CPT,78075,Adrenal cortex & medulla img,,,34.72,1453.0,99
CPT,78099,Unlisted endocrine px dx nuc,,,385.22,447.24,19
CPT,78102,Bone marrow imaging ltd,,,24.56,474.51,99
CPT,78102,HC NM BONE MARROW IMAGING LIMITED,876.97,657.73,10.52,789.27,119
CPT,78103,Bone marrow imaging mult,,,29.47,447.24,99
CPT,78104,Bone marrow imaging body,,,36.44,447.24,99
CPT,78104,HC BONE MARROW IMAGING WHOLE BODY,1202.52,901.89,14.43,1082.27,119
CPT,78110,Plasma volume single,,,7.67,1453.0,99
CPT,78111,Plasma volume multiple,,,9.0,1453.0,99
CPT,78120,Red cell mass single,,,3.66,447.24,99
CPT,78121,Red cell mass multiple,,,12.71,599.1,99
CPT,78122,Whl bld volume determination,,,4.84,599.1,99
CPT,78130,Red cell survival study,,,24.1,447.24,99
CPT,78140,Red cell sequestration,,,24.1,447.24,99
CPT,78185,Spleen imaging,,,16.04,607.12,99
CPT,78191,Platelet survival study,,,4.26,447.24,99
CPT,78195,HC NM LYMPHATIC IMAGING,2225.58,1669.18,26.71,2003.02,119
CPT,78195,Lymph system imaging,,,54.66,891.26,99
CPT,78199,Unlstd hematop ret/endo lymp,,,385.22,447.24,19
CPT,78201,HC NM LIVER IMAGING STATIC,900.89,675.67,10.81,810.8,119
CPT,78201,Liver imaging static only,,,19.89,599.1,99
CPT,78202,Liver imaging with vasc flow,,,22.89,599.1,99
CPT,78215,HC NM LIVER/SPLEEN STATIC IMAGING,1019.82,764.86,12.24,917.84,119
CPT,78215,Lvr&spleen img static only,,,22.53,447.24,99
CPT,78216,HC NM LIVER AND SPLEEN WITH FLOW,5590.83,4193.12,67.09,5031.75,119
CPT,78216,Lvr&spleen img w/vasc flow,,,26.14,447.24,99
CPT,78226,HC HEPATOBILIARY IMAGING,2547.29,1910.47,30.57,2292.56,119
CPT,78226,Hepatobiliary system imaging,,,34.09,1010.74,99
CPT,78227,HC HEPATOBILIARY W PHARM /EF,2567.22,1925.42,30.81,2310.5,119
CPT,78227,Hepatobil syst image w/drug,,,41.4,599.1,99
CPT,78230,Salivary gland imaging,,,20.86,494.18,99
CPT,78231,Salivary glnd img serial img,,,20.74,447.24,99
CPT,78232,Salivary gland function std,,,18.73,447.24,99
CPT,78258,Esophageal motility,,,33.15,529.69,99
CPT,78261,Gastric mucosa imaging,,,27.13,447.24,91
CPT,78262,Gastroesophageal reflux std,,,4.84,447.24,99
CPT,78262,HC NM GASTRO REFLUX IMAGING,2133.02,1599.76,25.6,1919.72,119
CPT,78264,Gastric emptying img study,,,36.42,447.24,99
CPT,78264,HC NM GASTRIC EMPTYING IMAGING,2150.36,1612.77,25.8,1935.32,119
CPT,78265,Gstr emptg img sm bwl trnst,,,44.74,686.5,99
CPT,78266,Gstr empt img sm bwl&colon,,,47.81,599.1,99
CPT,78266,HC GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,534.93,401.2,6.42,481.44,119
CPT,78267,Urea breath tst c-14 acquisj,,,9.85,12.84,55
CPT,78268,Urea breath test c-14 alys,,,84.12,109.61,55
CPT,78278,Acute gi blood loss imaging,,,45.39,916.16,99
CPT,78278,HC NM GI BLEED IMAGING,2191.65,1643.74,26.3,1972.48,119
CPT,78282,Gi protein loss,,,15.05,515.24,63
CPT,78290,HC NM MECKELS BOWEL IMAGING,2430.09,1822.57,29.16,2187.08,119
CPT,78290,Intestine imaging,,,31.43,891.77,99
CPT,78291,Pertl-ven shunt patency test,,,41.03,505.02,99
CPT,78299,Unlisted gi px dx nuc med,,,385.22,447.24,19
CPT,78300,Bone imaging limited area,,,29.09,1037.95,99
CPT,78300,HC NM BONE IMAGING LIMITED AREA,2222.21,1666.66,26.67,1999.99,119
CPT,78305,Bone imaging multiple areas,,,38.4,599.41,99
CPT,78305,HC NM BONE IMAGING MULTIPLE AREAS,2720.33,2040.25,32.64,2448.3,119
CPT,78306,Bone imaging whole body,,,39.42,447.24,99
CPT,78306,HC NM BONE IMAGING WHOLE BODY,2472.01,1854.01,29.66,2224.81,119
CPT,78315,Bone imaging 3 phase,,,46.72,674.76,99
CPT,78315,HC NM BONE IMAGING 3 PHASE,2745.56,2059.17,32.95,2471.0,119
CPT,78350,Bone mineral single photon,,,70.48,247.92,9
CPT,78351,Bone mineral dual photon,,,19.87,19.87,1
CPT,78399,Unlisted muscskel px dx nuc,,,385.22,447.24,19
CPT,78414,Non-imaging heart function,,,20.56,599.1,63
CPT,78428,Cardiac shunt imaging,,,35.45,564.76,99
CPT,78429,"HC MYOCARDIAL IMAGING, PET W/CT SCAN",7668.55,5751.41,92.02,6901.7,119
CPT,78429,Myocrd img pet 1 std w/ct,,,77.72,1623.42,63
CPT,78430,HC NM MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,7929.11,5946.83,95.15,7136.2,119
CPT,78430,Myocrd img pet rst/strs w/ct,,,73.45,1623.42,63
CPT,78431,HC MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,11353.55,8515.16,136.24,10218.2,119
CPT,78431,Myocrd img pet rst&strs ct,,,85.91,2504.82,62
CPT,78432,Myocrd img pet 2rtracer,,,91.65,2059.61,62
CPT,78433,HC NJH MYOCARDIAL IMAGING PET/CT PERFUSION W/ MET EVAL,8577.47,6433.1,102.93,7719.72,119
CPT,78433,Myocrd img pet 2rtracer ct,,,99.98,2230.38,62
CPT,78434,Aqmbf pet rest & rx stress,,,28.52,2077.77,44
CPT,78434,HC POSITIVE FLOW RESERVE CARDIAC PET,169.32,126.99,2.03,152.39,119
CPT,78445,HC NM VASCULAR IMAGING FLOW STUDY,1868.39,1401.29,22.42,1681.55,119
CPT,78445,Vascular flow imaging,,,23.74,955.44,99
CPT,78451,HC HEART MUSCLE SPECT SINGLE,5165.43,3874.07,61.99,4648.89,119
CPT,78451,Ht muscle image spect sing,,,62.69,1453.0,99
CPT,78452,HC HEART MUSCLE SPECT MULT,5931.57,4448.68,71.18,5338.41,119
CPT,78452,Ht muscle image spect mult,,,74.23,1453.0,99
CPT,78453,Ht muscle image planar sing,,,45.41,1453.0,99
CPT,78454,Ht musc image planar mult,,,62.52,1453.0,99
CPT,78456,Acute venous thrombus image,,,45.73,1453.0,99
CPT,78457,Venous thrombosis imaging,,,35.22,599.1,99
CPT,78458,Ven thrombosis images bilat,,,42.03,447.24,99
CPT,78459,HC PET MYOCARDIAL VIABILITY,9203.93,6902.95,110.45,8283.54,119
CPT,78459,Myocrd img pet single study,,,71.11,1453.0,63
CPT,78466,Heart infarct image,,,32.4,1013.71,99
CPT,78468,Heart infarct image (ef),,,36.17,599.1,99
CPT,78469,HC MYOCARDIAL INFARCT SPECT,2331.7,1748.78,27.98,2098.53,119
CPT,78469,Heart infarct image (3d),,,42.08,627.88,99
CPT,78472,Gated heart planar single,,,44.74,447.24,99
CPT,78472,HC CARDIAC BLOOD POOL IMAGING W EF,2481.6,1861.2,29.78,2233.44,119
CPT,78473,Gated heart multiple,,,66.68,447.24,99
CPT,78481,Heart first pass single,,,45.05,599.1,99
CPT,78483,Heart first pass multiple,,,66.99,599.1,99
CPT,78491,HC PET CARDIAC PERFUSION  SINGLE,6833.41,5125.06,82.0,6150.07,119
CPT,78491,Myocrd img pet 1std rst/strs,,,69.1,1623.42,63
CPT,78492,HC PET CARDIAC PERFUSION MULTIPLE,6281.4,4711.05,75.38,5653.26,119
CPT,78492,Myocrd img pet mlt rst&strs,,,82.21,1623.42,63
CPT,78494,Heart image spect,,,54.36,447.24,99
CPT,78496,Heart first pass add-on,,,17.55,376.6,80
CPT,78499,Unlisted cv px dx nuc med,,,385.22,447.24,19
CPT,78579,HC PULMONARY VENTILATION,1187.3,890.48,14.25,1068.57,119
CPT,78579,Lung ventilation imaging,,,22.53,447.24,99
CPT,78580,HC PULMONARY PERFUSION PARTICULATE,1476.4,1107.3,17.72,1328.76,119
CPT,78580,Lung perfusion imaging,,,34.09,447.24,99
CPT,78582,HC PULMONARY VENT/PERFUSION IMAGING,2538.0,1903.5,30.46,2284.2,119
CPT,78582,Lung ventilat&perfus imaging,,,48.73,599.1,99
CPT,78597,HC PULMONARY PERF INCL DIFF COUNTS,1942.15,1456.61,23.31,1747.94,119
CPT,78597,Lung perfusion differential,,,33.49,447.24,99
CPT,78598,HC PULM PERF/VENT W DIFF COUNTS,2147.73,1610.8,25.77,1932.96,119
CPT,78598,Lung perf&ventilat diferentl,,,38.45,599.1,99
CPT,78599,Unlisted resp px dx nuc med,,,385.22,447.24,19
CPT,78600,Brain image < 4 views,,,20.2,447.24,99
CPT,78601,Brain image w/flow < 4 views,,,23.2,447.24,99
CPT,78605,Brain image 4+ views,,,25.09,599.1,99
CPT,78606,Brain image w/flow 4 + views,,,29.45,776.53,99
CPT,78606,HC BRAIN IMAGING WITH FLOW STUDY,1674.86,1256.14,20.1,1507.37,119
CPT,78608,Brain imaging (pet),,,67.65,1623.42,63
CPT,78608,HC PET BRAIN METABOLIC EVALUATION,11377.02,8532.76,136.52,10239.32,119
CPT,78609,Brain imaging (pet),,,109.96,1413.72,9
CPT,78609,HC PET BRAIN PERFUSION EVALUATION,9967.72,7475.79,119.61,8970.95,119
CPT,78610,Brain flow imaging only,,,13.91,599.1,99
CPT,78610,HC CEREBRAL VASCULAR FLOW ONLY,2309.8,1732.35,27.72,2078.82,119
CPT,78630,Cerebrospinal fluid scan,,,31.43,599.1,99
CPT,78630,HC CISTERNOGRAM,2339.99,1754.99,28.08,2105.99,119
CPT,78635,Csf ventriculography,,,28.75,599.1,99
CPT,78645,Csf shunt evaluation,,,25.55,599.1,99
CPT,78645,HC CEREBROSPINAL SHUNT EVALUATION,1480.15,1110.11,17.76,1332.14,119
CPT,78650,Csf leakage imaging,,,17.6,1453.0,99
CPT,78650,HC CISTERNOG CSF LEAK-NUC MED,1617.09,1212.82,19.41,1455.38,119
CPT,78660,Nuclear exam of tear flow,,,21.08,447.24,99
CPT,78699,Unlisted nrvs sys px dx nuc,,,385.22,447.24,19
CPT,78700,Kidney imaging morphol,,,17.6,447.24,99
CPT,78701,Kidney imaging with flow,,,22.84,447.24,99
CPT,78707,HC KIDNEY IMAGING W/O PHARM SINGLE W FLOW,2060.33,1545.25,24.72,1854.3,119
CPT,78707,K flow/funct image w/o drug,,,19.96,599.1,99
CPT,78708,HC KIDNEY IMAGING W/PHARM SINGLE W FLOW,2528.2,1896.15,30.34,2275.38,119
CPT,78708,K flow/funct image w/drug,,,54.73,599.1,99
CPT,78709,HC KIDNEY IMAG MULT W/WO PHARM W FLOW,2408.39,1806.29,28.9,2167.55,119
CPT,78709,K flow/funct image multiple,,,64.29,646.66,99
CPT,78725,HC KIDNEY FUNCTION STUDY NON-IMAGING,827.11,620.33,9.93,744.4,119
CPT,78725,Kidney function study,,,17.25,447.24,99
CPT,78730,Urinary bladder retention,,,6.97,1072.32,80
CPT,78740,HC URETERAL REFLUX STUDY VOIDING,1391.83,1043.87,16.7,1252.65,119
CPT,78740,Ureteral reflux study,,,25.55,447.24,99
CPT,78761,Testicular imaging w/flow,,,33.39,1065.65,99
CPT,78799,Unlisted gu px dx nuc med,,,385.22,447.24,19
CPT,78800,Rp loclzj tum 1 area 1 d img,,,29.76,447.24,98
CPT,78801,Rp loclzj tum 2+area 1+d img,,,33.44,977.06,98
CPT,78802,HC NM RP LOCLZJ TUM WHBDY 1 D IMG,1619.65,1214.74,19.44,1457.69,119
CPT,78802,Rp loclzj tum whbdy 1 d img,,,36.44,1453.0,99
CPT,78803,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT 1 AREA",3089.01,2316.76,37.07,2780.11,119
CPT,78803,Rp loclzj tum spect 1 area,,,49.09,1453.0,99
CPT,78804,HC NM RADIOPHARM LOCTZN WHOLE BODY S&I,3092.81,2319.61,37.11,2783.53,119
CPT,78804,Rp loclzj tum whbdy 2+d img,,,45.75,1453.0,99
CPT,78808,HC INJECT PROC RADIOPHARM LOCALIZTN NON-IMAGING,489.49,367.12,5.87,440.54,119
CPT,78808,Iv inj ra drug dx study,,,37.44,447.24,55
CPT,78811,Pet image ltd area,,,69.01,1453.0,63
CPT,78812,Pet image skull-thigh,,,88.42,1623.42,63
CPT,78813,Pet image full body,,,89.26,4488.38,63
CPT,78814,HC PET ATTEN LOC W/CT LIMITED,7562.97,5672.23,90.76,6806.67,119
CPT,78814,Pet image w/ct lmtd,,,100.39,1623.42,63
CPT,78815,HC PET CT SKULL TO MID THIGH,11515.53,8636.65,138.19,10363.98,119
CPT,78815,Pet image w/ct skull-thigh,,,111.33,1623.42,63
CPT,78816,HC PET IMAGE W/CT FULL BODY,13170.61,9877.96,158.05,11853.55,119
CPT,78816,Pet image w/ct full body,,,112.13,1623.42,63
CPT,78830,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT W/CT 1",3089.01,2316.76,37.07,2780.11,119
CPT,78830,Rp loclzj tum spect w/ct 1,,,66.37,1453.0,99
CPT,78831,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT 2 AREAS",2560.82,1920.62,30.73,2304.74,119
CPT,78831,Rp loclzj tum spect 2 areas,,,82.53,1453.0,99
CPT,78832,"HC NM RP LOCLZJ TUM, INFLAM OR DISTRIB OF RP SPECT W/CT 2",2982.68,2237.01,35.79,2684.41,119
CPT,78832,Rp loclzj tum spect w/ct 2,,,95.48,1623.42,99
CPT,78835,Rp quan meas single area,,,20.91,389.82,80
CPT,78999,Unlisted misc px dx nuc med,,,385.22,447.24,19
CPT,79005,HC NM RADIOACTIVE THYROID TX-ORAL ADMIN,3650.49,2737.87,43.81,3285.44,119
CPT,79005,Nuclear rx oral admin,,,47.97,793.02,99
CPT,79101,HC NM RADIOPHARMACEUTICAL TX FOR METS,1351.14,1013.36,16.21,1216.03,119
CPT,79101,Nuclear rx iv admin,,,50.17,309.47,99
CPT,79200,Nuclear rx intracav admin,,,49.54,1129.26,99
CPT,79300,Nuclr rx interstit colloid,,,62.96,399.76,63
CPT,79403,Hematopoietic nuclear tx,,,87.78,249.45,99
CPT,79440,Nuclear rx intra-articular,,,37.3,313.47,99
CPT,79445,HC INTRA-ARTERIAL PARTICULATE ADMIN,2869.25,2151.94,34.43,2582.33,119
CPT,79445,Nuclear rx intra-arterial,,,107.4,249.45,63
CPT,79999,Rp therapy unlisted px,,,214.86,249.45,19
CPT,80047,Basic metablc pnl ionized ca,,,12.23,20.6,66
CPT,80047,HC BASIC METAB PANEL CALC IONIZED,294.74,221.06,3.54,265.27,119
CPT,80047,HC BASIC METABOLIC CALCIUM IONIZ POC,294.74,221.06,3.54,265.27,119
CPT,80048,Basic metabolic pnl total ca,,,7.54,67.0,93
CPT,80048,HC BASIC METABOLIC PANEL,64.73,48.55,0.78,58.26,119
CPT,80050,General health panel,,,55.44,68.04,4
CPT,80050,HC GENERAL HEALTH PANEL,254.34,190.76,3.05,228.91,119
CPT,80051,Electrolyte panel,,,6.25,13.21,66
CPT,80051,HC ELECTROLYTE PANEL,56.67,42.5,0.68,51.0,119
CPT,80051,HC ELECTROLYTE PANEL POC,269.15,201.86,3.23,242.24,119
CPT,80053,Comprehen metabolic panel,,,9.41,95.0,93
CPT,80053,HC COMPREHENSIVE METABOLIC PANEL,95.82,71.86,1.15,86.24,119
CPT,80055,HC OBSTETRIC PANEL,322.4,241.8,3.87,290.16,119
CPT,80055,Obstetric panel,,,47.81,129.0,85
CPT,80061,HC LIPID PANEL,94.57,70.93,1.13,85.11,119
CPT,80061,Lipid panel,,,11.93,95.0,93
CPT,80069,HC RENAL FUNCTION PANEL,67.55,50.66,0.81,60.8,119
CPT,80069,Renal function panel,,,7.73,53.0,93
CPT,80074,Acute hepatitis panel,,,42.44,71.45,58
CPT,80074,HC HEPATITIS ACUTE PROFILE,342.74,257.06,4.11,308.47,119
CPT,80076,HC HEPATIC FUNCTION PANEL,62.89,47.17,0.75,56.6,119
CPT,80076,Hepatic function panel,,,7.28,55.0,85
CPT,80081,HC OBSTETRIC PANEL W HIV TESTING,562.19,421.64,6.75,505.97,119
CPT,80081,Obstetric panel inc hiv tstg,,,66.7,248.39,66
CPT,80143,Drug assay acetaminophen,,,16.61,27.96,58
CPT,80143,HC DRUG ASSAY ACETAMINOPHEN,78.71,59.03,0.94,70.84,119
CPT,80145,Drug assay adalimumab,,,34.37,57.86,58
CPT,80145,HC DRUG ASSAY ADALIMUMAB,424.97,318.73,5.1,382.47,119
CPT,80150,Assay of amikacin,,,13.44,50.03,66
CPT,80150,HC AMIKACIN,85.35,64.01,1.02,76.82,119
CPT,80151,Drug assay amiodarone,,,16.61,27.96,58
CPT,80151,HC DRUG ASSAY AMIODARONE,79.06,59.3,0.95,71.15,119
CPT,80155,Drug assay caffeine,,,34.37,57.86,58
CPT,80155,HC DRUG SCREEN QUANT CAFFEINE,184.93,138.7,2.22,166.44,119
CPT,80156,Assay carbamazepine total,,,12.98,21.86,58
CPT,80156,HC CARBAMAZEPINE TOTAL,102.45,76.84,1.23,92.2,119
CPT,80157,Assay carbamazepine free,,,11.81,19.88,58
CPT,80158,Drug assay cyclosporine,,,16.08,59.89,66
CPT,80158,HC CYCLOSPORIN,166.06,124.54,1.99,149.45,119
CPT,80159,Drug assay clozapine,,,17.95,30.23,58
CPT,80159,HC DRUG SCREEN QUANT CLOZAPINE,115.83,86.87,1.39,104.25,119
CPT,80161,Asy carbamazepin 1011-epxid,,,16.61,27.96,58
CPT,80161,"HC DRUG ASSAY CARBAMAZEPINE - 10,11 - EPOXIDE",186.66,140.0,2.24,167.99,119
CPT,80162,Assay of digoxin total,,,11.83,19.92,58
CPT,80162,HC DIGOXIN; TOTAL,93.78,70.33,1.13,84.4,119
CPT,80163,Assay of digoxin free,,,11.83,19.92,58
CPT,80164,Assay dipropylacetic acd tot,,,12.06,20.31,58
CPT,80164,HC VALPROIC ACID; TOTAL,95.62,71.72,1.15,86.06,119
CPT,80165,Dipropylacetic acid free,,,12.06,20.31,58
CPT,80165,"HC VALPROIC ACID, FREE",323.21,242.41,3.88,290.89,119
CPT,80167,Drug assay felbamate,,,16.61,27.96,58
CPT,80167,HC DRUG ASSAY FELBAMATE,81.69,61.27,0.98,73.52,119
CPT,80168,Assay of ethosuximide,,,14.56,24.51,58
CPT,80168,HC ETHOSUXIMIDE,75.55,56.66,0.91,68.0,119
CPT,80169,Drug assay everolimus,,,12.23,20.6,58
CPT,80169,HC DRUG SCREEN QUANT EVEROLIMUS,582.59,436.94,6.99,524.33,119
CPT,80170,Assay of gentamicin,,,14.59,24.57,58
CPT,80170,HC GENTAMICIN,114.65,85.99,1.38,103.18,119
CPT,80171,Drug screen quant gabapentin,,,19.31,71.9,66
CPT,80171,HC DRUG SCREEN QUANT GABAPENTIN,125.52,94.14,1.51,112.97,119
CPT,80173,Assay of haloperidol,,,14.06,23.67,58
CPT,80173,HC HALOPERIDOL,80.19,60.14,0.96,72.17,119
CPT,80175,Drug screen quan lamotrigine,,,11.81,19.88,58
CPT,80175,HC DRUG SCREEN QUAN LAMOTRIGINE,134.77,101.08,1.62,121.29,119
CPT,80176,Assay of lidocaine,,,13.09,48.74,66
CPT,80176,HC LIDOCAIN LEVEL,166.1,124.58,1.99,149.49,119
CPT,80177,Drug scrn quan levetiracetam,,,11.81,19.88,58
CPT,80177,HC DRUG SCRN QUAN LEVETIRACETAM,341.82,256.36,4.1,307.64,119
CPT,80178,Assay of lithium,,,5.89,17.65,66
CPT,80178,HC LITHIUM,77.48,58.11,0.93,69.73,119
CPT,80179,Drug assay salicylate,,,16.61,27.96,58
CPT,80179,HC DRUG ASSAY SALICYLATE,125.4,94.05,1.5,112.86,119
CPT,80180,Drug scrn quan mycophenolate,,,16.08,59.89,66
CPT,80180,HC DRUG SCRN QUAN MYCOPHENOLATE,187.84,140.88,2.25,169.06,119
CPT,80181,Drug assay flecainide,,,16.61,27.96,58
CPT,80181,HC DRUG ASSAY FLECAINIDE,127.03,95.27,1.52,114.33,119
CPT,80183,Drug scrn quant oxcarbazepin,,,11.81,19.88,58
CPT,80183,HC DRUG SCRN QUANT OXCARBAZEPIN,152.49,114.37,1.83,137.24,119
CPT,80184,Assay of phenobarbital,,,13.63,22.95,58
CPT,80184,HC PHENOBARBITAL,107.42,80.56,1.29,96.68,119
CPT,80185,Assay of phenytoin total,,,11.81,19.88,58
CPT,80185,HC PHENYTOIN TOTAL,83.56,62.67,1.0,75.2,119
CPT,80186,Assay of phenytoin free,,,12.26,20.64,58
CPT,80186,HC PHENYTOIN (DILANTIN) FREE,137.71,103.28,1.65,123.94,119
CPT,80187,Drug assay posaconazole,,,24.15,89.95,66
CPT,80187,HC POSACONAZOLE,162.99,122.24,1.96,146.69,119
CPT,80188,Assay of primidone,,,14.78,24.89,58
CPT,80188,HC PRIMIDONE,54.01,40.51,0.65,48.61,119
CPT,80189,Drug assay itraconazole,,,24.15,89.95,66
CPT,80189,HC DRUG ASSAY ITRACONAZOLE,120.84,90.63,1.45,108.76,119
CPT,80190,Assay of procainamide,,,53.46,90.0,58
CPT,80192,Assay of procainamide,,,14.92,25.13,58
CPT,80192,HC PROCAINAMIDE W/METABOLITES,116.67,87.5,1.4,105.0,119
CPT,80193,Drug assay leflunomide,,,34.37,57.86,58
CPT,80193,HC LEFLUNOMIDE,309.46,232.1,3.71,278.51,119
CPT,80194,Assay of quinidine,,,13.01,21.9,58
CPT,80194,HC QUINIDINE,95.36,71.52,1.14,85.82,119
CPT,80195,Assay of sirolimus,,,12.23,20.6,58
CPT,80195,HC SIROLIMUS,273.08,204.81,3.28,245.77,119
CPT,80197,Assay of tacrolimus,,,12.23,20.6,58
CPT,80197,HC TACROLIMUS,137.06,102.8,1.64,123.35,119
CPT,80198,Assay of theophylline,,,12.6,21.21,58
CPT,80198,HC THEOPHYLLINE,99.55,74.66,1.19,89.6,119
CPT,80199,Drug screen quant tiagabine,,,24.15,89.95,66
CPT,80200,Assay of tobramycin,,,14.37,24.2,58
CPT,80200,HC TOBRAMYCIN,112.92,84.69,1.36,101.63,119
CPT,80201,Assay of topiramate,,,10.62,17.88,58
CPT,80201,HC TOPIRAMATE LEVEL-RL,241.02,180.76,2.89,216.92,119
CPT,80202,Assay of vancomycin,,,12.06,20.31,58
CPT,80202,HC VANCOMYCIN,95.62,71.72,1.15,86.06,119
CPT,80203,Drug screen quant zonisamide,,,11.81,19.88,58
CPT,80203,HC DRUG SCREEN QUANT ZONISAMIDE,343.96,257.97,4.13,309.56,119
CPT,80204,Drug assay methotrexate,,,34.37,57.86,58
CPT,80204,HC DRUG ASSAY  METHOTREXATE,273.76,205.32,3.29,246.38,119
CPT,80210,Drug assay rufinamide,,,24.15,89.95,66
CPT,80220,Drug asy hydroxychloroquine,,,16.61,27.96,58
CPT,80230,Drug assay infliximab,,,34.37,57.86,58
CPT,80230,HC DRUG ASSAY INFLIXIMAB,737.26,552.95,8.85,663.53,119
CPT,80235,Drug assay lacosamide,,,24.15,89.95,66
CPT,80235,HC LACOSAMIDE,391.57,293.68,4.7,352.41,119
CPT,80280,Drug assay vedolizumab,,,34.37,57.86,58
CPT,80280,HC DRUG ASSAY VEDLIZUMAB,402.4,301.8,4.83,362.16,119
CPT,80285,Drug assay voriconazole,,,24.15,89.95,66
CPT,80285,HC VORICONAZOLE,73.41,55.06,0.88,66.07,119
CPT,80299,HC CORTISOL DEXAMETHASONE SUPPRESSION TEST,187.33,140.5,2.25,168.6,119
CPT,80299,HC PREDNISOLONE,1506.44,1129.83,18.08,1355.8,119
CPT,80299,"HC QUANTITATION OF DRUG, NES",444.18,333.14,5.33,399.76,119
CPT,80299,HC THIOPURINE METABOLITES,342.99,257.24,4.12,308.69,119
CPT,80299,"HC VORICONAZOLE, SERUM",445.3,333.98,5.34,400.77,119
CPT,80299,Quantitative assay drug,,,16.61,27.96,58
CPT,80305,Drug test prsmv dir opt obs,,,11.23,18.9,66
CPT,80306,Drug test prsmv instrmnt,,,15.27,25.71,58
CPT,80306,"HC DRUG SCREEN PRESMPTV,ANY NO. INSTR ASSIST DIR OPT",684.02,513.02,8.21,615.62,119
CPT,80307,Drug test prsmv chem anlyzr,,,55.37,206.18,66
CPT,80307,HC COM CON UMBILICAL CORD TISSUE DOA,1280.89,960.67,15.37,1152.8,119
CPT,80307,"HC DRUG SCREEN PRESMPTV,ANY NO. BY INSTR CHEM ANAL",637.3,477.98,7.65,573.57,119
CPT,80307,HC PAIN MANAGEMENT PANEL W/REFLEX TO QUANTITATION,199.56,149.67,2.39,179.6,119
CPT,80320,HC DRUG SCREEN QUANT ALCOHOLS,65.73,49.3,0.79,59.16,119
CPT,80321,HC ALCOHOL BIOMARKERS; 1 OR 2,155.26,116.44,1.86,139.73,119
CPT,80323,HC ASSAY OF NICOTINE (ALKALOIDS NOS),436.97,327.73,5.24,393.27,119
CPT,80324,HC AMPHETAMINES; 1 OR 2,1188.08,891.06,14.26,1069.27,119
CPT,80325,HC AMPHETAMINES 3 OR 4,32.01,24.01,0.38,28.81,119
CPT,80326,HC AMPHETAMINES; 5 OR MORE,225.47,169.1,2.71,202.92,119
CPT,80328,HC ANABOLIC STEROID 3 OR MORE,640.33,480.25,7.68,576.3,119
CPT,80329,"HC ANALGESICS, NON-OPIOD; 1 OR 2",103.94,77.96,1.25,93.55,119
CPT,80331,HC ANALGESICS NON-OPIOID 6/MORE,168.74,126.56,2.02,151.87,119
CPT,80332,HC ANTIDEPRESSANTS CLASS 1 OR 2; QUAL,143.51,107.63,1.72,129.16,119
CPT,80335,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS; 1 OR 2,234.0,175.5,2.81,210.6,119
CPT,80337,HC ANTIDEPRESSANT TRICYCLIC AND OTHER CYCLICALS; 6 OR MORE,75.3,56.48,0.9,67.77,119
CPT,80338,HC ANTIDEPRESSANT NOT SPECIFIED; NON CHROMO,327.94,245.96,3.94,295.15,119
CPT,80338,HC TRAZADONE,49.28,36.96,0.59,44.35,119
CPT,80339,"HC ANTIEPILEPTICS, NOS  1-3",204.37,153.28,2.45,183.93,119
CPT,80342,HC ANTIPSYCHOTICS NOS 1-3,333.38,250.04,4.0,300.04,119
CPT,80345,HC BARBITURATES,224.81,168.61,2.7,202.33,119
CPT,80346,HC BENZODIAZEPINES; 1-12,503.68,377.76,6.04,453.31,119
CPT,80347,HC BENZODIAZEPINES;  13 OR MORE,226.01,169.51,2.71,203.41,119
CPT,80348,HC DRUG SCREENING BUPRENORPHINE,225.47,169.1,2.71,202.92,119
CPT,80349,"HC CANNABINOIDS, NATURAL",225.47,169.1,2.71,202.92,119
CPT,80352,HC CANNABINOID SYNTHETIC 7/MORE,567.96,425.97,6.82,511.16,119
CPT,80353,HC COCAINE,225.22,168.92,2.7,202.7,119
CPT,80354,HC DRUG SCREENING FENTANYL,224.87,168.65,2.7,202.38,119
CPT,80355,HC GABAPENTIN NON-BLOOD,48.44,36.33,0.58,43.6,119
CPT,80356,HC DRUG SCREENING HEROIN METABOLITE,309.82,232.36,3.72,278.84,119
CPT,80357,HC KETAMINE AND NORKETAMINE,715.45,536.59,8.59,643.91,119
CPT,80358,HC METHADONE,226.93,170.2,2.72,204.24,119
CPT,80359,HC DRUG SCREENING METHYLENEDIOXYAMPHETAMINES,309.82,232.36,3.72,278.84,119
CPT,80360,HC  DRUG SCREENING METHYLPHENIDATE,309.82,232.36,3.72,278.84,119
CPT,80361,"HC OPIATES, 1 OR MORE",226.01,169.51,2.71,203.41,119
CPT,80362,HC OPIOIDS AND OPIATE ANALOGS; 1 OR 2,273.47,205.1,3.28,246.12,119
CPT,80364,HC OPIOIDS AND OPIATE ANALOGS; 5 OR MORE,48.44,36.33,0.58,43.6,119
CPT,80365,HC DRUG SCREENING OXYCODONE,232.74,174.56,2.79,209.47,119
CPT,80366,HC DRUG SCREENING PREGABALIN,1474.84,1106.13,17.7,1327.36,119
CPT,80368,HC SEDATIVE HYPNOTICS (NON-BENZODIAZEPINES),309.82,232.36,3.72,278.84,119
CPT,80372,HC DRUG SCREENING TAPENTADOL,309.82,232.36,3.72,278.84,119
CPT,80373,HC DRUG SCREENING TRAMADOL,85.55,64.16,1.03,77.0,119
CPT,80375,HC DRUG/SUBSTANCE NOS 1-3;QUAL,2195.91,1646.93,26.35,1976.32,119
CPT,80377,"HC DEFINITIVE DRUG OR SUBSTANCE, QUAL OR QUAN; NOS",521.37,391.03,6.26,469.23,119
CPT,80400,Acth stimulation panel,,,29.06,48.93,58
CPT,80400,HC ACTH STIM ADRENAL INSUFF,242.55,181.91,2.91,218.3,119
CPT,80402,Acth stimulation panel,,,77.48,130.44,58
CPT,80406,Acth stimulation panel,,,69.73,259.67,66
CPT,80408,Aldosterone suppression eval,,,111.82,188.25,58
CPT,80410,Calcitonin stimul panel,,,71.61,266.67,66
CPT,80412,Crh stimulation panel,,,714.24,2659.78,66
CPT,80414,Testosterone response panel,,,46.01,77.46,58
CPT,80415,Tot estradiol response panel,,,49.8,83.84,58
CPT,80416,Renin stimulation panel,,,186.5,694.52,66
CPT,80417,Renin stimulation panel,,,39.2,145.96,66
CPT,80418,Pituitary evaluation panel,,,516.32,1922.72,66
CPT,80420,Dexamethasone panel,,,144.23,537.12,66
CPT,80422,Glucagon tolerance panel,,,41.05,69.11,58
CPT,80424,Glucagon tolerance panel,,,45.0,167.56,66
CPT,80426,Gonadotropin hormone panel,,,132.23,492.43,66
CPT,80428,Growth hormone panel,,,59.43,221.31,66
CPT,80430,Growth hormone panel,,,115.23,194.0,58
CPT,80432,Insulin suppression panel,,,147.56,549.5,66
CPT,80434,Insulin tolerance panel,,,253.96,945.72,66
CPT,80435,Insulin tolerance panel,,,91.77,154.5,58
CPT,80436,Metyrapone panel,,,81.22,136.74,58
CPT,80438,Trh stimulation panel,,,44.92,167.27,66
CPT,80439,Trh stimulation panel,,,59.88,223.0,66
CPT,80503,HC PATH CLIN CONSLT J SF 5-20,294.91,221.18,3.54,265.42,119
CPT,80503,Path clin consltj sf 5-20,,,21.43,76.13,58
CPT,80504,Path clin consltj mod 21-40,,,46.13,228.48,66
CPT,80505,Path clin consltj high 41-60,,,87.55,228.48,58
CPT,80506,Path clin consltj prolng svc,,,41.78,64.89,39
CPT,81000,Urinalysis nonauto w/scope,,,3.58,52.0,85
CPT,81001,HC URINALYSIS W/MICROSCOPY,43.67,32.75,0.52,39.3,119
CPT,81001,Urinalysis auto w/scope,,,2.82,52.0,85
CPT,81002,HC N-AUTOM URINALYS WO MICRO,27.95,20.96,0.34,25.16,119
CPT,81002,Urinalysis nonauto w/o scope,,,3.1,52.0,85
CPT,81003,HC URINALYSIS W/O MICRO AUTOMATED,19.68,14.76,0.24,17.71,119
CPT,81003,HC URINALYSIS W/O MICRO AUTOMATED POCL/POCBS,61.8,46.35,0.74,55.62,119
CPT,81003,Urinalysis auto w/o scope,,,2.0,52.0,93
CPT,81005,Urinalysis,,,1.93,7.2,66
CPT,81007,Urine screen for bacteria,,,26.71,44.97,66
CPT,81015,HC URINALYSIS MICROSCOPY ONLY,33.97,25.48,0.41,30.57,119
CPT,81015,Microscopic exam of urine,,,2.72,4.58,58
CPT,81020,Urinalysis glass test,,,4.19,7.05,58
CPT,81025,HC PREGNANCY TEST URINE,77.74,58.3,0.93,69.97,119
CPT,81025,HC PREGNANCY TEST URINE POC,41.35,31.01,0.5,37.22,119
CPT,81025,Urine pregnancy test,,,7.67,12.92,58
CPT,81050,HC TIMED URINE VOLUME MEASUREMENT,12.56,9.42,0.15,11.3,119
CPT,81050,Urinalysis volume measure,,,3.24,5.46,58
CPT,81099,Unlisted urinalysis px,,,0.5,0.5,3
CPT,81105,Hpa-1 genotyping,,,122.22,183.33,57
CPT,81106,Hpa-2 genotyping,,,122.22,183.33,57
CPT,81107,Hpa-3 genotyping,,,122.22,183.33,57
CPT,81108,Hpa-4 genotyping,,,122.22,183.33,57
CPT,81109,Hpa-5 genotyping,,,122.22,183.33,57
CPT,81110,Hpa-6 genotyping,,,122.22,183.33,57
CPT,81111,Hpa-9 genotyping,,,122.22,183.33,57
CPT,81112,Hpa-15 genotyping,,,122.22,183.33,57
CPT,81120,HC IDH1 COMMON VARIANTS,639.89,479.92,7.68,575.9,119
CPT,81120,Idh1 common variants,,,193.25,641.2,65
CPT,81121,HC IDH2 COMMON VARIANTS,979.41,734.56,11.75,881.47,119
CPT,81121,Idh2 common variants,,,295.79,981.44,65
CPT,81161,Dmd dup/delet analysis,,,279.0,925.72,65
CPT,81162,Brca1&2 gen full seq dup/del,,,1625.97,6054.95,66
CPT,81162,HC BRCA1/BRCA2 GENE ANALYSIS; FULL SEQUENCE DUP/DEL,2908.07,2181.05,34.9,2617.26,119
CPT,81163,Brca1&2 gene full seq alys,,,468.0,1552.82,65
CPT,81164,Brca1&2 gen ful dup/del alys,,,584.23,1938.48,65
CPT,81165,Brca1 gene full seq alys,,,282.88,938.6,65
CPT,81166,Brca1 gene full dup/del alys,,,301.35,999.88,65
CPT,81167,Brca2 gene full dup/del alys,,,282.88,938.6,65
CPT,81168,Ccnd1/igh translocation alys,,,207.31,687.86,65
CPT,81170,Abl1 gene,,,300.0,995.4,65
CPT,81170,HC ABL1 GENE,2419.61,1814.71,29.04,2177.65,119
CPT,81171,Aff2 gen aly detc abnl allel,,,137.0,454.57,65
CPT,81172,Aff2 gen alys charac alleles,,,274.83,911.88,65
CPT,81173,Ar gene full gene sequence,,,301.35,999.88,65
CPT,81174,Ar gene known famil variant,,,185.2,614.49,65
CPT,81175,Asxl1 full gene sequence,,,676.5,2244.63,65
CPT,81176,Asxl1 gene target seq alys,,,241.9,802.62,65
CPT,81177,Atn1 gene detc abnor alleles,,,137.0,454.57,65
CPT,81178,Atxn1 gene detc abnor allele,,,137.0,454.57,65
CPT,81179,Atxn2 gene detc abnor allele,,,137.0,454.57,65
CPT,81180,Atxn3 gene detc abnor allele,,,137.0,454.57,65
CPT,81181,Atxn7 gene detc abnor allele,,,137.0,454.57,65
CPT,81182,Atxn8os gen detc abnor allel,,,137.0,454.57,65
CPT,81183,Atxn10 gene detc abnor allel,,,137.0,454.57,65
CPT,81184,Cacna1a gen detc abnor allel,,,137.0,454.57,65
CPT,81185,Cacna1a gene full gene seq,,,846.27,2807.92,65
CPT,81186,Cacna1a gen known famil vrnt,,,185.2,614.49,65
CPT,81187,Cnbp gene detc abnor allele,,,137.0,454.57,65
CPT,81188,Cstb gene detc abnor allele,,,137.0,454.57,65
CPT,81189,Cstb gene full gene sequence,,,274.83,911.88,65
CPT,81190,Cstb gene known famil vrnt,,,185.2,614.49,65
CPT,81191,Ntrk1 translocation analysis,,,207.31,687.86,65
CPT,81192,Ntrk2 translocation analysis,,,207.31,687.86,65
CPT,81193,Ntrk3 translocation analysis,,,207.31,687.86,65
CPT,81194,Ntrk translocation analysis,,,518.28,1719.65,65
CPT,81195,Cytog genom-wid alys hem mal,,,1263.53,4192.39,29
CPT,81200,Aspa gene,,,47.25,70.88,57
CPT,81201,Apc gene full sequence,,,780.0,2588.04,65
CPT,81201,HC APC GENE FULL SEQUENCE,2653.82,1990.36,31.85,2388.44,119
CPT,81202,Apc gene known fam variants,,,280.0,929.04,65
CPT,81203,Apc gene dup/delet variants,,,200.0,663.6,65
CPT,81204,Ar gene charac alleles,,,137.0,454.57,65
CPT,81205,Bckdhb gene,,,94.99,142.49,57
CPT,81206,Bcr/abl1 gene major bp,,,163.96,544.02,65
CPT,81206,HC ARUP  BCR/ABL1 GENE MAJOR TYRONSINE KINASE INHIBITOR,577.92,433.44,6.94,520.13,119
CPT,81206,HC BCR/ABL1 GENE MAJOR BP QUALITATIVE,443.92,332.94,5.33,399.53,119
CPT,81206,HC COM CON P210 BCR ABL1 (REFLEX),567.16,425.37,6.81,510.44,119
CPT,81206,HC SPHZ BCR/ABL1 GENE MAJOR BP,407.51,305.63,4.89,366.76,119
CPT,81207,Bcr/abl1 gene minor bp,,,144.84,480.57,65
CPT,81207,HC BCR/ALB1 GENE MINOR BP,510.06,382.54,6.12,459.05,119
CPT,81208,Bcr/abl1 gene other bp,,,214.62,712.11,65
CPT,81208,"HC BCR/ALB1 OTR BREAKPOINT, QUAL OR QUAN",109.35,82.01,1.31,98.42,119
CPT,81209,Blm gene,,,39.31,58.97,57
CPT,81210,Braf gene,,,175.4,581.97,65
CPT,81210,HC ARUP BRAF CODON 600 MUTATION DECTECTION W REFLEX TO MLH 1,2732.21,2049.16,32.79,2458.99,119
CPT,81210,HC SPHZ BRAF GENE,1321.93,991.45,15.86,1189.74,119
CPT,81212,Brca1&2 185&5385&6174 vrnt,,,440.0,1459.92,65
CPT,81215,Brca1 gene known famil vrnt,,,375.25,1245.08,65
CPT,81216,Brca2 gene full seq alys,,,185.12,614.23,65
CPT,81217,Brca2 gene known famil vrnt,,,375.25,1245.08,65
CPT,81218,Cebpa gene full sequence,,,241.9,802.62,65
CPT,81219,Calr gene com variants,,,121.63,182.45,57
CPT,81219,"HC CALR MUTATION ANALY, MPN",950.67,713.0,11.41,855.6,119
CPT,81220,Cftr gene com variants,,,495.93,1846.8,66
CPT,81220,HC CFTR GENE COM VARIANTS,721.7,541.28,8.66,649.53,119
CPT,81221,Cftr gene known fam variants,,,86.62,145.83,58
CPT,81222,Cftr gene dup/delet variants,,,387.65,1443.56,66
CPT,81222,HC CFTR GENE DUP/DELET VARIANTS,1878.79,1409.09,22.55,1690.91,119
CPT,81223,Cftr gene full sequence,,,499.0,1834.06,66
CPT,81223,HC CFTR GENE DUP/DELET SEQUENCE,2008.0,1506.0,24.1,1807.2,119
CPT,81224,Cftr gene intron poly t,,,150.36,559.91,66
CPT,81225,Cyp2c19 gene com variants,,,291.36,966.74,65
CPT,81225,HC CYP2C19 GENE COM VARIANTS,575.24,431.43,6.9,517.72,119
CPT,81226,Cyp2d6 gene com variants,,,450.91,1496.12,65
CPT,81226,HC CYP2D6 GENE COM VARIANTS,963.61,722.71,11.56,867.25,119
CPT,81227,Cyp2c9 gene com variants,,,174.81,580.02,65
CPT,81228,Cytog alys chrml abnr cgh,,,900.0,2986.2,65
CPT,81229,Cytog alys chrml abnr snpcgh,,,1160.0,3848.88,65
CPT,81229,HC CYTOGEN M ARRAY COPY NO&SNP,7255.23,5441.42,87.06,6529.71,119
CPT,81230,Cyp3a4 gene common variants,,,174.81,580.02,65
CPT,81231,Cyp3a5 gene common variants,,,174.81,580.02,65
CPT,81232,Dpyd gene common variants,,,174.81,580.02,65
CPT,81232,HC DPYD GENE COMMON VARIANTS,492.22,369.16,5.91,443.0,119
CPT,81233,Btk gene common variants,,,175.4,581.97,65
CPT,81234,Dmpk gene detc abnor allele,,,137.0,454.57,65
CPT,81235,Egfr gene com variants,,,324.58,1076.95,65
CPT,81235,HC SPHZ EGFR GENE COM VARIANTS,2568.02,1926.02,30.82,2311.22,119
CPT,81236,Ezh2 gene full gene sequence,,,282.88,938.6,65
CPT,81237,Ezh2 gene common variants,,,175.4,581.97,65
CPT,81238,F9 full gene sequence,,,600.0,1990.8,65
CPT,81239,Dmpk gene charac alleles,,,274.83,911.88,65
CPT,81240,F2 gene,,,58.53,217.96,66
CPT,81240,HC  F2 GENE ANALYSIS,643.9,482.92,7.73,579.51,119
CPT,81241,F5 gene,,,65.37,243.44,66
CPT,81241,"HC  F5 GENE ANALYSIS, LEIDEN VARIANT",638.72,479.04,7.66,574.85,119
CPT,81242,Fancc gene,,,36.62,121.51,65
CPT,81243,Fmr1 gen aly detc abnl allel,,,57.04,85.56,57
CPT,81243,HC FMR1 GENE DETECTION,284.29,213.22,3.41,255.86,119
CPT,81244,Fmr1 gen alys charac alleles,,,44.89,67.34,57
CPT,81244,HC FMR1 GENE CHARAC ALLELES,2292.73,1719.55,27.51,2063.46,119
CPT,81245,Flt3 gene,,,165.51,549.16,65
CPT,81245,HC FLT3 GENE,2287.78,1715.84,27.45,2059.0,119
CPT,81246,Flt3 gene analysis,,,83.0,124.5,57
CPT,81246,HC FLT3 GENE ANALYSIS,224.72,168.54,2.7,202.25,119
CPT,81247,G6pd gene alys cmn variant,,,174.81,580.02,65
CPT,81248,G6pd known familial variant,,,375.25,1245.08,65
CPT,81249,G6pd full gene sequence,,,600.0,1990.8,65
CPT,81249,HC G6PD GENE ANALYSIS FULL GENE SEQUENCE,1624.5,1218.38,19.49,1462.05,119
CPT,81250,G6pc gene,,,58.49,194.07,65
CPT,81251,Gba gene,,,47.25,70.88,57
CPT,81251,HC GBA GENE,3343.21,2507.41,40.12,3008.89,119
CPT,81252,Gjb2 gene full sequence,,,101.12,151.68,57
CPT,81252,HC GJB2 GENE FULL SEQUENCE,2267.04,1700.28,27.2,2040.34,119
CPT,81253,Gjb2 gene known fam variants,,,61.52,92.28,57
CPT,81254,Gjb6 gene com variants,,,35.0,52.5,57
CPT,81255,Hexa gene,,,51.45,77.18,57
CPT,81256,HC HFE GENE ANALYSIS/HEMOCHROMOTOSIS,1033.13,774.85,12.4,929.82,119
CPT,81256,Hfe gene,,,65.36,216.87,65
CPT,81257,Hba1/hba2 gene,,,102.26,153.39,57
CPT,81258,Hba1/hba2 gene fam vrnt,,,375.25,1245.08,65
CPT,81259,HC HBA1/HBA2 FULL GENE SEQUENCE,1624.5,1218.38,19.49,1462.05,119
CPT,81259,Hba1/hba2 full gene sequence,,,600.0,1990.8,65
CPT,81260,Ikbkap gene,,,39.31,58.97,57
CPT,81261,HC IGH GENE REARRANGE AMP METH,1757.29,1317.97,21.09,1581.56,119
CPT,81261,Igh gene rearrange amp meth,,,197.99,656.93,65
CPT,81262,Igh gene rearrang dir probe,,,68.55,227.45,65
CPT,81263,HC IGH VARI REGIONAL MUTATION,1754.44,1315.83,21.05,1579.0,119
CPT,81263,HC SPHZ IGH VARI REGIONAL MUTATION,1594.96,1196.22,19.14,1435.46,119
CPT,81263,Igh vari regional mutation,,,294.52,977.21,65
CPT,81264,HC IGK REARRANGE ABN CLONAL POP,1325.41,994.06,15.9,1192.87,119
CPT,81264,Igk rearrangeabn clonal pop,,,172.73,573.12,65
CPT,81265,HC CHIMERISM DNR/RECP,942.78,707.08,11.31,848.5,119
CPT,81265,HC STR MARKERS SPECIMEN ANAL,1047.53,785.65,12.57,942.78,119
CPT,81265,Str markers specimen anal,,,233.07,773.33,65
CPT,81266,Str markers spec anal addl,,,304.81,1011.36,65
CPT,81267,Chimerism anal no cell selec,,,207.46,688.35,65
CPT,81267,HC CHIMERISM ANAL NO CELL SELEC,1036.77,777.58,12.44,933.09,119
CPT,81268,Chimerism anal w/cell select,,,260.79,865.31,65
CPT,81268,HC CHIMERISM POST SORTED,1029.36,772.02,12.35,926.42,119
CPT,81269,HC HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS,745.95,559.46,8.95,671.36,119
CPT,81269,Hba1/hba2 gene dup/del vrnts,,,202.4,671.56,65
CPT,81270,HC JAK2 GENE MUTATION,1510.27,1132.7,18.12,1359.24,119
CPT,81270,HC SPHZ JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,543.14,407.36,6.52,488.83,119
CPT,81270,Jak2 gene,,,91.66,137.49,57
CPT,81271,Htt gene detc abnor alleles,,,137.0,454.57,65
CPT,81272,HC KIT GENE TARGETED SEQ ANALYSIS,4409.61,3307.21,52.92,3968.65,119
CPT,81272,Kit gene targeted seq analys,,,329.51,1093.31,65
CPT,81273,HC KIT GENE ANALYS D816 VARIANT,983.07,737.3,11.8,884.76,119
CPT,81273,Kit gene analys d816 variant,,,124.87,187.31,57
CPT,81274,Htt gene charac alleles,,,274.83,911.88,65
CPT,81275,HC KRAS GENE,1675.04,1256.28,20.1,1507.54,119
CPT,81275,Kras gene variants exon 2,,,172.19,641.2,66
CPT,81276,HC KRAS GENE ADDL VARIANTS,1782.92,1337.19,21.4,1604.63,119
CPT,81276,Kras gene addl variants,,,172.19,641.2,66
CPT,81277,Cytogenomic neo microra alys,,,1160.0,3848.88,65
CPT,81277,HC CYTOGENOMIC NEOPLASIA MICROARRAY ANALYSIS,3140.7,2355.52,37.69,2826.63,119
CPT,81278,HC IGH@/BCL2 TRANSLOCATION ALYS,1393.08,1044.81,16.72,1253.77,119
CPT,81278,Igh@/bcl2 translocation alys,,,207.31,687.86,65
CPT,81279,HC JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,641.31,480.98,7.7,577.18,119
CPT,81279,HC SPHZ JAK2 GENE TRGT SEQ ALYS EXONS 12 AND 13,641.31,480.98,7.7,577.18,119
CPT,81279,Jak2 gene trgt sequence alys,,,185.2,614.49,65
CPT,81283,Ifnl3 gene,,,73.37,243.44,65
CPT,81284,Fxn gene detc abnor alleles,,,137.0,454.57,65
CPT,81285,Fxn gene charac alleles,,,274.83,911.88,65
CPT,81286,Fxn gene full gene sequence,,,274.83,911.88,65
CPT,81287,HC MGMT GENE PRMTR MTHLYTH ALYS,531.51,398.63,6.38,478.36,119
CPT,81287,Mgmt gene prmtr mthyltn alys,,,124.64,186.96,57
CPT,81288,HC MLH1 GENE,569.04,426.78,6.83,512.14,119
CPT,81288,Mlh1 gene,,,192.32,638.12,65
CPT,81289,Fxn gene known famil variant,,,185.2,614.49,65
CPT,81290,Mcoln1 gene,,,39.31,58.97,57
CPT,81291,HC MTHFR GENE,451.65,338.74,5.42,406.48,119
CPT,81291,Mthfr gene,,,65.34,216.79,65
CPT,81292,HC MLH1 GENE FULL SEQ,211.37,158.53,2.54,190.23,119
CPT,81292,Mlh1 gene full seq,,,675.4,2240.97,65
CPT,81293,Mlh1 gene known variants,,,331.0,1098.26,65
CPT,81294,HC MLH1 GENE DUP/DELETE VARIANT,548.0,411.0,6.58,493.2,119
CPT,81294,Mlh1 gene dup/delete variant,,,202.4,671.56,65
CPT,81295,HC MSH2 GENE FULL SEQ,1033.45,775.09,12.4,930.1,119
CPT,81295,Msh2 gene full seq,,,381.7,1266.48,65
CPT,81296,Msh2 gene known variants,,,337.73,1120.59,65
CPT,81297,HC MSH2 GENE DUP/DELETE VARIANT,577.51,433.13,6.93,519.76,119
CPT,81297,Msh2 gene dup/delete variant,,,213.3,707.73,65
CPT,81298,HC MSH6 GENE FULL SEQ,1737.81,1303.36,20.85,1564.03,119
CPT,81298,Msh6 gene full seq,,,641.85,2129.66,65
CPT,81299,Msh6 gene known variants,,,308.0,1021.94,65
CPT,81300,Msh6 gene dup/delete variant,,,238.0,789.68,65
CPT,81301,Microsatellite instability,,,348.56,1156.52,65
CPT,81302,Mecp2 gene full seq,,,527.87,1751.47,65
CPT,81303,Mecp2 gene known variant,,,120.0,180.0,57
CPT,81304,Mecp2 gene dup/delet variant,,,150.0,497.7,65
CPT,81305,HC MYD88 GENE P.LEU265PRO VRNT,1066.05,799.54,12.79,959.44,119
CPT,81305,HC SPHZ  MYD88 GENE P.LEU265PRO VRNT,1066.05,799.54,12.79,959.44,119
CPT,81305,Myd88 gene p.leu265pro vrnt,,,175.4,581.97,65
CPT,81306,HC NUDT15 GENE ANALYSIS COMMON VARIANT,425.34,319.0,5.1,382.81,119
CPT,81306,Nudt15 gene common variants,,,291.36,966.74,65
CPT,81307,Palb2 gene full gene seq,,,676.5,2244.63,65
CPT,81308,Palb2 gene known famil vrnt,,,301.35,999.88,65
CPT,81309,Pik3ca gene trgt seq alys,,,274.83,911.88,65
CPT,81310,HC NPM1 GENE,1459.73,1094.8,17.52,1313.76,119
CPT,81310,Npm1 gene,,,246.52,817.95,65
CPT,81311,HC NRAS GENE VARIANTS EXON 2&3,800.86,600.64,9.61,720.77,119
CPT,81311,Nras gene variants exon 2&3,,,295.79,981.44,65
CPT,81312,Pabpn1 gene detc abnor allel,,,137.0,454.57,65
CPT,81313,Pca3/klk3 antigen,,,227.25,846.26,66
CPT,81314,Pdgfra gene,,,329.51,1093.31,65
CPT,81315,HC PML/RARALPHA COM BREAKPOINTS,2495.77,1871.83,29.95,2246.19,119
CPT,81315,Pml/raralpha com breakpoints,,,207.31,687.86,65
CPT,81316,Pml/raralpha 1 breakpoint,,,207.31,687.86,65
CPT,81317,Pms2 gene full seq analysis,,,676.5,2244.63,65
CPT,81318,Pms2 known familial variants,,,331.0,1098.26,65
CPT,81319,Pms2 gene dup/delet variants,,,203.5,675.21,65
CPT,81320,Plcg2 gene common variants,,,291.36,966.74,65
CPT,81321,Pten gene full sequence,,,600.0,1990.8,65
CPT,81322,Pten gene known fam variant,,,46.6,69.9,57
CPT,81323,Pten gene dup/delet variant,,,300.0,995.4,65
CPT,81324,HC PMP22 GENE ANALYSIS DUP/DEL,974.92,731.19,11.7,877.43,119
CPT,81324,Pmp22 gene dup/delet,,,758.36,2516.24,65
CPT,81325,Pmp22 gene full sequence,,,769.58,2553.46,65
CPT,81326,Pmp22 gene known fam variant,,,46.6,69.9,57
CPT,81327,Sept9 gen prmtr mthyltn alys,,,192.0,637.06,65
CPT,81328,Slco1b1 gene com variants,,,174.81,580.02,65
CPT,81329,Smn1 gene dos/deletion alys,,,137.0,454.57,65
CPT,81330,Smpd1 gene common variants,,,47.0,70.5,57
CPT,81331,HC SNRPN/UBE3A METHYLATION ANALYSIS,593.9,445.42,7.13,534.51,119
CPT,81331,Snrpn/ube3a gene,,,51.07,169.45,65
CPT,81332,HC SERPINA1 GENE,584.68,438.51,7.02,526.21,119
CPT,81332,Serpina1 gene,,,43.65,144.83,65
CPT,81333,Tgfbi gene common variants,,,137.0,454.57,65
CPT,81334,Runx1 gene targeted seq alys,,,329.51,1093.31,65
CPT,81335,HC TPMT GENE COM VARIANTS,344.44,258.33,4.13,310.0,119
CPT,81335,Tpmt gene com variants,,,174.81,580.02,65
CPT,81336,Smn1 gene full gene sequence,,,301.35,999.88,65
CPT,81337,Smn1 gen nown famil seq vrnt,,,185.2,614.49,65
CPT,81338,HC MPL GENE ANALYSIS COMMON VARIANTS,1331.36,998.52,15.98,1198.22,119
CPT,81338,Mpl gene common variants,,,150.33,498.79,65
CPT,81339,Mpl gene seq alys exon 10,,,185.2,614.49,65
CPT,81340,Trb@ gene rearrange amplify,,,208.92,693.2,65
CPT,81341,Trb@ gene rearrange dirprobe,,,49.59,164.54,65
CPT,81342,HC TRG GENE REARRANGEMENT ANAL,2724.82,2043.62,32.7,2452.34,119
CPT,81342,Trg gene rearrangement anal,,,201.5,668.58,65
CPT,81343,Ppp2r2b gen detc abnor allel,,,137.0,454.57,65
CPT,81344,Tbp gene detc abnor alleles,,,137.0,454.57,65
CPT,81345,Tert gene targeted seq alys,,,185.2,614.49,65
CPT,81346,Tyms gene com variants,,,174.81,580.02,65
CPT,81347,Sf3b1 gene common variants,,,193.25,641.2,65
CPT,81348,Srsf2 gene common variants,,,175.4,581.97,65
CPT,81349,Cytog alys chrml abnr lw-ps,,,1033.56,3974.76,66
CPT,81350,HC COM CON  ARUP UGT1A1,806.84,605.13,9.68,726.16,119
CPT,81350,Ugt1a1 gene common variants,,,234.0,776.41,65
CPT,81351,HC TP53 GENE FULL GENE SEQUENCE,4128.65,3096.49,49.54,3715.78,119
CPT,81351,Tp53 gene full gene sequence,,,641.85,2129.66,65
CPT,81352,HC TP53 GENE TRGT SEQUENCE ALYS,892.15,669.11,10.71,802.94,119
CPT,81352,Tp53 gene trgt sequence alys,,,329.51,1093.31,65
CPT,81353,Tp53 gene known famil vrnt,,,308.0,1021.94,65
CPT,81354,Cytog alys chrml abnor ogm,,,1263.53,1263.53,9
CPT,81355,Vkorc1 gene,,,88.2,132.3,57
CPT,81357,U2af1 gene common variants,,,193.25,641.2,65
CPT,81360,Zrsr2 gene common variants,,,193.25,641.2,65
CPT,81361,Hbb gene com variants,,,174.81,580.02,65
CPT,81362,Hbb gene known fam variant,,,375.25,1245.08,65
CPT,81363,HC HBB GENE DUP/DEL VARIANTS,548.0,411.0,6.58,493.2,119
CPT,81363,Hbb gene dup/del variants,,,202.4,671.56,65
CPT,81364,HC HBB FULL GENE SEQUENCE,878.8,659.1,10.55,790.92,119
CPT,81364,Hbb full gene sequence,,,324.58,1076.95,65
CPT,81370,Hla i & ii typing lr,,,358.29,1334.24,66
CPT,81371,Hla i & ii type verify lr,,,360.43,1342.19,66
CPT,81372,HC HLA 1 TYPING LOW RES COMPLETE,804.0,603.0,9.65,723.6,119
CPT,81372,Hla i typing complete lr,,,359.6,1339.11,66
CPT,81373,"HC HLA CLASS 1 TYPING, LOW RESOLUTION, ONE LOCUS",2516.5,1887.38,30.2,2264.85,119
CPT,81373,Hla i typing 1 locus lr,,,113.54,191.15,58
CPT,81374,HC HLA I TYPING 1 ANTIGEN,289.56,217.17,3.47,260.6,119
CPT,81374,Hla i typing 1 antigen lr,,,66.23,246.62,66
CPT,81375,Hla ii typing ag equiv lr,,,196.68,732.42,66
CPT,81376,Hla ii typing 1 locus lr,,,108.9,183.33,58
CPT,81377,Hla ii type 1 ag equiv lr,,,84.41,142.11,58
CPT,81378,Hla i & ii typing hr,,,307.9,1146.6,66
CPT,81379,HC HLA 1 TYPING HIGH RES COMPLETE,5429.82,4072.36,65.16,4886.84,119
CPT,81379,Hla i typing complete hr,,,298.82,1112.79,66
CPT,81380,HC HLA I TYPING 1 LOCUS HR,1337.59,1003.19,16.05,1203.83,119
CPT,81380,Hla i typing 1 locus hr,,,157.93,588.12,66
CPT,81381,HC HLA I TYPING 1 ALLELE HR,2508.11,1881.08,30.1,2257.3,119
CPT,81381,Hla i typing 1 allele hr,,,151.38,563.72,66
CPT,81382,HC HLA II TYPING 1 LOC HR,2424.71,1818.53,29.1,2182.24,119
CPT,81382,Hla ii typing 1 loc hr,,,110.2,185.52,58
CPT,81383,HC NACROLEPSY GENOTYPE,2020.51,1515.38,24.25,1818.46,119
CPT,81383,Hla ii typing 1 allele hr,,,97.23,163.7,58
CPT,81400,HC MOLECULAR PATHOLOGY PROC LEVEL 1,6228.35,4671.26,74.74,5605.52,119
CPT,81400,Mopath procedure level 1,,,63.96,212.22,65
CPT,81401,HC MLHA METHYLATION,2279.31,1709.48,27.35,2051.38,119
CPT,81401,HC MOLECULAR PATHOLOGY PROC LEVEL 2,2279.31,1709.48,27.35,2051.38,119
CPT,81401,HC SPHZ MOLECULAR PATHOLOGY PROC LEVEL 2,6228.35,4671.26,74.74,5605.52,119
CPT,81401,Mopath procedure level 2,,,137.0,454.57,65
CPT,81402,HC MOLECULAR PATHOLOGY PROC LEVEL 3,6228.35,4671.26,74.74,5605.52,119
CPT,81402,Mopath procedure level 3,,,150.33,498.79,65
CPT,81403,HC MOLECULAR PATHOLOGY PROC LEVEL 4,641.31,480.98,7.7,577.18,119
CPT,81403,Mopath procedure level 4,,,185.2,614.49,65
CPT,81404,HC MOLECULAR PATHOLOGY PROC LEVEL 5,3754.74,2816.06,45.06,3379.27,119
CPT,81404,Mopath procedure level 5,,,274.83,911.88,65
CPT,81405,HC MOLECULAR PATHOLOGY PROC LEVEL 6,5605.52,4204.14,67.27,5044.97,119
CPT,81405,Mopath procedure level 6,,,301.35,999.88,65
CPT,81406,HC MOLECULAR PATHOLOGY PROC LEVEL 7,2079.81,1559.86,24.96,1871.83,119
CPT,81406,Mopath procedure level 7,,,282.88,938.6,65
CPT,81407,HC MOLECULAR PATHOLOGY PROC LEVEL 8 DIFF VENDOR,3836.97,2877.73,46.04,3453.27,119
CPT,81407,Mopath procedure level 8,,,846.27,2807.92,65
CPT,81408,HC MOLECULAR PATHOLOGY PROC LEVEL 9,123.3,92.48,1.48,110.97,119
CPT,81408,Mopath procedure level 9,,,2000.0,6636.0,65
CPT,81410,Aortic dysfunction/dilation,,,504.0,1672.27,65
CPT,81410,HC AORTIC DYSFUNCTION/DILATION,790.46,592.84,9.49,711.41,119
CPT,81411,Aortic dysfunction/dilation,,,1350.19,4479.93,65
CPT,81411,HC AORTIC DYSFUNCTION/DILATION DUP/DEL ANALYSIS,2117.61,1588.21,25.41,1905.85,119
CPT,81412,Ashkenazi jewish assoc dis,,,2448.56,8124.32,65
CPT,81413,Car ion chnnlpath inc 10 gns,,,584.9,1940.69,65
CPT,81414,Car ion chnnlpath inc 2 gns,,,584.9,1940.69,65
CPT,81415,Exome sequence analysis,,,4258.98,15860.04,66
CPT,81416,Exome sequence analysis,,,10692.0,39816.0,66
CPT,81417,Exome re-evaluation,,,285.12,1061.76,66
CPT,81418,HC RX METAB GENOMIC SEQ ALYS PANEL AT LEAST 6 GENES,742.37,556.78,8.91,668.13,119
CPT,81418,Rx metab gen seq alys pnl 6,,,817.12,3042.87,30
CPT,81419,Epilepsy gen seq alys panel,,,2448.56,8124.32,65
CPT,81420,Fetal chrmoml aneuploidy,,,759.05,2518.53,65
CPT,81420,HC FETAL CHROMOML ANEUPLOIDY,723.86,542.9,8.69,651.47,119
CPT,81422,Fetal chrmoml microdeltj,,,759.05,2518.53,65
CPT,81422,HC FETAL CHROMOML MICRODELTJ,2055.13,1541.35,24.66,1849.62,119
CPT,81425,Genome sequence analysis,,,4482.8,16693.52,66
CPT,81426,Genome sequence analysis,,,2414.56,8991.61,66
CPT,81427,Genome re-evaluation,,,2082.84,7756.32,66
CPT,81430,Hearing loss sequence analys,,,1625.0,5391.75,65
CPT,81431,Hearing loss dup/del analys,,,679.57,2254.81,65
CPT,81432,HC HRDTRY BRST CA-RLATD DSORDRS 5+ GEN,1766.33,1324.75,21.2,1589.7,119
CPT,81432,Hrdtry brst ca-rlatd do 5+,,,679.05,4326.5,65
CPT,81433,Hrdtry brst ca-rlatd dsordrs,,,438.93,1456.37,44
CPT,81434,Hered rta do gen seq 15,,,597.91,1983.87,65
CPT,81435,HC HEREDITARY COLON CA DISORDERS PANEL 5+,537.31,402.98,6.45,483.58,119
CPT,81435,Hered colon ca-rlatd do 5+,,,584.9,4326.5,65
CPT,81436,Hereditary colon ca dsordrs,,,584.9,1940.69,44
CPT,81437,HC HEREDTRY NURONDCRN TUM DSRDR 5+,3530.45,2647.84,42.37,3177.4,119
CPT,81437,Hered neuroend tum-rlt do 5+,,,438.93,4326.5,65
CPT,81438,Heredtry nurondcrn tum dsrdr,,,438.93,1456.37,44
CPT,81439,Hrdtry cardmypy gene panel,,,584.9,1940.69,65
CPT,81440,Mitochondrial gene,,,3324.0,11029.03,65
CPT,81441,Ibmfs seq alys pnl 30 genes,,,2448.56,8124.32,65
CPT,81442,Noonan spectrum disorders,,,2143.6,7112.47,65
CPT,81443,Genetic tstg severe inh cond,,,2448.56,8124.32,65
CPT,81443,HC GENETIC TESTING FOR SEVERE INHERITED CONDITIONS,2225.78,1669.34,26.71,2003.2,119
CPT,81445,So neo gsap 5-50dna/dna&rna,,,597.91,1983.87,65
CPT,81448,HC HEREDITARY PERIPHERAL NEUROPATHY GEN SEQ PNL,2225.78,1669.34,26.71,2003.2,119
CPT,81448,Hrdtry perph neurphy panel,,,584.9,1940.69,65
CPT,81449,So neo gsap 5-50 rna alys,,,597.91,1983.87,65
CPT,81450,HC TARGETED GENOMIC SEQ ANALYSIS,6422.8,4817.1,77.07,5780.52,119
CPT,81450,Hl neo gsap 5-50dna/dna&rna,,,759.53,2520.12,65
CPT,81451,Hl neo gsap 5-50 rna alys,,,759.53,2520.12,65
CPT,81455,HC GEN SEQ ANALYS SOL ORG/HEMTOLMPHOID NEO 51/>GEN,6422.8,4817.1,77.07,5780.52,119
CPT,81455,So/hl 51/>gsap dna/dna&rna,,,2919.6,9687.24,65
CPT,81456,HC TGSAP SO/HEMATOLYMPHOID NEO/DO 51/>RNA ANALYSIS,4481.82,3361.36,53.78,4033.64,119
CPT,81456,So/hl 51/>gsap rna alys,,,2919.6,9687.24,65
CPT,81457,So neo gsap dna mcrstl ins,,,896.87,2975.82,29
CPT,81458,So gsap dna cpy nmbr&mcrstl,,,1046.35,3471.79,29
CPT,81459,So neo gsap dna/dna&rna,,,2989.55,9919.33,29
CPT,81460,Whole mitochondrial genome,,,1287.0,4270.27,65
CPT,81462,So gsap cll fr dna/dna&rna,,,1195.83,3967.76,29
CPT,81463,So gsap cl fr cpy nmbr&mcrst,,,1345.31,4463.74,29
CPT,81464,So gsap cll fr mcrstl ins,,,3288.51,10911.27,29
CPT,81465,Whole mitochondrial genome,,,936.0,3105.65,65
CPT,81470,X-linked intellectual dblt,,,914.0,3032.65,65
CPT,81471,X-linked intellectual dblt,,,914.0,3032.65,65
CPT,81479,HC ARUP  TPMT & NUDT15 PCR PROBE HYBRIDIZATION,412.41,309.31,4.95,371.17,119
CPT,81479,HC BREAST TUMOR,2316.3,1737.22,27.8,2084.67,119
CPT,81479,"HC CYP2C8, CYP2C9 AND CYP2C CLUSTER",159.02,119.26,1.91,143.12,119
CPT,81479,HC SPHZ FAMILIAL HYPERSCHOL BY PGS,541.71,406.28,6.5,487.54,119
CPT,81479,HC UNLISTED MOLECULAR PATH PROC,159.01,119.26,1.91,143.11,119
CPT,81479,Unlisted molecular pathology,,,0.5,497.7,11
CPT,81490,Autoimmune ra alys 12 bmrk,,,840.65,2789.27,65
CPT,81493,Cor artery disease mrna,,,1050.0,3483.9,65
CPT,81500,Onco (ovar) two proteins,,,260.5,864.34,65
CPT,81503,Onco (ovar) five proteins,,,799.23,2976.25,66
CPT,81504,Oncology tissue of origin,,,520.0,1725.36,65
CPT,81506,Endo assay seven anal,,,68.92,228.68,65
CPT,81507,Fetal aneuploidy trisom risk,,,795.0,2637.81,65
CPT,81508,Ftl cgen abnor two proteins,,,54.3,81.45,58
CPT,81509,Ftl cgen abnor 3 proteins,,,1325.25,4935.09,66
CPT,81510,Ftl cgen abnor three anal,,,49.49,83.31,58
CPT,81511,Ftl cgen abnor four anal,,,136.77,509.31,66
CPT,81511,HC FTL CGEN ABNOR FOUR ANALYTES,338.58,253.94,4.06,304.72,119
CPT,81512,Ftl cgen abnor five anal,,,61.94,230.66,66
CPT,81513,Nfct ds bv rna vag flu alg,,,127.08,213.95,58
CPT,81514,Nfct ds bv&vaginitis dna alg,,,14.35,394.49,65
CPT,81515,HC NFCT DS BV&VAGINITIS RTPCR AMP DNA MARKERS,689.22,516.92,8.27,620.3,119
CPT,81515,Nfct ds bv&vaginitis dna alg,,,14.35,394.49,29
CPT,81517,Liver ds alys 3 bmrk srm alg,,,176.19,584.6,30
CPT,81518,Onc brst mrna 11 genes,,,3873.0,12850.61,65
CPT,81519,Oncology breast mrna,,,3873.0,12850.61,65
CPT,81520,Onc breast mrna 58 genes,,,2510.21,8328.87,65
CPT,81521,Onc breast mrna 70 genes,,,3873.0,12850.61,65
CPT,81522,Onc breast mrna 12 genes,,,3873.0,12850.61,65
CPT,81523,Onc brst mrna 70 cnt 31 gene,,,3873.0,12850.61,65
CPT,81525,Oncology colon mrna,,,3116.0,10338.89,65
CPT,81528,Oncology colorectal scr,,,453.4,1688.43,66
CPT,81529,Onc cutan mlnma mrna 31 gene,,,7193.0,23866.37,65
CPT,81535,Oncology gynecologic,,,579.46,1922.64,65
CPT,81536,Oncology gynecologic,,,177.56,589.14,65
CPT,81538,Oncology lung,,,2871.0,9525.98,65
CPT,81539,Oncology prostate prob score,,,760.0,2521.68,65
CPT,81540,Oncology tum unknown origin,,,3750.0,12442.5,65
CPT,81541,Onc prostate mrna 46 genes,,,3873.0,12850.61,65
CPT,81542,Onc prostate mrna 22 cnt gen,,,3873.0,12850.61,65
CPT,81546,Onc thyr mrna 10196 gen alg,,,3600.0,11944.8,65
CPT,81551,Onc prostate 3 genes,,,2030.0,6735.54,65
CPT,81552,Onc uveal mlnma mrna 15 gene,,,7776.0,25800.77,65
CPT,81554,Pulm ds ipf mrna 190 gen alg,,,5409.6,18066.51,65
CPT,81558,Trnspl rej kdn mrna qpcr 139,,,3240.0,10750.32,29
CPT,81560,Trnsplj pd lvr&bwl cd154+cll,,,570.89,2125.95,66
CPT,81595,Cardiology hrt trnspl mrna,,,2886.84,10750.32,66
CPT,81596,Nfct ds chrnc hcv 6 assays,,,72.19,108.29,57
CPT,81599,HC UNLISTED MULTI ANALTYE ASSAY ANALYSIS,680.56,510.42,8.17,612.5,119
CPT,81599,Unlisted maaa,,,0.5,0.5,3
CPT,82009,HC ACETONE SERUM,110.01,82.51,1.32,99.01,119
CPT,82009,Ketone bodys qual,,,4.03,6.78,58
CPT,82010,HC QUANT SERUM ACETONES/KETONES,147.19,110.39,1.77,132.47,119
CPT,82010,Ketone bodys quan,,,7.28,18.25,66
CPT,82013,Acetylcholinesterase assay,,,10.95,18.44,58
CPT,82016,Acylcarnitines qual,,,14.69,54.72,66
CPT,82017,Acylcarnitines quant,,,15.03,25.31,58
CPT,82017,HC ACYLCARNITINE PROFILE-RL,838.05,628.54,10.06,754.24,119
CPT,82024,Assay of acth,,,34.41,57.93,58
CPT,82024,HC ACTH HORMONE,142.87,107.15,1.71,128.58,119
CPT,82030,Assay of adp & amp,,,22.99,38.7,58
CPT,82040,Assay of serum albumin,,,4.41,11.88,66
CPT,82040,HC ALBUMIN SERUM,61.03,45.77,0.73,54.93,119
CPT,82042,"HC ALBUMIN; QUANTITATIVE OTHER SOURCE, EA SPECIMEN",61.03,45.77,0.73,54.93,119
CPT,82042,Other source albumin quan ea,,,6.93,13.3,66
CPT,82043,"HC MICROALBUMIN, URINE, QUANT",61.01,45.76,0.73,54.91,119
CPT,82043,Ur albumin quantitative,,,5.15,13.04,66
CPT,82044,Ur albumin semiquantitative,,,5.55,13.07,66
CPT,82045,Albumin ischemia modified,,,30.24,50.91,58
CPT,82075,Assay of breath ethanol,,,26.73,45.0,58
CPT,82077,Assay spec xcp ur&breath ia,,,17.27,25.91,57
CPT,82077,HC ASSAY OF ALCOHOL UR&BREATH IA,97.24,72.93,1.17,87.52,119
CPT,82085,Assay of aldolase,,,8.65,14.57,58
CPT,82085,HC ALDOLASE,45.56,34.17,0.55,41.0,119
CPT,82088,Assay of aldosterone,,,36.31,61.13,58
CPT,82088,HC ALDOSTERONE; SERUM,141.57,106.18,1.7,127.41,119
CPT,82103,Alpha-1-antitrypsin total,,,11.98,20.16,58
CPT,82103,HC ALPHA-1-ANTITRYPSIN,48.06,36.04,0.58,43.25,119
CPT,82104,Alpha-1-antitrypsin pheno,,,12.88,21.69,58
CPT,82104,HC ALPHA 1 ANTITRYPSIN PHENOTYPE,144.55,108.41,1.73,130.1,119
CPT,82105,Alpha-fetoprotein serum,,,14.94,25.16,58
CPT,82105,HC ALPHA-FETOPROTEIN; SERUM,102.18,76.64,1.23,91.96,119
CPT,82106,Alpha-fetoprotein amniotic,,,15.15,56.41,66
CPT,82106,HC ALPHA FETOPROTEIN; AMNIOTIC FLUID,86.68,65.01,1.04,78.01,119
CPT,82107,Alpha-fetoprotein l3,,,57.39,96.62,58
CPT,82108,Assay of aluminum,,,22.7,84.55,66
CPT,82108,HC ALUMINUM BLOOD,77.67,58.25,0.93,69.9,119
CPT,82120,Amines vaginal fluid qual,,,5.34,17.19,66
CPT,82127,Amino acid single qual,,,12.63,21.27,58
CPT,82128,Amino acids mult qual,,,12.36,20.81,58
CPT,82131,Amino acids single quant,,,20.48,34.47,58
CPT,82131,HC COM CON METHYLMALONIC ACID,1238.23,928.67,14.86,1114.41,119
CPT,82135,Assay aminolevulinic acid,,,14.66,54.58,66
CPT,82135,HC AMNIOLEVULINIC ACID DELTA URINE,223.75,167.81,2.68,201.38,119
CPT,82136,Amino acids quant 2-5,,,17.47,29.42,58
CPT,82139,Amino acids quan 6 or more,,,15.03,25.31,58
CPT,82139,HC AMINO ACIDS PLASMA QUANT,789.86,592.4,9.48,710.87,119
CPT,82140,Assay of ammonia,,,12.98,21.86,58
CPT,82140,HC AMMONIA,102.45,76.84,1.23,92.2,119
CPT,82143,Amniotic fluid scan,,,8.33,31.03,66
CPT,82143,HC AMNIOTIC FLUID SPECTROPH,148.79,111.59,1.79,133.91,119
CPT,82150,Assay of amylase,,,5.77,13.1,66
CPT,82150,HC AMYLASE,63.32,47.49,0.76,56.99,119
CPT,82154,Androstanediol glucuronide,,,25.69,43.25,58
CPT,82157,Assay of androstenedione,,,26.09,43.92,58
CPT,82157,HC ANDROSTENEDIONE LEVEL-RL,218.2,163.65,2.62,196.38,119
CPT,82160,Assay of androsterone,,,22.77,84.78,66
CPT,82163,Assay of angiotensin ii,,,18.28,30.78,58
CPT,82164,Angiotensin i enzyme test,,,13.01,21.9,58
CPT,82164,HC ANGIOTENSIN CONVERTING ENZYME,103.91,77.93,1.25,93.52,119
CPT,82166,Assay anti-mullerian horm,,,34.41,57.93,22
CPT,82166,HC ASSAY ANTI-MULLERIAN HORM,831.99,623.99,9.98,748.79,119
CPT,82172,Assay of apolipoprotein,,,18.79,31.64,58
CPT,82172,HC APOLIPOPROTEIN EACH,96.51,72.38,1.16,86.86,119
CPT,82175,Assay of arsenic,,,16.9,28.46,58
CPT,82175,HC ARSENIC,95.03,71.27,1.14,85.53,119
CPT,82180,Assay of ascorbic acid,,,8.81,14.84,58
CPT,82180,HC VITAMIN C BLOOD,164.41,123.31,1.97,147.97,119
CPT,82190,Atomic absorption,,,14.17,23.85,58
CPT,82232,Assay of beta-2 protein,,,14.42,24.27,58
CPT,82232,HC BETA 2 MICROGLOBULIN,76.98,57.74,0.92,69.28,119
CPT,82233,Beta-amyloid 1-40 (abeta 40),,,0.5,128.92,12
CPT,82234,Beta-amyloid 1-42 (abeta 42),,,0.5,128.92,12
CPT,82234,HC BETA-AMYLOID 1-42 (ABETA 42),860.99,645.74,10.33,774.89,119
CPT,82239,Bile acids total,,,15.25,25.68,58
CPT,82239,HC BILE ACIDS LEVEL TOTAL,86.85,65.14,1.04,78.16,119
CPT,82240,Bile acids cholylglycine,,,23.68,39.87,58
CPT,82247,Bilirubin total,,,4.47,7.53,58
CPT,82247,HC BILIRUBIN TOTAL,61.03,45.77,0.73,54.93,119
CPT,82248,Bilirubin direct,,,4.47,7.53,58
CPT,82248,HC BILIRUBIN DIRECT,61.03,45.77,0.73,54.93,119
CPT,82248,HC COM CON BILIRUBIN DIRECT,61.03,45.77,0.73,54.93,119
CPT,82252,Fecal bilirubin test,,,4.06,6.84,58
CPT,82261,Assay of biotinidase,,,15.03,25.31,58
CPT,82261,HC BIOTINIDASE LEVEL-RL,130.97,98.23,1.57,117.87,119
CPT,82270,HC OCCULT BLOOD SCREENING,88.8,66.6,1.07,79.92,119
CPT,82270,Occult blood feces,,,3.9,6.57,58
CPT,82271,HC GASTROCULT,99.68,74.76,1.2,89.71,119
CPT,82271,Occult blood other sources,,,4.74,13.01,66
CPT,82272,HC OCCULT BLD FECES 1-3 TESTS,79.85,59.89,0.96,71.86,119
CPT,82272,HC OCCULT BLD FECES 1-3 TESTS POC,79.85,59.89,0.96,71.86,119
CPT,82272,Occult bld feces 1-3 tests,,,3.77,6.35,58
CPT,82274,Assay test for blood fecal,,,12.8,23.88,66
CPT,82274,HC OCCULT BLD FHG QUAL 1-3,239.73,179.8,2.88,215.76,119
CPT,82286,Assay of bradykinin,,,4.6,7.74,58
CPT,82300,Assay of cadmium,,,21.06,35.46,58
CPT,82300,HC CADMIUM,99.96,74.97,1.2,89.96,119
CPT,82306,HC VITAMIN D 25 HYDROXY,195.28,146.46,2.34,175.75,119
CPT,82306,Vitamin d 25 hydroxy,,,26.37,44.4,58
CPT,82308,Assay of calcitonin,,,23.87,40.19,58
CPT,82308,HC CALCITONIN,166.0,124.5,1.99,149.4,119
CPT,82310,Assay of calcium,,,4.6,12.08,66
CPT,82310,HC CALCIUM; TOTAL,60.95,45.71,0.73,54.86,119
CPT,82330,Assay of calcium,,,12.19,20.52,66
CPT,82330,HC CALCIUM IONIZED,117.38,88.04,1.41,105.64,119
CPT,82330,HC CALCIUM IONIZED POC,230.05,172.54,2.76,207.04,119
CPT,82331,Calcium infusion test,,,11.89,20.01,58
CPT,82340,Assay of calcium in urine,,,5.37,9.05,58
CPT,82340,HC CALCIUM; URINE QUAN TIMED,60.95,45.71,0.73,54.86,119
CPT,82355,Calculus analysis qual,,,10.32,17.37,58
CPT,82360,Calculus assay quant,,,11.47,19.31,58
CPT,82365,Calculus spectroscopy,,,11.49,19.35,58
CPT,82365,HC KIDNEY STONE ANALYSIS,184.76,138.57,2.22,166.28,119
CPT,82370,X-ray assay calculus,,,11.16,18.78,58
CPT,82373,Assay c-d transfer measure,,,16.09,59.92,66
CPT,82373,HC CARBOHYDRATE DEFICIENT TRANSFERRIN,579.0,434.25,6.95,521.1,119
CPT,82374,Assay blood carbon dioxide,,,4.35,11.55,66
CPT,82374,HC CARBON DIOXIDE,60.95,45.71,0.73,54.86,119
CPT,82374,INACTIVE HC CARBON DIOXIDE POC,127.88,95.91,1.53,115.09,119
CPT,82375,Assay carboxyhb quant,,,10.98,18.48,58
CPT,82375,HC CARBON MONOXIDE,286.87,215.15,3.44,258.18,119
CPT,82376,Assay carboxyhb qual,,,12.54,21.11,58
CPT,82378,Carcinoembryonic antigen,,,16.89,28.44,58
CPT,82378,HC CARCINOEMBRONIC ANTIGEN (CEA),131.95,98.96,1.58,118.76,119
CPT,82379,Assay of carnitine,,,15.03,25.31,58
CPT,82379,HC CARNITENE FREE & TOTAL,524.17,393.13,6.29,471.75,119
CPT,82380,Assay of carotene,,,8.22,30.6,66
CPT,82380,HC CAROTENE,86.92,65.19,1.04,78.23,119
CPT,82382,Assay urine catecholamines,,,24.32,90.58,66
CPT,82383,Assay blood catecholamines,,,25.91,43.62,58
CPT,82384,Assay three catecholamines,,,22.5,37.88,58
CPT,82384,HC UR CATECHOLAMINES FRACTIONAL,204.38,153.28,2.45,183.94,119
CPT,82387,Assay of cathepsin-d,,,16.09,59.92,66
CPT,82390,Assay of ceruloplasmin,,,9.57,16.11,58
CPT,82390,HC CERULOPLASMIN,76.74,57.56,0.92,69.07,119
CPT,82397,Chemiluminescent assay,,,12.58,21.18,58
CPT,82397,HC PTH RELATED PEPTIDE,130.53,97.9,1.57,117.48,119
CPT,82415,Assay of chloramphenicol,,,11.29,19.01,58
CPT,82435,Assay of blood chloride,,,4.1,10.52,66
CPT,82435,HC CHLORIDE; BLOOD,60.95,45.71,0.73,54.86,119
CPT,82436,Assay of urine chloride,,,5.12,8.63,58
CPT,82436,HC CHLORIDE; URINE,60.95,45.71,0.73,54.86,119
CPT,82438,Assay other fluid chlorides,,,4.45,7.5,58
CPT,82438,HC CHLORIDE SWEAT TEST,204.9,153.68,2.46,184.41,119
CPT,82441,HC CHLORINATED HC SCREEN,669.34,502.0,8.03,602.41,119
CPT,82441,Test for chlorohydrocarbons,,,5.35,9.02,58
CPT,82465,Assay bld/serum cholesterol,,,3.88,10.02,66
CPT,82465,HC CHOLESTEROL,60.95,45.71,0.73,54.86,119
CPT,82480,Assay serum cholinesterase,,,7.01,11.81,58
CPT,82480,HC CHOLINESTERASE SERUM,105.09,78.82,1.26,94.58,119
CPT,82482,Assay rbc cholinesterase,,,8.74,14.72,58
CPT,82482,HC CHOLINESTERASE RBC,102.45,76.84,1.23,92.2,119
CPT,82485,Assay chondroitin sulfate,,,18.4,30.98,58
CPT,82495,Assay of chromium,,,18.07,30.42,58
CPT,82495,HC CHROMIUM,96.59,72.44,1.16,86.93,119
CPT,82507,Assay of citrate,,,24.77,92.24,66
CPT,82507,HC CITRIC ACID 24 HR URINE,104.47,78.35,1.25,94.02,119
CPT,82523,Collagen crosslinks,,,13.21,28.02,66
CPT,82523,HC COLLAGEN CROSS LINKS,183.83,137.87,2.21,165.45,119
CPT,82525,Assay of copper,,,11.06,18.62,58
CPT,82525,HC QUANTITATIVE COPPER ASSAY,91.68,68.76,1.1,82.51,119
CPT,82528,Assay of corticosterone,,,20.07,33.78,58
CPT,82530,Cortisol free,,,14.89,25.07,58
CPT,82530,HC CORTISOL FREE,114.32,85.74,1.37,102.89,119
CPT,82533,HC CORTISOL TOTAL,114.12,85.59,1.37,102.71,119
CPT,82533,Total cortisol,,,14.52,24.45,58
CPT,82540,Assay of creatine,,,4.13,6.96,58
CPT,82540,HC ASSAY OF CREATINE,467.29,350.47,5.61,420.56,119
CPT,82542,Col chromotography qual/quan,,,21.46,36.14,58
CPT,82542,HC COLUMN CHROMATOGRAPHY/MASS SPECT (SS/MP) QN  EA SPECIMEN,465.03,348.77,5.58,418.53,119
CPT,82550,Assay of ck (cpk),,,5.8,13.1,66
CPT,82550,HC CPK CREATINE PHOSPHOKINASE,61.03,45.77,0.73,54.93,119
CPT,82552,Assay of cpk in blood,,,11.93,20.09,58
CPT,82552,HC CPK ELECTROPHORESIS -RL,103.23,77.42,1.24,92.91,119
CPT,82553,Creatine mb fraction,,,10.29,17.33,58
CPT,82553,HC CK MB FRACTION,82.11,61.58,0.99,73.9,119
CPT,82554,Creatine isoforms,,,10.58,17.81,58
CPT,82565,Assay of creatinine,,,4.56,11.88,66
CPT,82565,HC CREATININE BLOOD,63.02,47.26,0.76,56.72,119
CPT,82565,HC CREATININE BLOOD POCL/POCBS,410.39,307.79,4.92,369.35,119
CPT,82570,Assay of urine creatinine,,,4.62,12.18,66
CPT,82570,HC CREATININE; OTHER SOURCE,62.99,47.24,0.76,56.69,119
CPT,82575,Creatinine clearance test,,,8.43,31.38,66
CPT,82575,HC CREATININE CLEARANCE,232.55,174.41,2.79,209.3,119
CPT,82585,Assay of cryofibrinogen,,,12.6,21.21,58
CPT,82585,HC CRYOFIBRINOGEN,55.74,41.8,0.67,50.17,119
CPT,82595,Assay of cryoglobulin,,,5.76,9.71,58
CPT,82595,HC CRYOGLOBULIN,90.7,68.03,1.09,81.63,119
CPT,82600,Assay of cyanide,,,17.29,29.1,58
CPT,82600,HC CYANIDE,219.07,164.3,2.63,197.16,119
CPT,82607,HC VITAMIN B-12,105.98,79.48,1.27,95.38,119
CPT,82607,Vitamin b-12,,,13.44,50.03,66
CPT,82608,B-12 binding capacity,,,12.76,21.48,58
CPT,82610,Cystatin c,,,16.5,27.78,58
CPT,82610,HC CYSTATIN C,124.62,93.46,1.5,112.16,119
CPT,82615,Test for urine cystines,,,8.51,31.69,66
CPT,82626,Dehydroepiandrosterone,,,22.52,37.91,58
CPT,82626,HC DEHYDROEPIANDROSTERONE (DHEA),221.93,166.45,2.66,199.74,119
CPT,82627,Dehydroepiandrosterone,,,19.81,33.35,58
CPT,82627,HC DHEA SULFATE,153.98,115.48,1.85,138.58,119
CPT,82633,Desoxycorticosterone,,,27.6,46.47,58
CPT,82633,HC DESOXYCORTICOSTERONE 11,1253.41,940.06,15.04,1128.07,119
CPT,82634,Deoxycortisol,,,26.09,43.92,58
CPT,82634,HC DEOXYCORTISOL 11,188.85,141.64,2.27,169.96,119
CPT,82638,Assay of dibucaine number,,,10.91,18.38,58
CPT,82642,Dihydrotestosterone,,,26.09,43.92,58
CPT,82642,HC DIHYDROTESTOSTERONE (DHT),84.65,63.49,1.02,76.18,119
CPT,82652,HC VITAMIN D 1 25 INCLDNG FRACTN,164.95,123.71,1.98,148.45,119
CPT,82652,Vit d 1 25-dihydroxy,,,34.3,57.75,58
CPT,82653,El-1 fecal quantitative,,,20.47,34.46,58
CPT,82653,HC ELASTASE PANCREATIC FECAL QUANTITATIVE,492.35,369.26,5.91,443.12,119
CPT,82656,El-1 fecal qual/semiq,,,10.27,38.25,66
CPT,82657,Enzyme cell activity,,,19.75,33.26,58
CPT,82657,"HC ALPHA GALACTOSIDASE, SERUM",60.03,45.02,0.72,54.03,119
CPT,82657,HC ENZYME ACTIVITY; NOT RA EA SPEC,154.87,116.15,1.86,139.38,119
CPT,82657,HC PORPHOBILINOGEN DEA RBC,340.42,255.32,4.09,306.38,119
CPT,82658,Enzyme cell activity ra,,,39.23,146.09,66
CPT,82664,Electrophoretic test,,,54.8,92.25,58
CPT,82664,HC ELECTROPHORE TEST,166.51,124.88,2.0,149.86,119
CPT,82668,Assay of erythropoietin,,,16.74,28.19,58
CPT,82668,HC ERYTHROPOIETIN,166.0,124.5,1.99,149.4,119
CPT,82670,Assay of total estradiol,,,24.89,92.7,66
CPT,82670,HC ESTRADIOL,192.43,144.32,2.31,173.19,119
CPT,82671,Assay of estrogens,,,28.78,48.45,58
CPT,82671,HC ESTROGENS FRACTIONATED,182.75,137.06,2.19,164.48,119
CPT,82672,Assay of estrogen,,,19.33,72.0,66
CPT,82677,Assay of estriol,,,21.54,36.27,58
CPT,82677,HC ESTERIOL,115.61,86.71,1.39,104.05,119
CPT,82679,Assay of estrone,,,13.52,37.43,66
CPT,82679,HC ESTRONE,193.13,144.85,2.32,173.82,119
CPT,82681,Assay dir meas fr estradiol,,,27.94,92.7,65
CPT,82693,Assay of ethylene glycol,,,13.28,49.43,66
CPT,82693,HC ETHYLENE & PROPYLENE GLYCOL,177.44,133.08,2.13,159.7,119
CPT,82696,Assay of etiocholanolone,,,23.38,39.36,58
CPT,82705,Fats/lipids feces qual,,,4.54,7.65,58
CPT,82705,HC FAT/LIPIDS FECES; QUAL,100.29,75.22,1.2,90.26,119
CPT,82710,Fats/lipids feces quant,,,14.97,25.2,58
CPT,82710,HC FAT FECES QUANTITATIVE,529.45,397.09,6.35,476.51,119
CPT,82715,Assay of fecal fat,,,20.47,34.46,58
CPT,82725,Assay of blood fatty acids,,,16.72,28.16,58
CPT,82725,HC FATTY ACIDS NONESTERIFIED,355.93,266.95,4.27,320.34,119
CPT,82726,HC FATTY ACIDS  VERY LONG CHAIN-RL,867.97,650.98,10.42,781.17,119
CPT,82726,Long chain fatty acids,,,17.6,29.63,58
CPT,82728,Assay of ferritin,,,12.14,20.45,58
CPT,82728,HC FERRITIN,96.15,72.11,1.15,86.54,119
CPT,82731,Assay of fetal fibronectin,,,57.39,213.72,66
CPT,82731,HC FETAL FIBRONECTION CV SEMIQUAN,931.01,698.26,11.17,837.91,119
CPT,82735,Assay of fluoride,,,16.52,27.81,58
CPT,82746,Assay of folic acid serum,,,13.1,48.77,66
CPT,82746,HC FOLIC ACID; SERUM,103.35,77.51,1.24,93.02,119
CPT,82747,Assay of folic acid rbc,,,15.73,26.48,58
CPT,82747,HC FOLIC ACID; RBC,96.29,72.22,1.16,86.66,119
CPT,82757,Assay of semen fructose,,,15.45,26.01,58
CPT,82759,Assay of rbc galactokinase,,,19.14,71.27,66
CPT,82760,Assay of galactose,,,9.98,16.8,58
CPT,82775,Assay galactose transferase,,,18.77,31.61,58
CPT,82775,HC GALACTOSE 1 PHOSPH URIDYL TRANSFERASE RL,544.59,408.44,6.54,490.13,119
CPT,82776,Galactose transferase test,,,10.46,17.61,58
CPT,82777,Galectin-3,,,39.43,146.82,66
CPT,82777,HC GALECTIN 3,218.0,163.5,2.62,196.2,119
CPT,82784,Assay iga/igd/igg/igm each,,,8.29,30.86,66
CPT,82784,HC IGG CEREB SPINAL FLUID,66.36,49.77,0.8,59.72,119
CPT,82784,HC IMMUNOGLOBULIN A,66.36,49.77,0.8,59.72,119
CPT,82784,HC IMMUNOGLOBULIN D,66.36,49.77,0.8,59.72,119
CPT,82784,HC IMMUNOGLOBULIN G,66.36,49.77,0.8,59.72,119
CPT,82784,HC IMMUNOGLOBULIN M,66.36,49.77,0.8,59.72,119
CPT,82784,HC IMMUNOGLOBULIN; EACH (A/D/G/M),66.36,49.77,0.8,59.72,119
CPT,82785,Assay of ige,,,14.67,54.61,66
CPT,82785,HC IMMUNOGLOBULIN E,118.44,88.83,1.42,106.6,119
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 1,258.53,193.9,3.1,232.68,119
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 2,258.53,193.9,3.1,232.68,119
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 3,258.53,193.9,3.1,232.68,119
CPT,82787,HC IMMUNOGLOBULIN G SUBCLASS 4,258.53,193.9,3.1,232.68,119
CPT,82787,HC IMMUNOGLOBULIN IGG SUBCLASS; EACH (1-4),39.35,29.51,0.47,35.42,119
CPT,82787,Igg 1 2 3 or 4 each,,,7.15,12.03,58
CPT,82800,Blood ph,,,9.8,16.5,58
CPT,82800,HC BLOOD GAS PH ONLY,153.44,115.08,1.84,138.1,119
CPT,82800,HC BLOOD GAS PH ONLY POC,153.44,115.08,1.84,138.1,119
CPT,82803,Blood gases any combination,,,23.23,39.11,58
CPT,82803,HC  BLOOD GASES WO 02 SAT POC,655.49,491.62,7.87,589.94,119
CPT,82803,HC BLOOD GASES ANY COMBINATION,482.66,362.0,5.79,434.39,119
CPT,82805,Blood gases w/o2 saturation,,,70.18,261.36,66
CPT,82805,HC BLOOD GASES W/02 SATURATION,431.54,323.65,5.18,388.39,119
CPT,82805,HC BLOOD GASES W/02 SATURATION POCL/POCBS,434.27,325.7,5.21,390.84,119
CPT,82810,Blood gases o2 sat only,,,8.71,14.66,58
CPT,82810,HC OXYGEN SATURATION,197.89,148.42,2.37,178.1,119
CPT,82810,HC OXYGEN SATURATION POC,221.57,166.18,2.66,199.41,119
CPT,82820,Hemoglobin-oxygen affinity,,,11.89,20.01,58
CPT,82930,Gastric analy w/ph ea spec,,,5.98,10.07,58
CPT,82938,Gastrin test,,,15.76,26.54,58
CPT,82941,Assay of gastrin,,,15.71,26.45,58
CPT,82941,HC GASTRIN,86.77,65.08,1.04,78.09,119
CPT,82943,Assay of glucagon,,,12.73,21.44,58
CPT,82943,HC GLUCAGON,115.74,86.8,1.39,104.17,119
CPT,82945,Glucose other fluid,,,3.5,5.9,58
CPT,82945,HC GLUCOSE; OTHER BODY FLUID,60.95,45.71,0.73,54.86,119
CPT,82946,Glucagon tolerance test,,,15.83,26.66,58
CPT,82947,Assay glucose blood quant,,,3.5,8.96,66
CPT,82947,HC GLUCOSE; QUAN BLOOD,60.95,45.71,0.73,54.86,119
CPT,82947,HC GLUCOSE; QUAN BLOOD POC,80.91,60.68,0.97,72.82,119
CPT,82948,HC GLUCOSE; BLOOD REAGENT STRIP POC,13.65,10.24,0.16,12.28,119
CPT,82948,Reagent strip/blood glucose,,,4.49,7.56,58
CPT,82950,Glucose test,,,4.23,10.88,66
CPT,82950,HC GLUCOSE; POST GLUCOSE DOSE,60.95,45.71,0.73,54.86,119
CPT,82951,Glucose tolerance test (gtt),,,11.47,19.31,66
CPT,82951,HC GLUCOSE TOLERANCE 3 SPEC,100.22,75.17,1.2,90.2,119
CPT,82952,Gtt-added samples,,,3.49,8.43,66
CPT,82952,HC GLUCOSE TOLERANCE EA ADDL,30.96,23.22,0.37,27.86,119
CPT,82955,Assay of g6pd enzyme,,,8.64,14.55,58
CPT,82955,HC G 6-PH DEHYDROGENASE,130.51,97.88,1.57,117.46,119
CPT,82960,Test for g6pd enzyme,,,5.39,9.08,58
CPT,82962,Glucose blood test,,,2.92,4.92,58
CPT,82963,Assay of glucosidase,,,19.14,71.27,66
CPT,82965,Assay of gdh enzyme,,,11.72,19.73,58
CPT,82977,Assay of ggt,,,6.42,13.24,66
CPT,82977,HC GAMMA GLUTAMYL TRANSFERASE,61.03,45.77,0.73,54.93,119
CPT,82978,Assay of glutathione,,,13.77,23.18,58
CPT,82979,Assay rbc glutathione,,,8.41,31.32,66
CPT,82985,Assay of glycated protein,,,13.07,25.14,66
CPT,82985,HC FRUCTOSAMINE -RL,73.13,54.85,0.88,65.82,119
CPT,83001,Assay of gonadotropin (fsh),,,13.21,27.87,66
CPT,83001,HC GONADOTROPIN FSH,129.45,97.09,1.55,116.5,119
CPT,83002,Assay of gonadotropin (lh),,,13.21,27.78,66
CPT,83002,HC LEUTENIZINE HORMONE-LH,129.07,96.8,1.55,116.16,119
CPT,83003,Assay growth hormone (hgh),,,14.85,25.01,58
CPT,83003,HC GROWTH HORMONE HGH,101.1,75.82,1.21,90.99,119
CPT,83006,Growth stimulation gene 2,,,75.6,113.4,57
CPT,83009,H pylori (c-13) blood,,,60.02,223.5,66
CPT,83010,Assay of haptoglobin quant,,,11.21,18.87,58
CPT,83010,"HC HAPTOGLOBIN, QUANTITATIVE",89.07,66.8,1.07,80.16,119
CPT,83012,Assay of haptoglobins,,,23.96,40.34,58
CPT,83013,H pylori (c-13) breath,,,60.02,223.5,66
CPT,83013,HC H PYLORI (C13) BREATH TEST,245.53,184.15,2.95,220.98,119
CPT,83014,H pylori drug admin,,,7.0,11.79,58
CPT,83014,HC H PYLORI DRUG ADMIN,36.65,27.49,0.44,32.98,119
CPT,83015,Heavy metal qual any number,,,18.66,31.41,58
CPT,83018,HC HEAVY METAL QUAN EACH NES,135.2,101.4,1.62,121.68,119
CPT,83018,Heavy metal quan each nes,,,19.57,32.94,58
CPT,83020,HC HEMOGLOBIN ELECTROPHORESIS,78.45,58.84,0.94,70.6,119
CPT,83020,Hemoglobin electrophoresis,,,12.87,19.31,57
CPT,83021,HC HGB CHROMATOGRAPHY,211.68,158.76,2.54,190.51,119
CPT,83021,Hemoglobin chromotography,,,16.09,59.92,66
CPT,83026,Hemoglobin copper sulfate,,,3.57,6.02,58
CPT,83030,Hemoglobin f fetal chemical,,,9.57,16.11,58
CPT,83033,HC HGB; FETAL QUAL,254.62,190.96,3.06,229.16,119
CPT,83033,Hemoglobin ftl f assay qual,,,7.13,12.0,58
CPT,83036,HC HEMOGLOBIN A1C,78.83,59.12,0.95,70.95,119
CPT,83036,Hemoglobin glycosylated a1c,,,8.65,14.57,66
CPT,83037,HC HB GLYCOSYLATED A1C HOME DEV,28.56,21.42,0.34,25.7,119
CPT,83037,Hb glycosylated a1c home dev,,,8.65,14.57,66
CPT,83045,Hgb methemoglobin qual,,,5.78,9.74,58
CPT,83050,HC METHEMOGLOBIN,180.66,135.5,2.17,162.59,119
CPT,83050,Hgb methemoglobin quan,,,7.31,12.3,58
CPT,83051,HC HEMOGLOBIN PLASMA,94.07,70.55,1.13,84.66,119
CPT,83051,Hemoglobin plasma,,,6.51,10.97,58
CPT,83060,Hgb sulfhemoglobin quan,,,7.84,13.2,58
CPT,83065,Hemoglobin thermolabile,,,8.02,13.5,58
CPT,83068,"HC UNSTABLE HEMOGLOBIN, B",164.5,123.38,1.97,148.05,119
CPT,83068,Hemoglobin unstable screen,,,8.44,31.43,66
CPT,83069,Hemoglobin urine,,,3.52,5.93,58
CPT,83070,Assay of hemosiderin qual,,,4.23,7.13,58
CPT,83070,HC HEMOSIDERIN; QUAL,62.37,46.78,0.75,56.13,119
CPT,83080,Assay of b hexosaminidase ea,,,15.03,25.31,58
CPT,83088,Assay of histamine,,,26.31,44.3,58
CPT,83088,HC HISTAMINE,174.82,131.12,2.1,157.34,119
CPT,83090,Assay of homocysteine,,,15.97,26.88,58
CPT,83090,HC HOMOCYSTEINE,125.0,93.75,1.5,112.5,119
CPT,83150,Assay of homovanillic acid,,,19.97,33.62,58
CPT,83150,HC HOMOVANILLIC ACID (HVA),119.58,89.68,1.43,107.62,119
CPT,83491,Asy hydroxycorticosteroids17,,,15.95,26.85,58
CPT,83491,"HC HYDROXYCORTICOSTEROIDS, 17-OHCS",309.75,232.31,3.72,278.78,119
CPT,83497,Assay of 5-hiaa,,,11.49,19.35,58
CPT,83497,HC 5-HIAA,117.51,88.13,1.41,105.76,119
CPT,83498,Asy hydroxyprogesterone 17-d,,,24.21,90.15,66
CPT,83498,HC HYDROXYPROGESTERONE 17,133.83,100.37,1.61,120.45,119
CPT,83500,Assay free hydroxyproline,,,20.18,33.98,58
CPT,83505,Assay total hydroxyproline,,,21.65,36.45,58
CPT,83516,HC ACETYCHOL MODULATING AB,87.85,65.89,1.05,79.06,119
CPT,83516,HC ANTI NEURONAL ANTIBODY HU IMMU,39.35,29.51,0.47,35.42,119
CPT,83516,"HC CENTROMERE AB, IGG",86.58,64.94,1.04,77.92,119
CPT,83516,HC COM CON TISSUE T'GLUTAMINASE IGG,152.65,114.49,1.83,137.39,119
CPT,83516,"HC GBM AB,IGG (MAFD)",57.12,42.84,0.69,51.41,119
CPT,83516,HC GLIADIN ANTIBODY IGA,22.61,16.96,0.27,20.35,119
CPT,83516,HC GLIADIN ANTIBODY IGG,95.63,71.72,1.15,86.07,119
CPT,83516,HC IMMUNOASSAY NONANTIBODY,145.27,108.95,1.74,130.74,119
CPT,83516,"HC IMMUNOASSAY NONANTIBODY - HSTNAB, CENTG, RPPAB, SMAB",152.65,114.49,1.83,137.39,119
CPT,83516,HC MYELOPEROXIDASE AB REFLEX,159.13,119.35,1.91,143.22,119
CPT,83516,HC SERINE PROTEASE 3 REFLEX,26.71,20.03,0.32,24.04,119
CPT,83516,HC TISSUE T'GLUTAMINASE AB,23.28,17.46,0.28,20.95,119
CPT,83516,Immunoassay nonantibody,,,10.27,17.3,66
CPT,83518,Immunoassay dipstick,,,8.59,14.46,66
CPT,83519,HC HYDROXYLAS-21 ANTIBODY,290.16,217.62,3.48,261.14,119
CPT,83519,HC RIA NONANTIBODY,244.9,183.68,2.94,220.41,119
CPT,83519,Ria nonantibody,,,16.39,27.6,58
CPT,83520,HC 14-3-3 ANTIGEN DETECTION,104.78,78.58,1.26,94.3,119
CPT,83520,"HC COM CON MAG IGM, 5",408.76,306.57,4.91,367.88,119
CPT,83520,HC HMGCR ANTIBODY IGG,114.03,85.52,1.37,102.63,119
CPT,83520,HC IMMUNOASSAY QUANT NOS NONAB,337.78,253.34,4.05,304.0,119
CPT,83520,HC INTERLEUKIN 2 RECPTOR,621.44,466.08,7.46,559.3,119
CPT,83520,HC MANNOSE BINDING LECTIN,220.87,165.65,2.65,198.78,119
CPT,83520,"HC PANCREATIC ELASTASE, FECAL",677.08,507.81,8.12,609.37,119
CPT,83520,HC TRYPTASE,337.78,253.34,4.05,304.0,119
CPT,83520,HC TSH RECEPTOR AB,218.51,163.88,2.62,196.66,119
CPT,83520,Immunoassay quant nos nonab,,,13.21,25.91,66
CPT,83521,HC IMMUNOGLOBULIN LIGHT CHAINS FREE EACH,271.88,203.91,3.26,244.69,119
CPT,83521,Ig light chains free each,,,15.39,25.91,58
CPT,83525,Assay of insulin,,,10.18,17.15,58
CPT,83525,HC INSULIN; TOTAL,81.33,61.0,0.98,73.2,119
CPT,83527,Assay of insulin,,,11.54,19.43,58
CPT,83527,HC INSULIN LEVEL FREE,96.41,72.31,1.16,86.77,119
CPT,83528,Assay of intrinsic factor,,,17.66,29.73,58
CPT,83529,Asay of interleukin-6 (il-6),,,15.39,25.91,58
CPT,83529,HC ASSAY OF INTERLEUKIN-6 (IL-6),736.57,552.43,8.84,662.91,119
CPT,83540,Assay of iron,,,5.76,9.71,58
CPT,83540,HC IRON,61.16,45.87,0.73,55.04,119
CPT,83550,HC IRON BINDING CAPACITY,177.8,133.35,2.13,160.02,119
CPT,83550,Iron binding test,,,7.79,13.11,58
CPT,83570,Assay of idh enzyme,,,7.89,13.28,58
CPT,83582,Assay of ketogenic steroids,,,13.78,23.21,58
CPT,83586,Assay 17- ketosteroids,,,11.4,19.2,58
CPT,83586,"HC 17 KETOSTEROIDS, URINE, TOTAL",144.13,108.1,1.73,129.72,119
CPT,83593,Fractionation ketosteroids,,,25.39,42.75,58
CPT,83605,Assay of lactic acid,,,10.31,17.36,66
CPT,83605,HC LACTIC ACID,82.25,61.69,0.99,74.03,119
CPT,83605,HC LACTIC ACID POC,328.84,246.63,3.95,295.96,119
CPT,83615,HC LACTATE DEHYDROGENASE,61.03,45.77,0.73,54.93,119
CPT,83615,Lactate (ld) (ldh) enzyme,,,5.38,9.06,58
CPT,83625,Assay of ldh enzymes,,,11.4,19.19,58
CPT,83625,HC LDH ISOENZYMES,107.43,80.57,1.29,96.69,119
CPT,83630,HC LACTOFERRIN FECAL (QUAL),331.08,248.31,3.97,297.97,119
CPT,83630,Lactoferrin fecal (qual),,,17.55,29.55,58
CPT,83631,Lactoferrin fecal (quant),,,17.49,29.45,58
CPT,83632,Placental lactogen,,,18.02,30.33,58
CPT,83633,Test urine for lactose,,,10.02,16.88,58
CPT,83655,Assay of lead,,,10.79,18.17,66
CPT,83655,HC LEAD,63.91,47.93,0.77,57.52,119
CPT,83661,L/s ratio fetal lung,,,19.59,32.99,58
CPT,83662,Foam stability fetal lung,,,16.85,28.37,58
CPT,83663,Fluoro polarize fetal lung,,,16.85,28.37,58
CPT,83664,HC LAMELLAR BODY DENSITY,90.86,68.14,1.09,81.77,119
CPT,83664,Lamellar bdy fetal lung,,,17.21,28.98,58
CPT,83670,Assay of lap enzyme,,,8.74,14.72,58
CPT,83670,HC LEUCINE AMINOPEPTIDASE-RL,171.66,128.74,2.06,154.49,119
CPT,83690,Assay of lipase,,,6.14,10.34,58
CPT,83690,HC LIPASE,63.32,47.49,0.76,56.99,119
CPT,83695,Assay of lipoprotein(a),,,12.76,21.48,58
CPT,83695,HC APOLIPOPROTEIN LEVEL RL,129.53,97.15,1.55,116.58,119
CPT,83698,Assay lipoprotein pla2,,,41.26,69.47,58
CPT,83698,HC ASSAY LIPOPROTEIN PLA2,154.5,115.88,1.85,139.05,119
CPT,83700,HC LIPOPROTEIN ELECTROPHORESIS,332.19,249.14,3.99,298.97,119
CPT,83700,Lipopro bld electrophoretic,,,10.03,16.89,58
CPT,83701,HC LIPOPROTEIN BLD HR FRACTION,251.03,188.27,3.01,225.93,119
CPT,83701,Lipoprotein bld hr fraction,,,30.17,50.79,58
CPT,83704,HC LIPOPROTEIN BLD BY NMR,252.26,189.2,3.03,227.03,119
CPT,83704,Lipoprotein bld quan part,,,30.46,51.29,58
CPT,83718,Assay of lipoprotein,,,7.3,13.93,66
CPT,83718,HC HIGH DENSITY LIPOPROTEIN,63.19,47.39,0.76,56.87,119
CPT,83719,Assay of blood lipoprotein,,,11.36,19.13,58
CPT,83721,Assay of blood lipoprotein,,,9.36,15.75,66
CPT,83721,HC LDL DIRECT MEASURE,79.62,59.72,0.96,71.66,119
CPT,83722,Lipoprtn dir meas sd ldl chl,,,30.46,51.29,58
CPT,83727,Assay of lrh hormone,,,15.32,25.79,58
CPT,83735,Assay of magnesium,,,5.97,10.05,58
CPT,83735,HC MAGNESIUM 24HR URINE,62.98,47.24,0.76,56.68,119
CPT,83735,HC MAGNESIUM URINE,62.98,47.24,0.76,56.68,119
CPT,83735,"HC MAGNESIUM, BLOOD",61.03,45.77,0.73,54.93,238
CPT,83775,Assay malate dehydrogenase,,,6.57,11.06,58
CPT,83785,Assay of manganese,,,23.75,39.98,58
CPT,83785,HC MANGANESE,103.75,77.81,1.25,93.38,119
CPT,83789,HC CORTISONE URINE RL,349.15,261.86,4.19,314.24,119
CPT,83789,HC HB VARIANT BY MASS SPEC,349.15,261.86,4.19,314.24,119
CPT,83789,Mass spectrometry qual/quan,,,21.48,36.17,58
CPT,83825,Assay of mercury,,,14.49,24.39,58
CPT,83825,HC MERCURY; QUANTITATIVE,72.88,54.66,0.87,65.59,119
CPT,83835,Assay of metanephrines,,,15.09,25.41,58
CPT,83835,HC METANEPHRINES PLASMA,479.99,359.99,5.76,431.99,119
CPT,83835,HC METANEPHRINES URINE,144.62,108.46,1.74,130.16,119
CPT,83857,Assay of methemalbumin,,,9.57,16.11,58
CPT,83861,Microfluid analy tears,,,18.0,33.72,66
CPT,83864,HC MUCOPOLYSACCH ACID; QUAN,1058.16,793.62,12.7,952.34,119
CPT,83864,Mucopolysaccharides,,,25.39,42.75,58
CPT,83872,Assay synovial fluid mucin,,,5.22,8.79,58
CPT,83873,Assay of csf protein,,,15.33,25.8,58
CPT,83873,HC MYELIN BASIC PROTEIN,102.12,76.59,1.23,91.91,119
CPT,83874,Assay of myoglobin,,,11.51,19.38,58
CPT,83874,HC MYOGLOBIN,82.85,62.14,0.99,74.56,119
CPT,83876,Assay myeloperoxidase,,,45.32,168.76,66
CPT,83876,HC MYELOPEROXIDASE MPO,159.13,119.35,1.91,143.22,119
CPT,83880,Assay of natriuretic peptide,,,13.9,58.89,66
CPT,83880,HC NATRIURETIC PEPTIDE,268.64,201.48,3.22,241.78,119
CPT,83883,Assay nephelometry not spec,,,12.12,20.4,58
CPT,83883,HC KAPPA/LAMBDA RATIO SERUM,95.17,71.38,1.14,85.65,119
CPT,83883,HC NEPHELOMETRY EA ANALYTE NES,212.76,159.57,2.55,191.48,119
CPT,83884,Assay neurflmnt light chain,,,0.5,116.23,12
CPT,83885,Assay of nickel,,,21.84,36.77,58
CPT,83885,HC NICKEL,57.65,43.24,0.69,51.88,119
CPT,83915,Assay of nucleotidase,,,9.93,16.73,58
CPT,83915,HC NUCLEOTIDASE 5 ASSAY,103.92,77.94,1.25,93.53,119
CPT,83916,HC CSF OLIGOCLONAL BANDS STUDY,208.51,156.38,2.5,187.66,119
CPT,83916,Oligoclonal bands,,,24.4,90.88,66
CPT,83918,HC ORGANIC ACIDS URINE,605.44,454.08,7.27,544.9,119
CPT,83918,Organic acids total quant,,,21.03,35.4,58
CPT,83919,Organic acids qual each,,,14.66,54.58,66
CPT,83921,HC METHYLMALONIC ACID SERUM,556.61,417.46,6.68,500.95,119
CPT,83921,Organic acid single quant,,,18.9,31.82,58
CPT,83930,Assay of blood osmolality,,,5.89,9.92,58
CPT,83930,HC OSMOLALITY; BLOOD,75.31,56.48,0.9,67.78,119
CPT,83935,Assay of urine osmolality,,,6.08,10.23,58
CPT,83935,HC OSMOLALITY URINE,75.23,56.42,0.9,67.71,119
CPT,83937,Assay of osteocalcin,,,26.6,44.78,58
CPT,83937,HC OSTEOCALCIN,291.64,218.73,3.5,262.48,119
CPT,83945,Assay of oxalate,,,12.87,21.68,58
CPT,83945,HC OXALATE BLOOD OR URINE,102.51,76.88,1.23,92.26,119
CPT,83950,Oncoprotein her-2/neu,,,57.39,213.72,66
CPT,83951,HC ONCOPROTEIN DCP,232.94,174.7,2.8,209.65,119
CPT,83951,Oncoprotein dcp,,,57.39,213.72,66
CPT,83970,Assay of parathormone,,,36.78,61.92,58
CPT,83970,HC PARATHORMONE; PTH,291.19,218.39,3.49,262.07,119
CPT,83986,Assay ph body fluid nos,,,3.19,7.86,66
CPT,83986,HC PH; BODY FLUID,25.42,19.07,0.31,22.88,119
CPT,83986,HC PH; BODY FLUID (NITROZENE) POC,25.42,19.07,0.31,22.88,119
CPT,83986,HC PH; FECAL,9.69,7.27,0.12,8.72,119
CPT,83987,Exhaled breath condensate,,,3.58,5.37,57
CPT,83992,Assay for phencyclidine,,,62.28,62.28,3
CPT,83992,HC PHENCYCLIDINE (PCP),588.57,441.43,7.06,529.71,119
CPT,83993,Assay for calprotectin fecal,,,17.49,29.45,58
CPT,83993,HC ASSAY FOR CALPROTECTIN FECAL,300.08,225.06,3.6,270.07,119
CPT,84030,Assay of blood pku,,,4.9,8.25,58
CPT,84030,HC NEWBORN PHENYLETONURIA SCREEN,677.26,507.94,8.13,609.53,119
CPT,84035,Assay of phenylketones,,,3.55,5.97,58
CPT,84060,Assay acid phosphatase,,,6.81,11.46,58
CPT,84060,HC ACID PHOSPHATASE,64.46,48.34,0.77,58.01,119
CPT,84066,Assay prostate phosphatase,,,8.61,14.49,58
CPT,84066,HC PROSTATIC ACID PHOSPHATASE,91.46,68.6,1.1,82.31,119
CPT,84075,Assay alkaline phosphatase,,,4.62,17.19,66
CPT,84075,HC ALKALINE PHOSPHATASE SERUM,61.03,45.77,0.73,54.93,119
CPT,84078,Assay alkaline phosphatase,,,7.36,12.39,58
CPT,84080,Assay alkaline phosphatases,,,13.17,49.04,66
CPT,84080,HC ALKALINE PHOSPHATASE ISOENZYME,352.4,264.3,4.23,317.16,119
CPT,84081,Assay phosphatidylglycerol,,,14.72,54.81,66
CPT,84085,Assay of rbc pg6d enzyme,,,8.41,31.32,66
CPT,84087,Assay phosphohexose enzymes,,,9.56,16.1,58
CPT,84100,Assay of phosphorus,,,4.22,7.11,58
CPT,84100,HC PHOSPHORUS,61.03,45.77,0.73,54.93,119
CPT,84105,Assay of urine phosphorus,,,5.15,8.67,58
CPT,84105,HC PHOSPHORUS; URINE,61.03,45.77,0.73,54.93,119
CPT,84106,Test for porphobilinogen,,,5.19,8.73,58
CPT,84110,Assay of porphobilinogen,,,7.52,12.66,58
CPT,84110,HC PORPHOBILINOGEN  URINE QUANT,197.99,148.49,2.38,178.19,119
CPT,84112,Eval amniotic fluid protein,,,87.42,147.17,58
CPT,84112,HC PLACENTA ALPHA MICRO (AMNISURE) IG C/V POCL/POCBS,682.32,511.74,8.19,614.09,119
CPT,84112,HC PLACENTA ALPHA MICRO IG C/V,682.31,511.73,8.19,614.08,119
CPT,84119,Test urine for porphyrins,,,11.9,20.04,58
CPT,84120,Assay of urine porphyrins,,,13.11,48.8,66
CPT,84120,HC QUAN URINE PORPHYRINS,188.2,141.15,2.26,169.38,119
CPT,84126,Assay of feces porphyrins,,,34.85,58.67,58
CPT,84126,HC ASSAY OF FECES PORPHYRINS,380.47,285.35,4.57,342.42,119
CPT,84132,Assay of serum potassium,,,4.24,10.88,66
CPT,84132,HC POTASSIUM; SERUM,60.95,45.71,0.73,54.86,119
CPT,84132,HC POTASSIUM; SERUM - POC,199.64,149.73,2.4,179.68,119
CPT,84133,Assay of urine potassium,,,4.21,7.1,58
CPT,84133,HC POTASSIUM; URINE,94.02,70.52,1.13,84.62,119
CPT,84134,Assay of prealbumin,,,13.0,21.89,58
CPT,84134,HC PREALBUMIN,102.58,76.94,1.23,92.32,119
CPT,84135,Assay of pregnanediol,,,18.95,70.57,66
CPT,84138,Assay of pregnanetriol,,,18.76,31.58,58
CPT,84140,Assay of pregnenolone,,,18.42,31.01,58
CPT,84140,HC ASSAY OF PREGNENOLONE-RL,194.98,146.24,2.34,175.48,119
CPT,84143,Assay of 17-hydroxypregneno,,,20.32,34.22,58
CPT,84143,HC HYDROXYPREGNENOLONE 17,10834.19,8125.64,130.01,9750.77,119
CPT,84144,Assay of progesterone,,,18.59,31.29,58
CPT,84144,HC PROGESTERONE,144.81,108.61,1.74,130.33,119
CPT,84145,HC PROCALCITONIN,183.09,137.32,2.2,164.78,119
CPT,84145,Procalcitonin (pct),,,24.25,90.32,66
CPT,84146,Assay of prolactin,,,17.27,29.07,58
CPT,84146,HC PROLACTIN,538.34,403.76,6.46,484.51,119
CPT,84150,Assay of prostaglandin,,,37.22,138.59,66
CPT,84150,HC PROSTAGLANDIN,637.22,477.92,7.65,573.5,119
CPT,84152,Assay of psa complexed,,,16.39,27.59,58
CPT,84153,Assay of psa total,,,16.39,102.0,85
CPT,84153,HC PROSTATE SPECIFIC ANTIGEN COMPLEX,128.14,96.1,1.54,115.33,119
CPT,84153,HC PROSTATIC SPECIFIC ANTIGEN TOTAL,128.14,96.1,1.54,115.33,119
CPT,84154,Assay of psa free,,,16.39,102.0,85
CPT,84154,HC PROSTATE SPECIFIC ANTIGEN FREE,128.14,96.1,1.54,115.33,119
CPT,84155,Assay of protein serum,,,3.27,5.51,58
CPT,84155,HC PROTEIN TOTAL SERUM,61.03,45.77,0.73,54.93,119
CPT,84156,Assay of protein urine,,,3.27,5.51,58
CPT,84156,HC TOTAL PROTEIN; URINE,63.99,47.99,0.77,57.59,119
CPT,84157,Assay of protein other,,,3.56,9.92,66
CPT,84157,HC TOTAL PROTEIN; OTHER BODY FLUID,63.99,47.99,0.77,57.59,119
CPT,84160,Assay of protein any source,,,5.0,8.42,58
CPT,84163,Pappa serum,,,13.41,49.94,66
CPT,84165,HC PROTEIN; EP FRACT & QUAN,161.88,121.41,1.94,145.69,119
CPT,84165,Protein e-phoresis serum,,,10.74,17.22,57
CPT,84166,HC PROTEIN ELECTROPHORESIS; OTHER FLUID,227.97,170.98,2.74,205.17,119
CPT,84166,Protein e-phoresis/urine/csf,,,17.22,26.75,57
CPT,84181,Western blot test,,,17.03,56.5,65
CPT,84182,HC PROTEIN WB; IM ID FOR BANDS,253.11,189.83,3.04,227.8,119
CPT,84182,Protein western blot test,,,17.22,43.82,57
CPT,84202,Assay rbc protoporphyrin,,,12.79,21.53,58
CPT,84202,HC ZINC PROTOPORPHYRIN BLOOD,344.69,258.52,4.14,310.22,119
CPT,84203,Test rbc protoporphyrin,,,8.68,14.61,58
CPT,84206,Assay of proinsulin,,,23.78,40.04,58
CPT,84206,HC PROINSULIN,194.16,145.62,2.33,174.74,119
CPT,84207,Assay of vitamin b-6,,,25.04,93.24,66
CPT,84207,HC VITAMIN B6,118.36,88.77,1.42,106.52,119
CPT,84210,Assay of pyruvate,,,12.9,21.72,58
CPT,84210,HC PYRUVIC ACID TEST,139.43,104.57,1.67,125.49,119
CPT,84220,Assay of pyruvate kinase,,,8.41,31.32,66
CPT,84220,HC ASSAY OF PYRUVATE KINASE,588.29,441.22,7.06,529.46,119
CPT,84228,Assay of quinine,,,10.36,17.45,58
CPT,84233,Assay of estrogen,,,78.3,131.82,58
CPT,84233,HC ESTROGEN RECEPTOR ASSAY,237.94,178.46,2.86,214.15,119
CPT,84234,Assay of progesterone,,,57.81,215.27,66
CPT,84235,Assay of endocrine hormone,,,63.47,106.85,58
CPT,84238,Assay nonendocrine receptor,,,32.58,121.34,66
CPT,84238,HC ASSAY NONENDOCRINE RECEPTOR,99.02,74.26,1.19,89.12,119
CPT,84244,Assay of renin,,,19.59,32.99,58
CPT,84244,HC RENIN,91.74,68.81,1.1,82.57,119
CPT,84252,Assay of vitamin b-2,,,18.03,30.36,58
CPT,84252,HC ASSAY OF RIBOFLAVIN,101.61,76.21,1.22,91.45,119
CPT,84255,Assay of selenium,,,22.75,84.7,66
CPT,84255,HC SELENIUM,95.23,71.42,1.14,85.71,119
CPT,84260,Assay of serotonin,,,27.6,46.47,58
CPT,84260,HC SEROTONIN SERUM,242.68,182.01,2.91,218.41,119
CPT,84270,Assay of sex hormone globul,,,19.36,72.1,66
CPT,84270,HC SEX HORMONE BINDING GLOBULIN,150.72,113.04,1.81,135.65,119
CPT,84275,Assay of sialic acid,,,11.98,20.16,58
CPT,84285,Assay of silica,,,22.46,37.82,58
CPT,84295,Assay of serum sodium,,,4.29,11.38,66
CPT,84295,HC SODIUM; SERUM,101.85,76.39,1.22,91.66,119
CPT,84295,HC SODIUM; SERUM - POC,212.32,159.24,2.55,191.09,119
CPT,84300,Assay of urine sodium,,,4.51,7.59,58
CPT,84300,HC SODIUM URINE,101.85,76.39,1.22,91.66,119
CPT,84302,Assay of sweat sodium,,,4.33,7.29,58
CPT,84302,HC SODIUM OTHER SOURCE,101.85,76.39,1.22,91.66,119
CPT,84305,Assay of somatomedin,,,18.94,31.89,58
CPT,84305,HC SOMATOMEDIN,95.61,71.71,1.15,86.05,119
CPT,84307,Assay of somatostatin,,,16.29,27.42,58
CPT,84307,HC SOMATOSTATIN,1334.36,1000.77,16.01,1200.92,119
CPT,84311,"HC CHOLESTEROL,FLUID",149.2,111.9,1.79,134.28,119
CPT,84311,HC SPECTROPHOTOMETRY ANALYTE NES,111.52,83.64,1.34,100.37,119
CPT,84311,Spectrophotometry,,,7.22,12.15,58
CPT,84315,Body fluid specific gravity,,,2.92,4.92,58
CPT,84315,HC SPECIFIC GRAVITY BODY FLUID,56.89,42.67,0.68,51.2,119
CPT,84375,Chromatogram assay sugars,,,34.75,58.5,58
CPT,84376,HC REDUCING SUBSTANCE STOOL,47.72,35.79,0.57,42.95,119
CPT,84376,HC SUGARS SINGLE QUAL EA,47.72,35.79,0.57,42.95,119
CPT,84376,Sugars single qual,,,4.9,8.25,58
CPT,84377,Sugars multiple qual,,,4.9,8.25,58
CPT,84378,"HC SUGARS, SINGLE QUANTITATIVE, EA SPECIMEN",31.22,23.42,0.37,28.1,119
CPT,84378,Sugars single quant,,,10.27,17.3,58
CPT,84379,Sugars multiple quant,,,10.27,17.3,58
CPT,84392,Assay of urine sulfate,,,4.89,8.24,58
CPT,84392,HC SULFATE; URINE,15.24,11.43,0.18,13.72,119
CPT,84393,HC  TAU PHOSPHORYLATED EACH,723.86,542.9,8.69,651.47,119
CPT,84393,Tau phosphorylated ea,,,0.5,128.92,12
CPT,84394,HC TOTAL TAU (TTAU),562.51,421.88,6.75,506.26,119
CPT,84394,Total tau,,,0.5,128.92,12
CPT,84402,Assay of free testosterone,,,22.69,84.51,66
CPT,84402,HC TESTOSTERONE FREE,184.81,138.61,2.22,166.33,119
CPT,84403,Assay of total testosterone,,,23.0,38.72,58
CPT,84403,HC TESTOSTERONE TOTAL,182.59,136.94,2.19,164.33,119
CPT,84410,Testosterone bioavailable,,,45.69,170.14,66
CPT,84425,Assay of vitamin b-1,,,18.92,31.85,58
CPT,84425,HC THIAMINE VITAMIN B-1,136.95,102.71,1.64,123.26,119
CPT,84430,Assay of thiocyanate,,,10.36,17.45,58
CPT,84430,HC THIOCYANATE LEVEL,163.44,122.58,1.96,147.1,119
CPT,84431,HC THROMBOXANE URINE,95.07,71.3,1.14,85.56,119
CPT,84431,Thromboxane urine,,,31.28,52.67,58
CPT,84432,Assay of thyroglobulin,,,14.31,24.09,58
CPT,84432,HC THYROGLOBULIN,54.33,40.75,0.65,48.9,119
CPT,84433,Asy thiopurin s-mthyltrnsfrs,,,19.75,33.26,58
CPT,84433,HC ASSAY THIOPURINE S-METHYLTRANSFERASE,559.38,419.54,6.71,503.44,119
CPT,84436,Assay of total thyroxine,,,6.12,10.31,58
CPT,84436,HC THYROXINE TOTAL T4,42.83,32.12,0.51,38.55,119
CPT,84437,Assay of neonatal thyroxine,,,5.76,9.71,58
CPT,84437,HC THYROXINE T4 NEONATAL-RL,42.83,32.12,0.51,38.55,119
CPT,84439,Assay of free thyroxine,,,8.04,13.53,58
CPT,84439,HC FREE THYROXINE,65.2,48.9,0.78,58.68,119
CPT,84442,Assay of thyroid activity,,,13.17,49.04,66
CPT,84442,HC THYROXINE BINDING GLOBULIN,93.31,69.98,1.12,83.98,119
CPT,84443,Assay thyroid stim hormone,,,13.13,78.0,93
CPT,84443,HC THYROID STIMULATING HORMONE,117.52,88.14,1.41,105.77,119
CPT,84445,Assay of tsi globulin,,,45.32,168.76,66
CPT,84445,HC THYROID STIMULATING IMMUNOGLOB,443.1,332.32,5.32,398.79,119
CPT,84446,Assay of vitamin e,,,12.63,21.27,58
CPT,84446,HC TOCOPHEROL ALPHA VITAMIN E,95.02,71.26,1.14,85.52,119
CPT,84449,Assay of transcortin,,,16.04,59.72,66
CPT,84450,HC TRANSAMINASE AST/SGOT,61.03,45.77,0.73,54.93,119
CPT,84450,Transferase (ast) (sgot),,,4.62,12.18,66
CPT,84460,Alanine amino (alt) (sgpt),,,4.72,12.71,66
CPT,84460,HC TRANSAMINASE ALT/SGPT,61.03,45.77,0.73,54.93,119
CPT,84466,Assay of transferrin,,,11.37,19.14,58
CPT,84466,HC TRANSFERRIN LEVEL,90.38,67.78,1.08,81.34,119
CPT,84478,Assay of triglycerides,,,5.11,17.19,66
CPT,84478,HC TRIGLYCERIDES,61.03,45.77,0.73,54.93,119
CPT,84479,Assay of thyroid (t3 or t4),,,5.76,9.71,58
CPT,84479,HC THYROID HORMONE UPTAKE/BIND RATIO,45.03,33.77,0.54,40.53,119
CPT,84480,Assay triiodothyronine (t3),,,12.63,21.27,58
CPT,84480,HC TRIIODOTHYRONINE TOTAL,99.81,74.86,1.2,89.83,119
CPT,84481,Free assay (ft-3),,,15.09,56.21,66
CPT,84481,HC TRIIODOTHYRONINE T3 FREE,118.45,88.84,1.42,106.6,119
CPT,84482,HC T3; REVERSE,180.17,135.13,2.16,162.15,119
CPT,84482,T3 reverse,,,14.04,23.64,58
CPT,84484,Assay of troponin quant,,,11.11,18.71,58
CPT,84484,HC TROPONIN QUANTITATIVE,194.18,145.64,2.33,174.76,119
CPT,84484,HC TROPONIN QUANTITATIVE POC,895.08,671.31,10.74,805.57,119
CPT,84485,Assay duodenal fluid trypsin,,,6.42,10.8,58
CPT,84488,HC TRYPSIN; FECES QUAL,83.59,62.69,1.0,75.23,119
CPT,84488,Test feces for trypsin,,,6.5,10.95,58
CPT,84490,Assay of feces for trypsin,,,8.85,14.9,58
CPT,84510,Assay of tyrosine,,,9.47,15.95,58
CPT,84510,HC TYROSINE,485.53,364.15,5.83,436.98,119
CPT,84512,Assay of troponin qual,,,8.99,15.14,58
CPT,84520,Assay of urea nitrogen,,,3.52,9.03,66
CPT,84520,HC UREA NITROGEN QUANT,60.95,45.71,0.73,54.86,119
CPT,84520,HC UREA NITROGEN QUANT BLOOD POC,327.13,245.35,3.93,294.42,119
CPT,84525,Urea nitrogen semi-quant,,,4.57,7.7,58
CPT,84540,Assay of urine/urea-n,,,4.95,8.34,58
CPT,84540,HC UREA NITROGEN URINE,60.95,45.71,0.73,54.86,119
CPT,84545,HC UREA NITROGEN CLEARANCE,60.46,45.34,0.73,54.41,119
CPT,84545,Urea-n clearance test,,,6.42,10.8,58
CPT,84550,Assay of blood/uric acid,,,4.03,10.12,66
CPT,84550,HC URIC ACID BLOOD,61.03,45.77,0.73,54.93,119
CPT,84560,Assay of urine/uric acid,,,4.53,7.62,58
CPT,84560,HC URIC ACID; OTHER SOURCE,61.03,45.77,0.73,54.93,119
CPT,84577,Assay of feces/urobilinogen,,,14.97,25.2,58
CPT,84578,Test urine urobilinogen,,,3.98,6.71,58
CPT,84580,Assay of urine urobilinogen,,,8.51,31.69,66
CPT,84583,Assay of urine urobilinogen,,,5.39,9.08,58
CPT,84585,Assay of urine vma,,,13.81,23.25,58
CPT,84585,HC URINE VMA ACID,103.57,77.68,1.24,93.21,119
CPT,84586,Assay of vip,,,31.48,53.0,58
CPT,84586,HC VASOACTIVE INTESTINAL PEPTIDE,183.4,137.55,2.2,165.06,119
CPT,84588,Assay of vasopressin,,,30.24,50.91,58
CPT,84588,HC VASOPRESSIN ANTIDURETIC HORM,202.11,151.58,2.43,181.9,119
CPT,84590,Assay of vitamin a,,,10.34,17.42,58
CPT,84590,HC VITAMIN A;  RETINOL,91.17,68.38,1.09,82.05,119
CPT,84591,Assay of nos vitamin,,,15.2,25.59,58
CPT,84591,HC VITAMIN NOS,216.81,162.61,2.6,195.13,119
CPT,84597,Assay of vitamin k,,,12.22,20.58,58
CPT,84597,HC VITAMIN K,355.46,266.6,4.27,319.91,119
CPT,84600,Assay of volatiles,,,15.24,25.67,58
CPT,84600,HC ASSAY OF VOLATILES (BLOOD),172.48,129.36,2.07,155.23,119
CPT,84620,Xylose tolerance test,,,11.5,19.37,58
CPT,84630,Assay of zinc,,,10.15,17.09,58
CPT,84630,HC ZINC,58.76,44.07,0.71,52.88,119
CPT,84681,Assay of c-peptide,,,18.54,31.22,58
CPT,84681,HC C-PEPTIDE,81.82,61.36,0.98,73.64,119
CPT,84702,Chorionic gonadotropin test,,,13.41,49.94,66
CPT,84702,"HC GONADOTROPIN, CHORIONIC (HCG); QUANTITATIVE POC",125.34,94.0,1.5,112.81,119
CPT,84702,HC HUMAN CHORIONIC GONADOTROPIN QUANT,125.32,93.99,1.5,112.79,119
CPT,84703,Chorionic gonadotropin assay,,,6.7,13.27,66
CPT,84703,HC PREGNANCY TEST QUALITATIVE,67.97,50.98,0.82,61.17,119
CPT,84703,HC PREGNANCY TEST QUALITATIVE POC,41.33,31.0,0.5,37.2,119
CPT,84704,HC HCG FREE BETACHAIN TEST,69.64,52.23,0.84,62.68,119
CPT,84704,Hcg free betachain test,,,13.62,50.74,66
CPT,84830,Ovulation tests,,,11.32,19.05,58
CPT,84999,HC COM CON POTASSIUM,132.33,99.25,1.59,119.1,119
CPT,84999,HC COM CON PROMETHEUS ANSER IFX,1752.58,1314.44,21.03,1577.32,119
CPT,84999,HC OSMOLALITY STOOL,117.62,88.22,1.41,105.86,119
CPT,84999,"HC PHENOPHTHALEIN,FECES",117.62,88.22,1.41,105.86,119
CPT,84999,Unlisted chemistry procedure,,,0.5,0.5,3
CPT,85002,Bleeding time test,,,4.29,7.23,58
CPT,85002,HC BLEEDING TIME,182.83,137.12,2.19,164.55,119
CPT,85004,Automated diff wbc count,,,5.76,9.71,58
CPT,85007,Bl smear w/diff wbc count,,,3.39,5.7,58
CPT,85007,HC DIFFERENTIAL MANUAL WBC COUNT,39.11,29.33,0.47,35.2,119
CPT,85008,Bl smear w/o diff wbc count,,,3.06,5.15,58
CPT,85009,Manual diff wbc count b-coat,,,4.52,7.61,58
CPT,85013,HC HEMATOCRIT SPUN,226.13,169.6,2.71,203.52,119
CPT,85013,Spun microhematocrit,,,6.24,10.5,58
CPT,85014,HC HEMATOCRIT,48.09,36.07,0.58,43.28,119
CPT,85014,HC HEMATOCRIT POC,48.09,36.07,0.58,43.28,119
CPT,85014,Hematocrit,,,2.11,7.86,66
CPT,85018,HC HEMOGLOBIN,127.08,95.31,1.52,114.37,119
CPT,85018,HC HEMOGLOBIN POCL/POCBS,127.08,95.31,1.52,114.37,119
CPT,85018,Hemoglobin,,,2.11,3.56,58
CPT,85025,Complete cbc w/auto diff wbc,,,6.92,63.0,93
CPT,85025,HC CBC/PLT AUTO DIFFERENTIAL,91.45,68.59,1.1,82.3,119
CPT,85025,HC CBC/PLT AUTO DIFFERENTIAL POC,91.45,68.59,1.1,82.3,119
CPT,85027,Complete cbc automated,,,5.76,55.0,85
CPT,85027,HC CBC W/O DIFFERENTIAL,68.67,51.5,0.82,61.8,119
CPT,85032,Manual cell count each,,,3.84,6.47,58
CPT,85041,Automated rbc count,,,2.69,4.53,58
CPT,85041,HC RBC-RED BLOOD COUNT AUTOMATED,58.18,43.64,0.7,52.36,119
CPT,85044,HC MANUAL RETICULOCYTE COUNT,373.49,280.12,4.48,336.14,119
CPT,85044,Manual reticulocyte count,,,3.84,6.47,58
CPT,85045,Automated reticulocyte count,,,3.56,5.99,58
CPT,85045,HC RETICULOCYTE COUNT AUTOMATED,46.54,34.9,0.56,41.89,119
CPT,85046,HC RETICYTE/HGB CONCENTRATE,94.65,70.99,1.14,85.18,119
CPT,85046,Reticyte/hgb concentrate,,,4.96,8.36,58
CPT,85048,Automated leukocyte count,,,2.26,3.81,58
CPT,85048,HC BLOOD COUNT LEUKOCYTE WBC AUTOMATED,46.47,34.85,0.56,41.82,119
CPT,85049,Automated platelet count,,,3.99,6.72,58
CPT,85049,HC PLATELET COUNT AUTOMATED,34.65,25.99,0.42,31.18,119
CPT,85055,HC RETICULATED PLATELET ASSAY,27.61,20.71,0.33,24.85,119
CPT,85055,Reticulated platelet assay,,,31.84,53.61,58
CPT,85060,Blood smear interpretation,,,23.33,51.22,40
CPT,85097,Bone marrow interpretation,,,46.52,984.23,66
CPT,85130,Chromogenic substrate assay,,,10.59,17.84,58
CPT,85130,HC CHROMGNC SUBSTRT ASSAY,951.76,713.82,11.42,856.58,119
CPT,85170,Blood clot retraction,,,14.52,24.45,58
CPT,85175,Blood clot lysis time,,,18.15,30.56,58
CPT,85175,HC BLOOD CLOT LYSIS TIME,55.16,41.37,0.66,49.64,119
CPT,85210,Clot factor ii prothrom spec,,,11.57,19.47,58
CPT,85210,HC FACTOR II ASSAY,269.03,201.77,3.23,242.13,119
CPT,85220,Blooc clot factor v test,,,15.73,26.48,58
CPT,85220,"HC CLOT FACTOR V (ACG, PROACCELERIN)",153.24,114.93,1.84,137.92,119
CPT,85230,Clot factor vii proconvertin,,,15.95,26.85,58
CPT,85230,HC FACTOR VII ASSAY,181.28,135.96,2.18,163.15,119
CPT,85240,Clot factor viii ahg 1 stage,,,15.95,26.85,58
CPT,85240,HC COM CON FACTOR VIII ASSAY,445.1,333.82,5.34,400.59,119
CPT,85240,HC FACTOR VIII ASSAY,157.22,117.92,1.89,141.5,119
CPT,85244,Clot factor viii reltd antgn,,,18.19,30.63,58
CPT,85245,Clot factor viii vw ristoctn,,,20.44,34.41,58
CPT,85245,HC VW FACTOR 8 ASSAY /RIST COFACT,204.67,153.5,2.46,184.2,119
CPT,85246,Clot factor viii vw antigen,,,20.44,34.41,58
CPT,85246,HC VW FACTOR 8 ANTIGEN,189.11,141.83,2.27,170.2,119
CPT,85247,Clot factor viii multimetric,,,20.44,34.41,58
CPT,85247,HC VW FACTOR 8 MULTIMRIC,200.86,150.65,2.41,180.77,119
CPT,85250,Clot factor ix ptc/chrstmas,,,16.96,28.56,58
CPT,85250,HC FACTOR IX ASSAY,224.41,168.31,2.69,201.97,119
CPT,85260,Clot factor x stuart-power,,,15.95,26.85,58
CPT,85260,HC FACTOR X ASSAY,182.56,136.92,2.19,164.3,119
CPT,85270,Clot factor xi pta,,,15.95,26.85,58
CPT,85270,HC FACTOR XI ASSAY,315.56,236.67,3.79,284.0,119
CPT,85280,Clot factor xii hageman,,,17.24,29.03,58
CPT,85280,HC FACTOR XII ASSAY,318.63,238.97,3.82,286.77,119
CPT,85290,Clot factor xiii fibrin stab,,,14.56,24.51,58
CPT,85291,Clot factor xiii fibrin scrn,,,8.12,13.67,58
CPT,85291,"HC FACTOR XIII, QUALITATIVE",166.98,125.24,2.0,150.28,119
CPT,85292,Clot factor fletcher fact,,,16.87,28.4,58
CPT,85293,Clot factor wght kininogen,,,16.87,28.4,58
CPT,85300,Antithrombin iii activity,,,10.56,17.78,58
CPT,85300,HC ANTITHROMBIN III ACTIVITY,451.28,338.46,5.42,406.15,119
CPT,85301,Antithrombin iii antigen,,,9.63,16.22,58
CPT,85301,HC ANTITHROMBIN III ANTIGEN ASSAY-RL,163.63,122.72,1.96,147.27,119
CPT,85302,Clot inhibit prot c antigen,,,10.7,18.02,58
CPT,85302,HC PROTEIN C ANTIGEN,105.32,78.99,1.26,94.79,119
CPT,85303,Clot inhibit prot c activity,,,12.33,20.76,58
CPT,85303,HC PROTEIN C ACTIVITY,165.1,123.82,1.98,148.59,119
CPT,85305,Clot inhibit prot s total,,,10.34,17.42,58
CPT,85305,HC PROTEIN S TOTAL ANTIGEN,101.7,76.28,1.22,91.53,119
CPT,85306,Clot inhibit prot s free,,,13.65,22.98,58
CPT,85306,HC PROTEIN S-FREE,216.51,162.38,2.6,194.86,119
CPT,85307,Assay activated protein c,,,13.65,22.98,58
CPT,85307,HC ACTIVATED PROTEIN C RESISTANCE,141.63,106.22,1.7,127.47,119
CPT,85335,Factor inhibitor test,,,11.47,19.31,58
CPT,85337,Thrombomodulin,,,15.39,25.91,58
CPT,85345,Coagulation time lee & white,,,4.18,7.04,58
CPT,85347,Coagulation time activated,,,3.81,6.42,58
CPT,85347,HC COAGULATION TIME ACTIVATED,61.33,46.0,0.74,55.2,119
CPT,85347,HC COAGULATION TIME ACTIVATED POCL/POCBS,146.25,109.69,1.76,131.62,119
CPT,85348,Coagulation time otr method,,,4.0,6.74,58
CPT,85360,Euglobulin lysis,,,7.49,12.62,58
CPT,85362,Fibrin degradation products,,,6.14,10.34,58
CPT,85362,HC FIBRIN SPLIT PRODUCTS,131.92,98.94,1.58,118.73,119
CPT,85366,Fibrinogen test,,,71.69,266.96,66
CPT,85366,HC FIBRINOGEN DEGRADATION PRODUCTS; PARACOAGULATION,238.43,178.82,2.86,214.59,119
CPT,85370,Fibrinogen test,,,11.08,18.65,58
CPT,85378,Fibrin degrade semiquant,,,8.66,14.58,58
CPT,85378,HC D-DIMER SEMI-QUANTITATIVE,185.44,139.08,2.23,166.9,119
CPT,85379,Fibrin degradation quant,,,9.07,15.27,58
CPT,85379,HC D DIMER QUAN,288.88,216.66,3.47,259.99,119
CPT,85380,Fibrin degradj d-dimer,,,9.07,15.27,58
CPT,85384,Fibrinogen activity,,,8.66,14.58,58
CPT,85384,HC FIBRINOGEN ACTIVITY,74.37,55.78,0.89,66.93,119
CPT,85385,Fibrinogen antigen,,,12.88,21.69,58
CPT,85385,HC FIBRINOGEN; ANTIGEN,171.02,128.26,2.05,153.92,119
CPT,85390,Fibrinolysins screen i&r,,,15.48,78.44,65
CPT,85390,HC SPECIAL COAGULATION INTER,2858.93,2144.2,34.31,2573.04,119
CPT,85396,Clotting assay whole blood,,,18.77,59.72,47
CPT,85397,Clotting funct activity,,,27.5,46.29,58
CPT,85397,HC CLOTTING FUNCT ACTIVITY,1192.68,894.51,14.31,1073.41,119
CPT,85400,Fibrinolytic plasmin,,,6.87,11.57,58
CPT,85410,Fibrinolytic antiplasmin,,,6.87,11.57,58
CPT,85410,HC FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN,233.33,175.0,2.8,210.0,119
CPT,85415,Fibrinolytic plasminogen,,,15.32,25.79,58
CPT,85415,HC FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,126.94,95.2,1.52,114.25,119
CPT,85420,Fibrinolytic plasminogen,,,5.82,9.8,58
CPT,85420,HC FUNCTIONAL PLASMINOGEN,143.21,107.41,1.72,128.89,119
CPT,85421,Fibrinolytic plasminogen,,,9.07,15.27,58
CPT,85441,Heinz bodies direct,,,3.74,6.3,58
CPT,85445,Heinz bodies induced,,,6.08,10.23,58
CPT,85460,HC KLEIHAUER BETKE STAIN,455.41,341.56,5.46,409.87,119
CPT,85460,HC KLEIHAUER FETAL ELUTION,341.78,256.33,4.1,307.6,119
CPT,85460,Hemoglobin fetal,,,6.89,11.6,58
CPT,85461,HC FETAL HGB SCREEN ROSETTE,221.83,166.37,2.66,199.65,119
CPT,85461,Hemoglobin fetal,,,8.34,31.06,66
CPT,85475,Hemolysin acid,,,7.9,13.31,58
CPT,85520,HC HEPARIN ASSAY,512.61,384.46,6.15,461.35,119
CPT,85520,Heparin assay,,,11.66,43.43,66
CPT,85525,HC HEPARIN ADSORPTION OF PLASMA,58.28,43.71,0.7,52.45,119
CPT,85525,Heparin neutralization,,,10.55,17.76,58
CPT,85530,Heparin-protamine tolerance,,,11.66,43.43,66
CPT,85536,Iron stain peripheral blood,,,6.13,10.32,58
CPT,85540,HC LEUKOCYTE ALKALINE PHOSPHATASE,386.24,289.68,4.63,347.62,119
CPT,85540,Wbc alkaline phosphatase,,,7.66,12.9,58
CPT,85547,Rbc mechanical fragility,,,7.66,12.9,58
CPT,85549,HC MURAMIDASE,93.68,70.26,1.12,84.31,119
CPT,85549,Muramidase,,,16.71,28.13,58
CPT,85555,"HC OSMOTIC FRAGILITY, RBC; UNINCUBATED",48.62,36.47,0.58,43.76,119
CPT,85555,Rbc osmotic fragility,,,6.66,11.21,58
CPT,85557,"HC OSMTC FRGLTY,RBC,INCUB",525.76,394.32,6.31,473.18,119
CPT,85557,Rbc osmotic fragility,,,11.9,20.04,58
CPT,85576,Blood platelet aggregation,,,13.49,37.37,101
CPT,85576,HC BLOOD PLATELET AGGREGATION POC,546.58,409.94,6.56,491.92,119
CPT,85576,"HC PLATELET AGGREGATION, EACH AGENT",241.49,181.12,2.9,217.34,119
CPT,85597,HC PHOSPHOLIPID NEUTRALIZATION; PLTLT,381.21,285.91,4.57,343.09,119
CPT,85597,Phospholipid pltlt neutraliz,,,16.02,26.97,58
CPT,85598,HC HEXAGONAL PHOSPHOLIPID; PLTLT,156.1,117.08,1.87,140.49,119
CPT,85598,Hexagnal phosph pltlt neutrl,,,16.02,26.97,58
CPT,85610,HC PROTHROMBIN TIME,30.66,23.0,0.37,27.59,119
CPT,85610,HC PROTHROMBIN TIME POCL/POCBS,117.71,88.28,1.41,105.94,119
CPT,85610,Prothrombin time,,,3.82,38.0,93
CPT,85611,HC PROTHROMBIN TIME CORRECTION,112.56,84.42,1.35,101.3,119
CPT,85611,Prothrombin test,,,3.51,5.91,58
CPT,85612,Viper venom prothrombin time,,,15.58,26.24,58
CPT,85613,HC RUSSELL VIPER VENOM TIME; DILUTED,69.28,51.96,0.83,62.35,119
CPT,85613,Russell viper venom diluted,,,8.54,31.78,66
CPT,85635,HC REPTILASE TIME-RL,188.0,141.0,2.26,169.2,119
CPT,85635,Reptilase test,,,8.78,14.78,58
CPT,85651,HC SED RATE ERYTHROCYTE NONAUTO,90.7,68.03,1.09,81.63,119
CPT,85651,Rbc sed rate nonautomated,,,3.8,6.41,58
CPT,85652,HC AUTOM ERYTHROCYTE SED RATE,64.82,48.62,0.78,58.34,119
CPT,85652,Rbc sed rate automated,,,2.41,4.05,58
CPT,85660,HC SICKLE CELL SCREEN,88.37,66.28,1.06,79.53,119
CPT,85660,Rbc sickle cell test,,,4.91,8.27,58
CPT,85670,HC THROMBIN TIME,151.0,113.25,1.81,135.9,119
CPT,85670,Thrombin time plasma,,,5.14,8.66,58
CPT,85675,Thrombin time titer,,,6.1,10.28,58
CPT,85705,Thromboplastin inhibition,,,8.58,31.95,66
CPT,85730,HC PARTIAL THROMBOPLASTIN TIME,30.66,23.0,0.37,27.59,119
CPT,85730,Thromboplastin time partial,,,5.35,37.0,85
CPT,85732,HC PTT SUBSTITUTION PLASMA FRACTIONS EA,106.43,79.82,1.28,95.79,119
CPT,85732,Thromboplastin time partial,,,5.76,9.71,58
CPT,85810,Blood viscosity examination,,,10.4,17.51,58
CPT,85810,HC VISCOSITY,67.78,50.84,0.81,61.0,119
CPT,85999,Unlisted hematology&coagj px,,,0.5,0.5,3
CPT,86000,Agglutinins febrile antigen,,,6.22,10.47,58
CPT,86000,HC AGGLUTININS FEBRILE EACH ANTIGEN,107.69,80.77,1.29,96.92,119
CPT,86001,Allergen specific igg,,,6.97,11.73,58
CPT,86001,HC ALLERG SP IGG QUAN OR SEMIQUAN,149.1,111.82,1.79,134.19,119
CPT,86003,Allg spec ige crude xtrc ea,,,4.65,7.83,58
CPT,86003,"HC ALLERGEN SPECIFIC IGE, EACH ALLERGEN",36.57,27.43,0.44,32.91,119
CPT,86005,Allg spec ige multiallg scr,,,7.1,11.96,58
CPT,86005,HC QUALITATIVE MULTIALLERGEN SCREEN,76.98,57.74,0.92,69.28,119
CPT,86008,Allg spec ige recomb ea,,,15.98,26.9,58
CPT,86008,HC QUALITATIVE OR SEMIQUANITATIVE IMMUNOASSAY,97.98,73.48,1.18,88.18,119
CPT,86015,Actin antibody each,,,10.74,17.3,58
CPT,86015,HC ACTIN SMOOTH MUSCLE ANTIBODY EACH,59.1,44.32,0.71,53.19,119
CPT,86021,HC ANTIBODY ID; LEUKOCYTE AB,437.98,328.48,5.26,394.18,119
CPT,86021,Wbc antibody identification,,,13.41,49.94,66
CPT,86022,HC ANTIBODY ID; PLATELET ANTIBODIES,2816.54,2112.41,33.8,2534.89,119
CPT,86022,Platelet antibodies,,,16.37,27.56,58
CPT,86023,HC AB ID; PLATELET IG ASSAY (G/M),209.22,156.92,2.51,188.3,119
CPT,86023,Immunoglobulin assay,,,11.1,18.69,58
CPT,86036,Anca screen each antibody,,,10.74,18.08,58
CPT,86036,HC ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,118.18,88.64,1.42,106.36,119
CPT,86037,Anca titer each antibody,,,10.74,18.08,58
CPT,86037,HC COM CON NEUTROPHIL CYTOPLASM AB SCREEN,118.18,88.64,1.42,106.36,119
CPT,86038,Antinuclear antibodies,,,10.77,18.14,58
CPT,86038,HC ANTI-NUCLEAR ANTIBODIES,48.91,36.68,0.59,44.02,119
CPT,86039,Antinuclear antibodies (ana),,,9.94,16.74,58
CPT,86039,HC ANA TITER,97.46,73.1,1.17,87.71,119
CPT,86041,Acetylcholn rcptr bndng antb,,,16.39,27.6,22
CPT,86041,HC ACETYLCHOLN RCPTR BNDNG ANTB,287.88,215.91,3.45,259.09,119
CPT,86042,Acetylcholn rcptr blckg antb,,,16.39,27.6,22
CPT,86042,HC ACETYLCHOLN RCPTR BLCKG ANTB,521.57,391.18,6.26,469.41,119
CPT,86043,Acetylcholn rcptr modlg antb,,,10.74,18.08,22
CPT,86043,HC ACETYLCHOLN RCPTR MODLG ANTB,622.05,466.54,7.46,559.84,119
CPT,86051,Aquaporin-4 antb elisa,,,10.27,17.3,58
CPT,86051,HC AQUAPORIN-4 ANTIBODY ELISA,1477.07,1107.8,17.72,1329.36,119
CPT,86052,Aquaporin-4 antb cba each,,,10.74,18.08,58
CPT,86052,HC AQUAPORIN-4 ANTIBODY CELL-BASED IMFLUOR ASSAY EA,1516.47,1137.35,18.2,1364.82,119
CPT,86053,Aqaprn-4 antb flo cytmtry ea,,,18.08,125.19,66
CPT,86053,HC AQAPRN-4 ANTB FLO CYTMTRY EA,957.58,718.18,11.49,861.82,119
CPT,86060,Antistreptolysin o titer,,,6.5,10.95,58
CPT,86060,HC ANTISTREPTOLYSIN O TITER,191.82,143.86,2.3,172.64,119
CPT,86063,Antistreptolysin o screen,,,5.14,8.66,58
CPT,86077,Phys blood bank serv xmatch,,,23.47,164.98,66
CPT,86078,Phys blood bank serv reactj,,,47.46,223.74,66
CPT,86079,Phys blood bank serv authrj,,,47.77,163.95,66
CPT,86140,C-reactive protein,,,4.62,7.77,58
CPT,86140,HC C-REACTIVE PROTEIN,63.32,47.49,0.76,56.99,119
CPT,86141,C-reactive protein hs,,,11.54,19.43,58
CPT,86141,HC CRP-HIGH SENSITIVITY,91.56,68.67,1.1,82.4,119
CPT,86146,Beta-2 glycoprotein antibody,,,22.68,38.18,58
CPT,86146,"HC BETA 2 GLYCOPROTEIN 1 ANTIBODY, EA (A/G/M)",133.18,99.88,1.6,119.86,119
CPT,86147,Cardiolipin antibody ea ig,,,22.68,38.18,58
CPT,86147,HC ANTICARDIOLIPIN IGG,86.89,65.17,1.04,78.2,119
CPT,86147,HC ANTICARDIOLIPIN IGM,86.89,65.17,1.04,78.2,119
CPT,86147,HC CARDIOLIPIN AB; EA IG CLASS (A/G/M),86.89,65.17,1.04,78.2,119
CPT,86148,Anti-phospholipid antibody,,,14.32,24.11,58
CPT,86148,HC ANTI-PHOSPHOLIPID ANTIBODIES,125.84,94.38,1.51,113.26,119
CPT,86152,Cell enumeration & id,,,223.44,832.08,66
CPT,86153,Cell enumeration phys interp,,,0.5,32.44,39
CPT,86155,Chemotaxis assay,,,14.25,23.99,58
CPT,86156,Cold agglutinin screen,,,7.19,12.11,58
CPT,86157,Cold agglutinin titer,,,7.18,12.09,58
CPT,86157,HC COLD AGGLUTININS TITER,58.21,43.66,0.7,52.39,119
CPT,86160,Complement antigen,,,10.69,18.0,58
CPT,86160,HC COMPLEMENT ANTIGEN; EACH COMPONENT,85.13,63.85,1.02,76.62,119
CPT,86160,HC COMPLEMENT C3,85.13,63.85,1.02,76.62,119
CPT,86160,HC COMPLEMENT C4,85.13,63.85,1.02,76.62,119
CPT,86161,Complement/function activity,,,10.69,18.0,58
CPT,86161,HC C1 ESTERASE INHIBITOR,188.56,141.42,2.26,169.7,119
CPT,86162,Complement total (ch50),,,18.11,30.48,58
CPT,86162,HC COMPLEMENT TOTAL,67.02,50.26,0.8,60.32,119
CPT,86171,Complement fixation each,,,8.92,15.02,58
CPT,86200,Ccp antibody,,,11.54,19.43,58
CPT,86200,HC CITRULLINATED PEPTIDE IGGCCP ANTIBODY,96.03,72.02,1.15,86.43,119
CPT,86215,Deoxyribonuclease antibody,,,11.81,19.88,58
CPT,86215,HC DNASE B ANTIBODY,69.96,52.47,0.84,62.96,119
CPT,86225,Dna antibody native,,,12.24,20.61,58
CPT,86225,HC DSDNA AB IGG,60.29,45.22,0.72,54.26,119
CPT,86226,Dna antibody single strand,,,10.79,18.17,58
CPT,86226,HC ANTI SINGLE-STRANDED DNA,131.4,98.55,1.58,118.26,119
CPT,86231,Ema each ig class,,,10.77,18.14,58
CPT,86231,HC ENDOMYSIAL ANTIBODY EACH IMMUNOGLOBULIN CLASS,231.82,173.86,2.78,208.64,119
CPT,86235,HC ANTIBODIES TO NUCLEAR ANTIGENS,84.99,63.74,1.02,76.49,119
CPT,86235,HC COM CON ANTISMOOTH MUSCLE ANTIBODY,416.05,312.04,4.99,374.44,119
CPT,86235,"HC ENA, ANY METHOD, EACH ANTIBODY",84.99,63.74,1.02,76.49,119
CPT,86235,HC JO-1 ANTIBODY IGG,150.57,112.93,1.81,135.51,119
CPT,86235,HC SCLERODERMA (SCL-70) (ENA) AB,416.05,312.04,4.99,374.44,119
CPT,86235,HC SMITH (ENA) ANTIBODY,24.26,18.2,0.29,21.83,119
CPT,86235,HC SSA (RO) (ENA) AB IGG,19.42,14.56,0.23,17.48,119
CPT,86235,HC SSB (LA) (ENA) AB IGG,142.32,106.74,1.71,128.09,119
CPT,86235,Nuclear antigen antibody,,,15.98,26.9,58
CPT,86255,Fluorescent antibody screen,,,12.05,18.08,57
CPT,86255,HC ANTI-NEURONAL CELL ANTIBODY,699.4,524.55,8.39,629.46,119
CPT,86255,HC ANTI-SMOOTH MUSCLE ANTIBODY,426.5,319.88,5.12,383.85,119
CPT,86255,"HC COM CONN MUSK ANTIBODY, IGG WITH REFLEX TO TITER",170.45,127.84,2.05,153.4,119
CPT,86255,HC FLUORESCENT AB; SCRN EA AB,379.11,284.33,4.55,341.2,119
CPT,86255,HC GBM ANTIBODY IGG,170.45,127.84,2.05,153.4,119
CPT,86255,HC LRP4 AUTOANTIBODY,426.5,319.88,5.12,383.85,119
CPT,86255,"HC MYELIN OLIGODENDROCYTE GLYCOPROTEIN FLUORESCENCE-ACTIVATED CELL SORTING ASSAY, SERUM",426.5,319.88,5.12,383.85,119
CPT,86255,HC NEURONAL NUCLEAR ABS (HU & RI),699.4,524.55,8.39,629.46,119
CPT,86256,Fluorescent antibody titer,,,12.05,18.08,57
CPT,86256,HC ANNA TITER,217.07,162.8,2.6,195.36,119
CPT,86256,HC ANTI RETICULIN AB TITER FLUORESCENT,255.78,191.84,3.07,230.2,119
CPT,86256,"HC ENDOMYSIAL AB,IGA TITER",287.75,215.81,3.45,258.98,119
CPT,86256,HC FLUORESCENT AB; TITER EA AB,410.83,308.12,4.93,369.75,119
CPT,86256,"HC NEUTROPHIL CYTOPLASMIC AB, IGG",32.63,24.47,0.39,29.37,119
CPT,86256,HC STRIATED MUSCLE IGG TITER BILL,332.65,249.49,3.99,299.38,119
CPT,86258,Dgp antibody each ig class,,,10.74,17.3,58
CPT,86258,HC GLIADIN ANTIBODY EACH IMMUNOGLOBULIN CLASS,95.63,71.72,1.15,86.07,119
CPT,86277,Growth hormone antibody,,,14.02,23.61,58
CPT,86280,Hemagglutination inhibition,,,7.3,12.29,58
CPT,86294,Immunoassay tumor qual,,,13.57,38.36,66
CPT,86300,HC CANCER ANTIGEN 15-3 (27.29),96.54,72.4,1.16,86.89,119
CPT,86300,Immunoassay tumor ca 15-3,,,18.54,31.22,58
CPT,86301,HC CANCER ANTIGEN 19-9,115.82,86.86,1.39,104.24,119
CPT,86301,Immunoassay tumor ca 19-9,,,18.54,31.22,58
CPT,86304,HC CANCER ANTIGEN 125,144.43,108.32,1.73,129.99,119
CPT,86304,Immunoassay tumor ca 125,,,18.54,31.22,58
CPT,86305,Human epididymis protein 4,,,18.54,31.22,58
CPT,86308,HC HETEROPHILE SCREEN,66.38,49.78,0.8,59.74,119
CPT,86308,Heterophile antibody screen,,,4.62,12.61,66
CPT,86309,Heterophile antibody titer,,,5.76,9.71,58
CPT,86310,Heterophile antibody absrbj,,,6.57,11.06,58
CPT,86316,HC IMMASY TUMOR AG QUAN,231.32,173.49,2.78,208.19,119
CPT,86316,Immunoassay tumor other,,,18.54,31.22,58
CPT,86317,HC IA INFECTIOUS AGENT AB QUAN NOS,71.03,53.27,0.85,63.93,119
CPT,86317,"HC PNEUMOCOCCAL, IGG",79.91,59.93,0.96,71.92,119
CPT,86317,HC S.PNEUMONIAE ANTIBODIES IGG SEROTYPE 9V,71.03,53.27,0.85,63.93,119
CPT,86317,Immunoassay infectious agent,,,13.36,49.74,66
CPT,86318,Ia infectious agent antibody,,,16.12,27.14,66
CPT,86320,Serum immunoelectrophoresis,,,17.22,44.88,57
CPT,86325,Other immunoelectrophoresis,,,17.22,34.7,57
CPT,86327,Immunoelectrophoresis assay,,,21.12,21.12,36
CPT,86328,Ia nfct ab sarscov2 covid19,,,13.96,67.92,66
CPT,86329,Immunodiffusion nes,,,12.52,21.08,58
CPT,86331,"HC IMMUNODIFFUSION; GEL QUAL, EA AB/AG",39.54,29.66,0.47,35.59,119
CPT,86331,Immunodiffusion ouchterlony,,,10.67,17.97,58
CPT,86332,HC IMMUNE COMPLEX ASSAY,124.72,93.54,1.5,112.25,119
CPT,86332,Immune complex assay,,,21.71,36.56,58
CPT,86334,HC IMMUNOFIXATION ELECTROPHORESIS SERUM,252.78,189.58,3.03,227.5,119
CPT,86334,HC IMMUNOGLOBULIN REFLEX,252.78,189.58,3.03,227.5,119
CPT,86334,Immunofix e-phoresis serum,,,17.22,33.51,57
CPT,86335,HC BENCE JONES PROT ELEC URINE,287.63,215.72,3.45,258.87,119
CPT,86335,Immunfix e-phorsis/urine/csf,,,17.22,44.03,57
CPT,86336,HC INHIBIN A ANTIBODY SCREEN-RL,118.17,88.63,1.42,106.35,119
CPT,86336,Inhibin a,,,13.89,23.39,58
CPT,86337,HC ANTI INSULIN ANTIBODIES-RL,271.68,203.76,3.26,244.51,119
CPT,86337,Insulin antibodies,,,19.08,71.04,66
CPT,86340,HC INTRINSIC FACTOR BLOCKING AB,156.36,117.27,1.88,140.72,119
CPT,86340,Intrinsic factor antibody,,,13.44,50.03,66
CPT,86341,HC ISLET CELL ANTIBODY-RL,174.89,131.17,2.1,157.4,119
CPT,86341,Islet cell antibody,,,21.0,35.36,58
CPT,86343,Leukocyte histamine release,,,11.1,18.69,58
CPT,86344,Leukocyte phagocytosis,,,9.26,15.59,58
CPT,86352,Cell function assay w/stim,,,121.05,450.79,66
CPT,86352,HC CELL FUNCTION ASSAY W/STIM,1333.13,999.85,16.0,1199.82,119
CPT,86353,HC LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,595.62,446.72,7.15,536.06,119
CPT,86353,HC WB PWM LYMPH PROLIF,670.1,502.58,8.04,603.09,119
CPT,86353,Lymphocyte transformation,,,43.69,162.68,66
CPT,86355,B cells total count,,,33.62,125.19,66
CPT,86355,HC B CELLS TOTAL COUNT,496.2,372.15,5.95,446.58,119
CPT,86356,HC ACTIVATED T IMMUNE STATUS  RL,992.43,744.32,11.91,893.19,119
CPT,86356,"HC CD2 IMMUNE STATUS, RL",376.03,282.02,4.51,338.43,119
CPT,86356,HC MONONUCLEAR CELL ANTIGEN QUANT NOS EA,376.03,282.02,4.51,338.43,119
CPT,86356,Mononuclear cell antigen,,,23.86,40.17,58
CPT,86357,HC CD56 (NK CELLS) TOTAL COUNT RL,454.89,341.17,5.46,409.4,119
CPT,86357,Nk cells total count,,,33.62,125.19,66
CPT,86359,HC TOTAL T CELL COUNT,454.89,341.17,5.46,409.4,119
CPT,86359,T cells total count,,,33.62,125.19,66
CPT,86360,HC CD4/CD8 ABSOLUTE AND RATIO,551.68,413.76,6.62,496.51,119
CPT,86360,T cell absolute count/ratio,,,41.86,70.47,58
CPT,86361,HC T CELLS CD4 COUNT,916.84,687.63,11.0,825.16,119
CPT,86361,T cell absolute count,,,23.86,40.17,58
CPT,86362,HC MOG-IGG1 AB CELL-BASED IMFLUOR ASSAY EA,353.16,264.87,4.24,317.84,119
CPT,86362,Mog-igg1 antb cba each,,,10.74,18.08,58
CPT,86363,HC MOG-IGG1 ANTB FLO CYTMTRY EA,507.26,380.44,6.09,456.53,119
CPT,86363,Mog-igg1 antb flo cytmtry ea,,,18.08,125.19,66
CPT,86364,HC TISS TRNSGLMNASE EA IG CLAS,59.1,44.32,0.71,53.19,119
CPT,86364,Tiss trnsgltmnase ea ig clas,,,10.27,17.3,58
CPT,86366,HC MUSCLE-SPECIFIC KINASE ANTB,4256.27,3192.2,51.08,3830.64,119
CPT,86366,Muscle-specific kinase antb,,,16.39,27.6,22
CPT,86367,"HC STEM CELLS, TOTAL COUNT",886.13,664.6,10.63,797.52,119
CPT,86367,Stem cells total count,,,69.3,258.07,66
CPT,86376,HC LIVER KIDNEY MICROSOMAL ANTIBO,91.04,68.28,1.09,81.94,119
CPT,86376,HC THYROID PEROXIDASE ANTIBODY,91.04,68.28,1.09,81.94,119
CPT,86376,Microsomal antibody each,,,12.96,21.83,58
CPT,86381,HC MITOCHONDRIAL ANTIBODY EACH,114.62,85.96,1.38,103.16,119
CPT,86381,Mitochondrial antibody each,,,22.68,38.18,58
CPT,86382,Neutralization test viral,,,15.07,25.37,58
CPT,86384,Nitroblue tetrazolium dye,,,12.13,20.42,58
CPT,86386,Nuclear matrix protein 22,,,13.38,32.67,66
CPT,86403,HC BACTERIAL ANTIGEN,297.86,223.4,3.57,268.07,119
CPT,86403,Particle agglut antbdy scrn,,,10.28,17.31,58
CPT,86406,Particle agglut antbdy titr,,,9.48,15.96,58
CPT,86408,Neutrlzg antb sarscov2 scr,,,37.54,139.79,66
CPT,86409,Neutrlzg antb sarscov2 titer,,,79.61,264.15,29
CPT,86413,Sars-cov-2 antb quantitative,,,51.43,91.65,22
CPT,86430,HC RHEUMATOID FACTOR QAUL,217.28,162.96,2.61,195.55,119
CPT,86430,Rheumatoid factor test qual,,,5.47,9.21,58
CPT,86431,HC RHEUMATOID FACTOR QUANT,101.54,76.16,1.22,91.39,119
CPT,86431,Rheumatoid factor quant,,,5.05,8.51,58
CPT,86480,"HC TB TEST, CELL IMMUN MEASURE RL",181.91,136.43,2.18,163.72,119
CPT,86480,Tb test cell immun measure,,,55.22,205.65,66
CPT,86481,"HC TB, AG RESPONSE T-CELL SUSP",266.68,200.01,3.2,240.01,119
CPT,86481,Tb ag response t-cell susp,,,89.1,150.0,58
CPT,86485,HC SKIN TEST CANDIDA POC,281.23,210.92,3.37,253.11,119
CPT,86485,Skin test candida,,,23.47,37.01,22
CPT,86486,Skin test unlisted antign ea,,,5.94,37.01,58
CPT,86490,Coccidioidomycosis skin test,,,73.09,73.09,36
CPT,86510,Histoplasmosis skin test,,,6.88,83.49,58
CPT,86580,HC SKIN TEST TUBERCULOSIS POC,139.98,104.98,1.68,125.98,119
CPT,86580,Tb intradermal test,,,9.39,37.01,58
CPT,86581,HC STRPTCS PNEUM ANTIBODY IGG SEROTYPES MLT IA QUAN,228.57,171.43,2.74,205.71,119
CPT,86581,Strptcs pneum antb serot ia,,,0.5,92.03,12
CPT,86590,Streptokinase antibody,,,11.28,18.99,58
CPT,86592,"HC RPR REFLEX TO TITER, FTA & TPPA",57.25,42.94,0.69,51.52,119
CPT,86592,HC SYPHILLIS NON-TREPONEMAL,57.25,42.94,0.69,51.52,119
CPT,86592,HC VDRL  SPINAL FLUID QUAL,37.78,28.34,0.45,34.0,119
CPT,86592,Syphilis test non-trep qual,,,3.8,6.41,58
CPT,86593,HC RPR TITER BILL,128.16,96.12,1.54,115.34,119
CPT,86593,HC SYPHILIS TEST NON-TREP QUANT,128.16,96.12,1.54,115.34,119
CPT,86593,"HC VDRL TITER, SPINAL FLUID",128.16,96.12,1.54,115.34,119
CPT,86593,Syphilis test non-trep quant,,,3.92,6.6,58
CPT,86596,HC VOLTAGE-GTD CA CHNL ANTB EA,1564.13,1173.1,18.77,1407.72,119
CPT,86596,Voltage-gtd ca chnl antb ea,,,10.74,27.6,58
CPT,86602,Antinomyces antibody,,,9.07,15.27,58
CPT,86603,Adenovirus antibody,,,11.47,19.31,58
CPT,86603,HC ADENOVIRUS ANTIBODY,66.79,50.09,0.8,60.11,119
CPT,86606,Aspergillus antibody,,,13.41,49.94,66
CPT,86606,HC ASPERGILLUS ANTIBODY,77.04,57.78,0.92,69.34,119
CPT,86609,Bacterium antibody,,,11.48,19.32,58
CPT,86609,HC ANTIBODY BACTERIUM NO ELSEWHERE SPECIFIED,276.28,207.21,3.32,248.65,119
CPT,86611,Bartonella antibody,,,9.07,15.27,58
CPT,86611,"HC ANTIBODY; BARTONELLA, EACH (A/G/M)",76.08,57.06,0.91,68.47,119
CPT,86611,HC BARTONELL QUINTANA IGG TITER,76.08,57.06,0.91,68.47,119
CPT,86611,HC BARTONELL QUINTANA IGM TITER,76.08,57.06,0.91,68.47,119
CPT,86611,HC BARTONELLA HENSELAE IGG,76.08,57.06,0.91,68.47,119
CPT,86611,HC BARTONELLA HENSELAE IGM,76.08,57.06,0.91,68.47,119
CPT,86612,Blastomyces antibody,,,11.49,19.35,58
CPT,86612,HC BLASTOMYCES ANTIBODY CF-RL,80.32,60.24,0.96,72.29,119
CPT,86615,Bordetella antibody,,,11.75,19.79,58
CPT,86615,HC ANTIBODY; BORDETELLA,211.43,158.57,2.54,190.29,119
CPT,86617,HC AB;LYME'S (WB) IGG CONFIRM,133.04,99.78,1.6,119.74,119
CPT,86617,HC AB;LYME'S (WB) IGM CONFIRM,133.04,99.78,1.6,119.74,119
CPT,86617,Lyme disease antibody,,,13.8,23.24,58
CPT,86618,HC LYME DISEASE ANTIBODY,61.34,46.0,0.74,55.21,119
CPT,86618,Lyme disease antibody,,,13.18,25.55,66
CPT,86619,Borrelia antibody,,,11.92,20.07,58
CPT,86622,Brucella antibody,,,7.96,13.4,58
CPT,86622,HC BRUCELLA ANTIBODY,91.59,68.69,1.1,82.43,119
CPT,86625,Campylobacter antibody,,,11.69,19.68,58
CPT,86628,Candida antibody,,,10.7,18.02,58
CPT,86628,HC AB; CANDIDA,88.34,66.26,1.06,79.51,119
CPT,86631,Chlamydia antibody,,,10.53,17.73,58
CPT,86631,HC ANTIBODY; CHLAMYDIA IGG,45.66,34.24,0.55,41.09,119
CPT,86631,HC C. PNEUMONIAE IGG,45.66,34.24,0.55,41.09,119
CPT,86631,HC C. PSITTACI IGG,45.66,34.24,0.55,41.09,119
CPT,86631,HC C. TRACHOMATIS IGG,45.66,34.24,0.55,41.09,119
CPT,86632,Chlamydia igm antibody,,,11.3,19.02,58
CPT,86632,HC ANTIBODY; CHLAMYDIA IGM,70.83,53.12,0.85,63.75,119
CPT,86632,HC C. PNEUMONIAE IGM,70.83,53.12,0.85,63.75,119
CPT,86632,HC C. PSITTACI IGM,70.83,53.12,0.85,63.75,119
CPT,86632,HC C. TRACHOMATIS IGM,70.83,53.12,0.85,63.75,119
CPT,86635,Coccidioides antibody,,,10.22,38.06,66
CPT,86635,"HC ANTIBODY; COCCIDIOIDES, EACH (A/G/M)",77.04,57.78,0.92,69.34,119
CPT,86635,HC COCCIDIODES-L.D.A.,77.04,57.78,0.92,69.34,119
CPT,86635,"HC COCCIDIOIDES ANTIBODY, IGG",77.04,57.78,0.92,69.34,119
CPT,86635,"HC COCCIDIOIDES ANTIBODY, IGM",77.04,57.78,0.92,69.34,119
CPT,86638,HC Q FEVER ANTIBODY,115.6,86.7,1.39,104.04,119
CPT,86638,Q fever antibody,,,10.8,18.18,58
CPT,86641,Cryptococcus antibody,,,12.84,21.62,58
CPT,86644,Cmv antibody,,,12.82,21.59,58
CPT,86644,HC CYTOMEGALOVIRUS ANTIOBYD,105.73,79.3,1.27,95.16,119
CPT,86645,Cmv antibody igm,,,15.01,25.28,58
CPT,86645,HC CYTOMEGALOVIRUS ANTIBODY IGM,122.38,91.78,1.47,110.14,119
CPT,86648,Diphtheria antibody,,,13.55,50.46,66
CPT,86648,HC DIPHTHERIA ANTIBODY-RL,35.5,26.62,0.43,31.95,119
CPT,86651,Encephalitis californ antbdy,,,11.75,19.79,58
CPT,86651,"HC ENCEPHALITIS, CALIFORNIA- RL",108.27,81.2,1.3,97.44,119
CPT,86652,Encephaltis east eqne anbdy,,,11.75,19.79,58
CPT,86652,"HC ENCEPHALITIS, EASTERN",108.27,81.2,1.3,97.44,119
CPT,86653,Encephaltis st louis antbody,,,11.75,19.79,58
CPT,86653,"HC ENCEPHALITIS, ST. LOUIS- RL",108.27,81.2,1.3,97.44,119
CPT,86654,Encephaltis west eqne antbdy,,,11.75,19.79,58
CPT,86654,"HC ENCEPHALITIS, WESTERN- RL",108.27,81.2,1.3,97.44,119
CPT,86658,Enterovirus antibody,,,11.61,19.55,58
CPT,86658,HC AB; ENTEROVIRUS,168.57,126.43,2.02,151.71,119
CPT,86658,"HC ANTIBODY; COXSACKIE VIRUS, EACH",286.17,214.63,3.43,257.55,119
CPT,86658,HC COXSACKIE B1 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSACKIE B2 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSACKIE B3 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSACKIE B4 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSACKIE B5 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSACKIE B6 ANTIBODY,168.57,126.43,2.02,151.71,119
CPT,86658,HC COXSAKIE A TYPE A9 ANTIBODY,272.48,204.36,3.27,245.23,119
CPT,86663,Epstein-barr antibody,,,11.69,19.68,58
CPT,86663,HC EPSTEIN-BARR VIRUS AB EARLY,119.62,89.72,1.44,107.66,119
CPT,86664,Epstein-barr nuclear antigen,,,13.62,50.74,66
CPT,86664,HC NUCLEAR AG ANTIBODY,125.4,94.05,1.5,112.86,119
CPT,86665,Epstein-barr capsid vca,,,16.16,27.21,58
CPT,86665,"HC ANTIBODY; EPSTEIN-BARR, VIRAL CAPSID, EACH (A/G/M)",144.43,108.32,1.73,129.99,119
CPT,86665,HC VIRAL CAPSID IGG,144.43,108.32,1.73,129.99,119
CPT,86665,HC VIRAL CAPSID IGM,144.43,108.32,1.73,129.99,119
CPT,86666,Ehrlichia antibody,,,9.07,15.27,58
CPT,86666,HC EHRLICHIA CHAFFEENSIS G/M,84.5,63.38,1.01,76.05,119
CPT,86668,Francisella tularensis,,,12.62,21.24,58
CPT,86668,HC TULAREMIA ANTIBODY,651.41,488.56,7.82,586.27,119
CPT,86671,Fungus nes antibody,,,10.91,18.38,58
CPT,86671,HC AB FUNGUS NES,187.26,140.44,2.25,168.53,119
CPT,86671,HC IBD SYNDROME FUNGUS NEC,166.52,124.89,2.0,149.87,119
CPT,86674,Giardia lamblia antibody,,,13.12,48.85,66
CPT,86674,HC ANTIBODY GIARDIA LAMBLIA,2058.99,1544.24,24.71,1853.09,119
CPT,86677,HC H PYLORI ANTIBODY,374.33,280.75,4.49,336.9,119
CPT,86677,Helicobacter pylori antibody,,,15.01,25.28,58
CPT,86682,HC AB; HELMINTH NES,128.25,96.19,1.54,115.42,119
CPT,86682,Helminth antibody,,,11.59,19.52,58
CPT,86684,Hemophilus influenza antibdy,,,14.11,23.76,58
CPT,86687,HC HTLV-I AB,43.98,32.98,0.53,39.58,119
CPT,86687,Htlv-i antibody,,,8.1,13.64,58
CPT,86688,Htlv-ii antibody,,,12.47,21.0,58
CPT,86689,HC HTLV WESTERN BLOT TEST DIAGNOSTIC,502.11,376.58,6.03,451.9,119
CPT,86689,Htlv/hiv confirmj antibody,,,17.24,29.03,58
CPT,86692,HC HEPATITIS DELTA AB,86.62,64.96,1.04,77.96,119
CPT,86692,Hepatitis delta agent antbdy,,,15.29,25.74,58
CPT,86694,"HC ANTIBODY; HERPES SIMPLEX VIRUS, NON-SPEC",82.72,62.04,0.99,74.45,119
CPT,86694,HC HERPE SIMPLEX VIRUS IGG & IGM,372.21,279.16,4.47,334.99,119
CPT,86694,Herpes simplex nes antbdy,,,12.82,21.59,58
CPT,86695,HC HERPES TYPE I AB IGG,130.46,97.84,1.57,117.41,119
CPT,86695,Herpes simplex type 1 test,,,11.75,19.79,58
CPT,86696,HC AB HSV TYPE 2,140.49,105.37,1.69,126.44,119
CPT,86696,Herpes simplex type 2 test,,,17.24,29.03,58
CPT,86698,HC HISTOPLASMA ANTIBODY,67.21,50.41,0.81,60.49,119
CPT,86698,Histoplasma antibody,,,12.29,20.69,58
CPT,86701,HC AB; HIV-1 DIAGNOSTIC,106.3,79.72,1.28,95.67,119
CPT,86701,Hiv-1antibody,,,7.92,14.16,66
CPT,86702,HC AB; HIV-2 DIAGNOSTIC,422.37,316.78,5.07,380.13,119
CPT,86702,Hiv-2 antibody,,,12.05,20.28,58
CPT,86703,HC HIV-1/2 ANTIBODY DIAGNOSTIC,171.95,128.96,2.06,154.76,119
CPT,86703,Hiv-1/hiv-2 1 result antbdy,,,12.22,20.57,58
CPT,86704,HC AB; HBCAB - TOTAL,89.99,67.49,1.08,80.99,119
CPT,86704,Hep b core antibody total,,,10.74,18.08,58
CPT,86705,HC HEPATITIS B CORE IGM ANTIBODY,88.17,66.13,1.06,79.35,119
CPT,86705,Hep b core antibody igm,,,10.49,17.66,58
CPT,86706,HC HEPATITIS B SURFACE ANTIBODY,81.19,60.89,0.97,73.07,119
CPT,86706,Hep b surface antibody,,,9.57,16.11,58
CPT,86707,HC HEPATITIS BE ANTIBODY,103.57,77.68,1.24,93.21,119
CPT,86707,Hepatitis be antibody,,,10.31,17.36,58
CPT,86708,HC HEPATITIS A ANTIBODY; TOTAL,296.93,222.7,3.56,267.24,119
CPT,86708,Hepatitis a antibody,,,11.04,18.59,58
CPT,86709,HC HEPATITIS A ANTIBODY IGM,84.73,63.55,1.02,76.26,119
CPT,86709,Hepatitis a igm antibody,,,10.03,16.89,58
CPT,86710,HC COM CON INFLUENZA B VIRUS ANTIBODY,61.79,46.34,0.74,55.61,119
CPT,86710,Influenza virus antibody,,,12.07,20.33,58
CPT,86711,HC ANTIBODY; JOHN CUNNINGHAM VIRUS,45.74,34.3,0.55,41.17,119
CPT,86711,John cunningham antibody,,,15.05,25.34,58
CPT,86713,HC LEGIONELLA PNEUMOPHILA ANTIBODY IGG-RL,161.75,121.31,1.94,145.58,119
CPT,86713,Legionella antibody,,,13.63,22.95,58
CPT,86717,Leishmania antibody,,,10.91,18.38,58
CPT,86720,HC LEPTOSPIRA ANTIBODIES,577.18,432.88,6.93,519.46,119
CPT,86720,Leptospira antibody,,,14.43,24.3,58
CPT,86723,HC LISTERIA AB,481.81,361.36,5.78,433.63,119
CPT,86723,Listeria monocytogenes,,,11.75,19.79,58
CPT,86727,HC AB; LCMIGG,234.82,176.12,2.82,211.34,119
CPT,86727,HC AB; LCMIGM,234.82,176.12,2.82,211.34,119
CPT,86727,HC LYMPHOCYTIC CHORIOMENINGITIS (LCM) VIRUS AN,234.82,176.12,2.82,211.34,119
CPT,86727,Lymph choriomeningitis ab,,,11.47,19.31,58
CPT,86732,Mucormycosis antibody,,,13.36,49.77,66
CPT,86735,HC MUMPS AB,119.09,89.32,1.43,107.18,119
CPT,86735,HC MUMPS IGG ANTIBODY,119.09,89.32,1.43,107.18,119
CPT,86735,HC MUMPS IGM  ANTIBODY,119.09,89.32,1.43,107.18,119
CPT,86735,Mumps antibody,,,11.63,43.3,66
CPT,86738,"HC ANTIBODY; MYCOPLASMA, EACH (A/G/M)",67.08,50.31,0.8,60.37,119
CPT,86738,Mycoplasma antibody,,,11.8,19.86,58
CPT,86741,Neisseria meningitidis,,,11.75,19.79,58
CPT,86744,Nocardia antibody,,,14.25,23.99,58
CPT,86747,"HC ANTIBODY; PARVOVIRUS, EACH (A/G/M)",113.72,85.29,1.36,102.35,119
CPT,86747,HC PARVOVIRUS B19 ANTIBODY IGG,113.72,85.29,1.36,102.35,119
CPT,86747,HC PARVOVIRUS B19 ANTIBODY IGM,113.72,85.29,1.36,102.35,119
CPT,86747,Parvovirus antibody,,,13.39,49.86,66
CPT,86750,Malaria antibody,,,11.75,19.79,58
CPT,86753,HC ANTIBODY; PROTOZOA NES,82.04,61.53,0.98,73.84,119
CPT,86753,Protozoa antibody nos,,,11.04,18.59,58
CPT,86756,Respiratory virus antibody,,,14.16,23.84,58
CPT,86757,"HC ANTIBODY; RICKETTSIA AB, EACH (A/G/M)",100.02,75.02,1.2,90.02,119
CPT,86757,HC ROCKY MTN SPOTTED FEVER IGM,100.02,75.02,1.2,90.02,119
CPT,86757,HC TYPHUS FEVER IGG TITER,34.91,26.18,0.42,31.42,119
CPT,86757,HC TYPHUS FEVER IGM TITER,52.4,39.3,0.63,47.16,119
CPT,86757,Rickettsia antibody,,,17.24,29.03,58
CPT,86759,Rotavirus antibody,,,16.24,27.35,58
CPT,86762,HC RUBELLA ANTIBODY,108.35,81.26,1.3,97.52,119
CPT,86762,Rubella antibody,,,12.82,21.59,58
CPT,86765,HC RUBEOLA ANTIBODIES IGM,109.01,81.76,1.31,98.11,119
CPT,86765,HC RUBEOLA IGG ANTIBODY,109.01,81.76,1.31,98.11,119
CPT,86765,Rubeola antibody,,,11.48,19.32,58
CPT,86768,HC AB; SALMONELLA; EIA,24.13,18.1,0.29,21.72,119
CPT,86768,Salmonella antibody,,,11.75,19.79,58
CPT,86769,HC SER IA NFCT AB SARSCOV2 COVID19 MULTI-STEP IGG,154.07,115.55,1.85,138.66,119
CPT,86769,Sars-cov-2 covid-19 antibody,,,18.46,63.2,66
CPT,86771,Shigella antibody,,,21.81,36.72,58
CPT,86774,HC TETANUS ANTIBODY-RL,84.0,63.0,1.01,75.6,119
CPT,86774,Tetanus antibody,,,13.19,49.11,66
CPT,86777,HC AB TOXOPLASMA IGG,182.88,137.16,2.19,164.59,119
CPT,86777,Toxoplasma antibody,,,12.82,21.59,58
CPT,86778,HC AB TOXOPLASMA IGM,70.44,52.83,0.85,63.4,119
CPT,86778,Toxoplasma antibody igm,,,12.84,21.62,58
CPT,86780,HC ANTIBODY TREPONEMA PALLIDUM,89.07,66.8,1.07,80.16,119
CPT,86780,HC TREPONEMA PALLIDUM AB BY TP-PA,89.07,66.8,1.07,80.16,119
CPT,86780,Treponema pallidum,,,11.8,19.86,66
CPT,86784,Trichinella antibody,,,11.19,18.84,58
CPT,86787,HC VARICELLA ZOSTER ANTIBODY,118.07,88.55,1.42,106.26,119
CPT,86787,HC VARICELLA ZOSTER ANTIBODY IGG,118.07,88.55,1.42,106.26,119
CPT,86787,Varicella-zoster antibody,,,11.48,19.32,58
CPT,86788,"HC ANTIBODY; WEST NILE VIRUS, IGM",144.81,108.61,1.74,130.33,119
CPT,86788,West nile virus ab igm,,,15.01,25.28,58
CPT,86789,"HC ANTIBODY; WEST NILE VIRUS, IGG",128.42,96.32,1.54,115.58,119
CPT,86789,West nile virus antibody,,,12.82,21.59,58
CPT,86790,"HC ANTIBODY; VIRUS, NES",95.62,71.72,1.15,86.06,119
CPT,86790,HC COM CON SIN NOMBRE VIRUS IGM,437.11,327.83,5.25,393.4,119
CPT,86790,HC HANTAVIRUS ANTIBODY,95.62,71.72,1.15,86.06,119
CPT,86790,HC HTLV I/II ANTIBODIES,53.24,39.93,0.64,47.92,119
CPT,86790,Virus antibody nos,,,11.48,19.32,58
CPT,86793,HC YERSINIA ANTIBODY,236.48,177.36,2.84,212.83,119
CPT,86793,Yersinia antibody,,,11.75,19.79,58
CPT,86794,HC ZIKA VIRUS IGM ANTIBODY,45.63,34.22,0.55,41.07,119
CPT,86794,Zika virus igm antibody,,,15.01,25.28,58
CPT,86800,HC AB THYROGLOBULIN,55.74,41.8,0.67,50.17,119
CPT,86800,Thyroglobulin antibody,,,14.18,23.87,58
CPT,86803,HC HCV TEST,104.92,78.69,1.26,94.43,119
CPT,86803,Hepatitis c ab test,,,12.57,21.41,66
CPT,86804,HC HCV RIBA REFLEX BILL,935.77,701.83,11.23,842.19,119
CPT,86804,Hep c ab test confirm,,,13.8,23.24,58
CPT,86805,Lymphocytotoxicity assay,,,168.85,628.79,66
CPT,86806,Lymphocytotoxicity assay,,,42.4,71.39,58
CPT,86807,Cytotoxic antibody screening,,,70.08,260.96,66
CPT,86808,Cytotoxic antibody screening,,,26.44,44.52,58
CPT,86812,HC HLA-B27 ANTIGEN,1423.79,1067.84,17.09,1281.41,119
CPT,86812,Hla typing a b or c,,,23.0,38.72,58
CPT,86813,HC HLA TYPING A/B/C MULTIPLE ANTIGENS,2608.2,1956.15,31.3,2347.38,119
CPT,86813,Hla typing a b or c,,,51.68,87.0,58
CPT,86816,Hla typing dr/dq,,,26.88,45.26,58
CPT,86817,HC NJH HLA MATCHING FEE,2996.63,2247.47,35.96,2696.97,119
CPT,86817,Hla typing dr/dq,,,94.57,159.21,58
CPT,86821,Lymphocyte culture mixed,,,32.57,54.84,58
CPT,86825,HC HLA X-MATCH NON-CYTOTOXIC,1475.94,1106.96,17.71,1328.35,119
CPT,86825,Hla x-math non-cytotoxic,,,97.56,164.24,58
CPT,86826,HC HLA X-MATCH ADDL SAMPLE,1475.94,1106.96,17.71,1328.35,119
CPT,86826,Hla x-match noncytotoxc addl,,,32.55,54.8,58
CPT,86828,HC HLA CLASS III ANTIBODY QUAL,1028.57,771.43,12.34,925.71,119
CPT,86828,Hla class i&ii antibody qual,,,57.19,96.29,58
CPT,86829,Hla class i/ii antibody qual,,,57.19,96.29,58
CPT,86830,Hla class i phenotype qual,,,85.11,143.28,58
CPT,86831,HC HLA CLASS II PHENOTYPE QUAL,362.97,272.23,4.36,326.67,119
CPT,86831,Hla class ii phenotype qual,,,72.96,122.82,58
CPT,86832,HC HLA CLASS I IG DEFIN QUAL,980.59,735.44,11.77,882.53,119
CPT,86832,Hla class i high defin qual,,,288.46,1074.2,66
CPT,86833,HC HLA CLASS II IG DEFIN QUAL,2123.96,1592.97,25.49,1911.56,119
CPT,86833,Hla class ii high defin qual,,,290.29,1081.01,66
CPT,86834,HC HLA CLASS I SEMIQUANT PANEL,4156.43,3117.32,49.88,3740.79,119
CPT,86834,Hla class i semiquant panel,,,318.59,1186.38,66
CPT,86835,HC HLA CLASS II SEMIQUANT PANEL,4207.03,3155.27,50.48,3786.33,119
CPT,86835,Hla class ii semiquant panel,,,287.76,1071.58,66
CPT,86849,Immunology procedure,,,0.5,0.5,3
CPT,86850,HC RBC AB SCRN EA TECHNIQUE,98.24,73.68,1.18,88.42,119
CPT,86850,Rbc antibody screen,,,9.77,59.47,58
CPT,86860,HC ANTIBODY ELUTION RBC EACH,599.77,449.83,7.2,539.79,119
CPT,86860,Rbc antibody elution,,,164.27,223.74,22
CPT,86870,HC AB ID RBC EA PANEL EA TECHN,481.06,360.8,5.77,432.95,119
CPT,86870,Rbc antibody identification,,,344.85,436.89,22
CPT,86880,Coombs test direct,,,5.39,66.11,58
CPT,86880,"HC COOMBS; DIRECT, EACH ANTISERUM",135.48,101.61,1.63,121.93,119
CPT,86885,Coombs test indirect qual,,,5.72,190.73,58
CPT,86886,Coombs test indirect titer,,,5.18,190.73,58
CPT,86886,HC COOMBS TEST INDIRECT TITER,793.69,595.27,9.52,714.32,119
CPT,86890,Autologous blood process,,,164.27,223.74,22
CPT,86890,"HC AUTO BLOOD, PREDEPOSITED",1577.61,1183.21,18.93,1419.85,119
CPT,86891,Autologous blood op salvage,,,783.13,984.23,22
CPT,86900,Blood typing serologic abo,,,2.99,143.47,58
CPT,86900,"HC BLOOD TYPING, SEROLOGIC; ABO",33.46,25.1,0.4,30.11,119
CPT,86901,Blood typing serologic rh(d),,,2.99,43.69,58
CPT,86901,HC BLOOD TYPING; SEROLOGIC; RH D,43.04,32.28,0.52,38.74,119
CPT,86902,Blood type antigen donor ea,,,6.35,400.37,58
CPT,86902,HC BLOOD TYPE SER AN DONOR;EA AN,594.47,445.85,7.13,535.02,119
CPT,86904,Blood typing patient serum,,,16.34,66.11,58
CPT,86904,HC BLD TYP SER; AGN SCRN SERUM;EA,154.17,115.63,1.85,138.75,119
CPT,86905,Blood typing rbc antigens,,,3.83,400.37,58
CPT,86905,HC BLD TYP SER RBC AN NOT ABO/RHD,173.1,129.82,2.08,155.79,119
CPT,86906,Bld typing serologic rh phnt,,,7.75,43.69,58
CPT,86906,"HC BLD TYP SER RH PHENO, COMPL",373.49,280.12,4.48,336.14,119
CPT,86910,Blood typing paternity test,,,39.78,39.78,3
CPT,86911,Blood typing antigen system,,,34.55,34.55,3
CPT,86920,Compatibility test spin,,,164.27,223.74,22
CPT,86920,HC COMPATIBILITY TEST SPIN EA UNIT,284.16,213.12,3.41,255.74,119
CPT,86921,Compatibility test incubate,,,164.27,223.74,22
CPT,86922,Compatibility test antiglob,,,164.27,223.74,22
CPT,86922,HC COMP TEST EA UNIT AHG TECH,352.28,264.21,4.23,317.05,119
CPT,86923,Compatibility test electric,,,164.27,223.74,22
CPT,86923,HC ELECTRONIC CROSSMATCH COMPATIBILITY,323.17,242.38,3.88,290.85,119
CPT,86927,HC FFP THAWING EACH UNIT,283.64,212.73,3.4,255.28,119
CPT,86927,Plasma fresh frozen,,,164.27,223.74,22
CPT,86930,Frozen blood prep,,,164.27,436.89,22
CPT,86931,Frozen blood thaw,,,164.27,436.89,22
CPT,86932,Frozen blood freeze/thaw,,,37.63,50.76,22
CPT,86940,Hemolysins/agglutinins auto,,,7.81,13.16,58
CPT,86941,HC COLD AGGLUTININS/HEMOLYSINS SCREEN,147.1,110.32,1.77,132.39,119
CPT,86941,Hemolysins/agglutinins,,,10.79,18.17,58
CPT,86945,Blood product/irradiation,,,37.63,50.76,22
CPT,86945,HC IRRADIATION BLOOD COMP EA UNIT,346.81,260.11,4.16,312.13,119
CPT,86950,Leukacyte transfusion,,,164.27,223.74,22
CPT,86960,HC VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT,282.98,212.24,3.4,254.68,119
CPT,86960,Vol reduction of blood/prod,,,164.27,223.74,22
CPT,86965,HC POOLING PLATELETS OTHER,329.17,246.88,3.95,296.25,119
CPT,86965,Pooling blood platelets,,,164.27,223.74,22
CPT,86970,HC PRETREAT RBC; CHEM OR DRUGS,1130.24,847.68,13.56,1017.22,119
CPT,86970,Rbc pretx incubatj w/chemicl,,,50.76,66.11,22
CPT,86971,HC ARUP 17451 AB IDENT PANEL- ENZYME,247.55,185.66,2.97,222.8,119
CPT,86971,Rbc pretx incubatj w/enzymes,,,164.27,436.89,22
CPT,86972,HC PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP,269.67,202.25,3.24,242.7,119
CPT,86972,Rbc pretx incubatj w/density,,,164.27,223.74,22
CPT,86975,Rbc serum pretx incubj drugs,,,382.54,452.32,22
CPT,86976,Rbc serum pretx id dilution,,,23.47,37.01,22
CPT,86977,HC SERUM PRETX; INHIBITOR INCUBATE,346.94,260.2,4.16,312.25,119
CPT,86977,Rbc serum pretx incubj/inhib,,,164.27,223.74,22
CPT,86978,HC ANTIBODY ABSORPTION EACH,632.24,474.18,7.59,569.02,119
CPT,86978,Rbc pretreatment serum,,,50.76,66.11,22
CPT,86985,HC SPLIT BLD PRODUCT EA UNIT,335.19,251.39,4.02,301.67,119
CPT,86985,Split blood or products,,,164.27,223.74,22
CPT,86999,HC BLOOD BANK MISC,1146.88,860.16,13.76,1032.19,119
CPT,86999,Unlisted transfusion med px,,,23.47,37.01,22
CPT,87003,Small animal inoculation,,,15.0,25.26,58
CPT,87015,HC AFB CONCENTRATE-RL,317.07,237.8,3.8,285.36,119
CPT,87015,"HC CONCENTRATE, INF AGENT",317.07,237.8,3.8,285.36,119
CPT,87015,Specimen infect agnt concntj,,,5.95,10.02,58
CPT,87040,Blood culture for bacteria,,,9.2,15.48,58
CPT,87040,HC CULTURE BLOOD,171.31,128.48,2.06,154.18,119
CPT,87045,Feces culture aerobic bact,,,8.41,31.32,66
CPT,87045,HC CULTURE STOOL,240.69,180.52,2.89,216.62,119
CPT,87046,"HC CULTURE, STOOL, AEROBIC, ADDL PATHOG, EA PLATE",246.11,184.58,2.95,221.5,119
CPT,87046,Stool cultr aerobic bact ea,,,8.41,31.32,66
CPT,87070,Culture othr specimn aerobic,,,7.68,12.93,58
CPT,87070,HC CATHETER TIP CULTURE,141.81,106.36,1.7,127.63,119
CPT,87070,HC CSF CULTURE AND GRAM STAIN,141.81,106.36,1.7,127.63,119
CPT,87070,HC CULTURE BACTERIAL OTHER,141.81,106.36,1.7,127.63,119
CPT,87070,HC CULTURE TISSUE,141.81,106.36,1.7,127.63,119
CPT,87070,"HC CULTURE, BACTERIAL, OTHER SOURCE",141.81,106.36,1.7,127.63,119
CPT,87070,HC EAR CULTURE,141.81,106.36,1.7,127.63,119
CPT,87070,HC EYE CULTURE AND GRAM STAIN,141.81,106.36,1.7,127.63,119
CPT,87070,HC GENITAL CULTURE,206.74,155.06,2.48,186.07,119
CPT,87070,HC RESPIRATORY CULTURE,141.81,106.36,1.7,127.63,119
CPT,87070,HC TISSUE CUL/GRAM W/O ANAEROBE,141.81,106.36,1.7,127.63,119
CPT,87070,HC WOUND CULTURE,141.81,106.36,1.7,127.63,119
CPT,87071,Culture aerobic quant other,,,8.81,14.84,58
CPT,87071,HC CULTURE WOUND QUANT AEROBIC,357.64,268.23,4.29,321.88,119
CPT,87073,Culture bacteria anaerobic,,,8.61,14.49,58
CPT,87073,HC CULTURE WOUND QUANT ANAEROBIC,26.15,19.61,0.31,23.54,119
CPT,87075,Cultr bacteria except blood,,,8.44,31.43,66
CPT,87075,HC CULTURE ANAEROBIC,368.34,276.26,4.42,331.51,119
CPT,87076,Culture anaerobe ident each,,,7.2,12.12,58
CPT,87076,HC ORGANISM ID ANAEROBIC,209.22,156.92,2.51,188.3,119
CPT,87077,Culture aerobic identify,,,7.2,13.34,66
CPT,87077,HC ORGANISM ID AEROBIC,184.5,138.38,2.21,166.05,119
CPT,87081,Culture screen only,,,5.91,9.95,58
CPT,87081,HC CULTURE BETA STREP,148.46,111.34,1.78,133.61,119
CPT,87081,"HC CULTURE SCREENING, RAPID STREP OR GENITAL GRP B",100.34,75.26,1.2,90.31,119
CPT,87081,"HC CULTURE, PRESUMPTIVE PATHOGENS, SCREENING ONLY",100.34,75.26,1.2,90.31,119
CPT,87081,HC SCREEN MRSA,100.34,75.26,1.2,90.31,119
CPT,87081,HC SCREEN VRE,148.46,111.34,1.78,133.61,119
CPT,87084,Culture of specimen by kit,,,24.12,89.82,66
CPT,87086,HC CULTURE URINE,134.7,101.02,1.62,121.23,119
CPT,87086,Urine culture/colony count,,,7.19,12.11,58
CPT,87088,"HC URINE BACTERIA CULTURE, EACH ISOLATE",142.98,107.24,1.72,128.68,119
CPT,87088,Urine bacteria culture,,,7.21,12.14,58
CPT,87101,HC CULT FUNGUS W P ID SKIN HR NL,261.6,196.2,3.14,235.44,119
CPT,87101,Skin fungi culture,,,6.87,11.57,58
CPT,87102,Fungus isolation culture,,,7.49,12.62,58
CPT,87102,HC CULTURE FUNGUS EXCEPT BLOOD,368.9,276.68,4.43,332.01,119
CPT,87103,Blood fungus culture,,,18.23,30.69,58
CPT,87103,HC CULTURE FUNGUS BLOOD,338.98,254.24,4.07,305.08,119
CPT,87106,Fungi identification yeast,,,9.2,15.48,58
CPT,87106,HC YEAST ID,119.14,89.36,1.43,107.23,119
CPT,87107,Fungi identification mold,,,9.2,15.48,58
CPT,87107,HC ORGANISM ID FUNGUS MOLD,190.08,142.56,2.28,171.07,119
CPT,87109,HC CULTURE MYCOPLASMA,256.27,192.2,3.08,230.64,119
CPT,87109,Mycoplasma,,,13.71,23.09,58
CPT,87110,Chlamydia culture,,,17.46,29.4,58
CPT,87110,HC CULTURE CHLAMYDIA  ANY,634.58,475.94,7.61,571.12,119
CPT,87116,HC AFB CULTURE,528.94,396.7,6.35,476.05,119
CPT,87116,Mycobacteria culture,,,9.62,16.2,58
CPT,87118,Mycobacteric identification,,,13.02,21.92,58
CPT,87140,Culture type immunofluoresc,,,4.96,8.36,58
CPT,87140,HC ORG ID BY IMMUNOFLUORESCENCE,98.98,74.24,1.19,89.08,119
CPT,87143,Culture typing glc/hplc,,,11.16,18.78,58
CPT,87147,Culture type immunologic,,,4.62,7.77,58
CPT,87147,HC ORG ID AGGLUTINATIONS,159.61,119.71,1.92,143.65,119
CPT,87149,Dna/rna direct probe,,,17.86,66.53,66
CPT,87149,"HC NUCLEIC ACID PROBE CULTURE TYPING, EACH",303.75,227.81,3.64,273.38,119
CPT,87150,Dna/rna amplified probe,,,31.27,52.64,58
CPT,87150,"HC BLOOD CULTURE ID, MOLECULAR",595.51,446.63,7.15,535.96,119
CPT,87150,HC DNA/RNA AMPLIFIED PROBE,595.51,446.63,7.15,535.96,119
CPT,87152,Culture type pulse field gel,,,6.9,11.61,58
CPT,87153,Dna/rna sequencing,,,102.79,173.04,58
CPT,87153,HC DNA/RNA SEQUENCING,269.15,201.86,3.23,242.24,119
CPT,87154,Cul typ id bld pthgn 6+ trgt,,,194.29,723.52,66
CPT,87154,"HC ORGANISM ID BY NUCLEIC ACID PROBES, AMPLIFIED PROBE",972.72,729.54,11.67,875.45,119
CPT,87158,Culture typing added method,,,6.9,11.61,58
CPT,87158,HC CULTURE; OTHER METHOD,178.14,133.6,2.14,160.33,119
CPT,87164,Dark field exam spec collj,,,10.74,18.48,57
CPT,87166,Dark field exam w/o collj,,,10.07,16.95,58
CPT,87168,Macroscopic exam arthropod,,,3.8,6.41,58
CPT,87169,HC MACROSCOPIC PARASITE,41.08,30.81,0.49,36.97,119
CPT,87169,Macroscopic exam parasite,,,3.84,6.47,58
CPT,87172,HC PINWORM EXAM,353.03,264.77,4.24,317.73,119
CPT,87172,Pinworm exam,,,3.8,6.41,58
CPT,87176,HC HOMOGENATION TISSUE CULTURE,38.62,28.96,0.46,34.76,119
CPT,87176,Tissue homogenization cultr,,,5.24,8.82,58
CPT,87177,HC OVA AND PARASITE EXAM,235.46,176.6,2.83,211.91,119
CPT,87177,Ova and parasites smears,,,7.93,13.35,58
CPT,87181,"HC MIC GRADIENT STRIP, EACH AGENT",139.47,104.6,1.67,125.52,119
CPT,87181,Sc std agar dilution per agt,,,4.23,7.13,58
CPT,87183,Sc std carbapenem resist gen,,,35.09,35.09,9
CPT,87184,HC SUSCEPTIBILITY DISK METHOD,157.01,117.76,1.88,141.31,119
CPT,87184,Sc std disk method per plate,,,6.66,11.22,58
CPT,87185,HC SUSCEPTIBILITY TEST BY ENZYME,431.76,323.82,5.18,388.58,119
CPT,87185,"HC SUSCEPTIBILITY TEST BY ENZYME, EACH",431.76,323.82,5.18,388.58,119
CPT,87185,Sc std enzyme detcj per nzm,,,4.23,7.13,58
CPT,87186,HC ANTIBIOTIC MIC LEVEL,133.91,100.43,1.61,120.52,119
CPT,87186,HC ARUP 3002632 SUSCEPTIBILITY - BROTH DILUTION PANEL 2,128.93,96.7,1.55,116.04,119
CPT,87186,HC ARUP 3006422 ERM41 MOLECULAR DETECTION,874.98,656.24,10.5,787.48,119
CPT,87186,HC ARUP 60200 SUSCEPTIBILITY - NOCARDIA BY BROTH DILUTION,128.93,96.7,1.55,116.04,119
CPT,87186,HC FUNGUS SUSCEPTIBILITY,133.91,100.43,1.61,120.52,119
CPT,87186,HC MIC ANAEROBIC,133.91,100.43,1.61,120.52,119
CPT,87186,HC SO ARUP 60402 SUSCEPTIBILITY - ANAEAROBE BY BROTH DILUTION,145.72,109.29,1.75,131.15,119
CPT,87186,HC SO ARUP 60492 SUSCEPTIBILITY - AFB/NOCARDIA BY BROTH DILUTION,147.55,110.66,1.77,132.8,119
CPT,87186,HC SO ARUP 60790 SUSCEPTIBILITY - AUTOMATED BROTH DILUTION,109.63,82.22,1.32,98.67,119
CPT,87186,HC SO ARUP 61010 SUSCEPTIBILITY - MOLD BY BROTH DILUTION,229.7,172.28,2.76,206.73,119
CPT,87186,HC SO ARUP 65070 SUSCEPTIBILITY BROTH DILUTION PANEL,116.27,87.2,1.4,104.64,119
CPT,87186,HC YEAST MIC PANEL,874.98,656.24,10.5,787.48,119
CPT,87186,Sc std microdil/agar dil,,,7.71,12.98,58
CPT,87187,Sc std microdil/agar mlc,,,35.79,60.26,58
CPT,87188,HC SENSITIVITY MAC DIL EA ANTIBIO,17.98,13.48,0.22,16.18,119
CPT,87188,Sc std macrobroth dil meth,,,5.92,9.96,58
CPT,87190,Sc std myobacteria prop meth,,,6.51,10.97,58
CPT,87197,Serum bactericidal titer,,,13.38,49.83,66
CPT,87205,HC SMEAR - GRAM OR GIEMSA,135.12,101.34,1.62,121.61,119
CPT,87205,HC SMEAR PRIMARY SOURCE,135.12,101.34,1.62,121.61,119
CPT,87205,Smear gram stain,,,3.8,6.41,58
CPT,87206,HC SMEAR FLUORESCENT OR AFB STAIN,299.48,224.61,3.59,269.53,119
CPT,87206,Smear fluorescent/acid stai,,,4.8,8.09,58
CPT,87207,HC BLOOD PARASITE SMEAR,495.16,371.37,5.94,445.64,119
CPT,87207,HC BLOOD PARASITE THICK SMEAR,495.16,371.37,5.94,445.64,119
CPT,87207,HC BLOOD PARASITE THIN SMEAR,495.16,371.37,5.94,445.64,119
CPT,87207,HC SMEAR MALARIA/BORRELIA,556.41,417.31,6.68,500.77,119
CPT,87207,HC STAIN & CONCENTRATION,557.05,417.79,6.68,501.34,119
CPT,87207,Smear special stain,,,5.99,17.22,57
CPT,87209,HC STAIN MICROSPORIDUM,257.34,193.0,3.09,231.61,119
CPT,87209,Smear complex stain,,,16.02,59.66,66
CPT,87210,HC WET PREP,194.0,145.5,2.33,174.6,119
CPT,87210,Smear wet mount saline/ink,,,5.19,13.04,66
CPT,87220,HC WET MOUNT KOH FUNI/YEASTS,193.42,145.06,2.32,174.08,119
CPT,87220,Tissue exam for fungi,,,3.8,6.41,58
CPT,87230,HC C DIFFICILE TOXIN CONFIRMATION,173.55,130.16,2.08,156.2,119
CPT,87230,Toxin/antitoxin asy tiss cul,,,17.59,29.61,58
CPT,87250,Virus inoculate eggs/animal,,,17.43,29.34,58
CPT,87252,HC VIRUS INOCULATION TISSUE,472.42,354.32,5.67,425.18,119
CPT,87252,Virus inoculation tissue,,,23.23,39.11,58
CPT,87253,HC VIRAL IDENTIFICATION,33.56,25.17,0.4,30.2,119
CPT,87253,Virus inoculate tissue addl,,,18.0,30.3,58
CPT,87254,HC VIRUS INOCULATION SHELL,619.87,464.9,7.44,557.88,119
CPT,87254,Virus inoculation shell via,,,17.43,29.34,58
CPT,87255,Genet virus isolate hsv,,,30.17,50.79,58
CPT,87255,HC VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,58.15,43.61,0.7,52.34,119
CPT,87260,Adenovirus ag if,,,12.86,21.65,58
CPT,87260,HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; ADENOVIRUS,72.14,54.1,0.87,64.93,119
CPT,87265,HC COM CON BORDETELLA PERTUSSIS,223.15,167.36,2.68,200.84,119
CPT,87265,Pertussis ag if,,,10.67,17.97,58
CPT,87267,Enterovirus antibody dfa,,,11.96,20.13,58
CPT,87269,Giardia ag if,,,12.13,20.42,58
CPT,87269,HC GIARDIA AG BY IF,501.62,376.22,6.02,451.46,119
CPT,87270,Chlamydia trachomatis ag if,,,10.67,17.97,58
CPT,87270,HC SMEAR CHLAMYDIA,238.03,178.52,2.86,214.23,119
CPT,87271,Cytomegalovirus dfa,,,11.96,20.13,58
CPT,87272,Cryptosporidium ag if,,,10.67,17.97,58
CPT,87273,HC IAADI HERPES SMPLX VIRUS TYPE 2,155.85,116.89,1.87,140.26,119
CPT,87273,Herpes simplex 2 ag if,,,10.67,17.97,58
CPT,87274,HC IAADI HERPES SMPLX VIRUS TYPE 1,363.51,272.63,4.36,327.16,119
CPT,87274,Herpes simplex 1 ag if,,,10.67,17.97,58
CPT,87275,HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; INFLUENZA B VIRUS,68.25,51.19,0.82,61.42,119
CPT,87275,Influenza b ag if,,,10.91,18.38,58
CPT,87276,"HC CHG INFLUENZA AG, DFA",68.25,51.19,0.82,61.42,119
CPT,87276,Influenza a ag if,,,14.32,24.11,58
CPT,87278,HC LEGIONELLA P AG BY DFA,251.06,188.3,3.01,225.95,119
CPT,87278,Legion pneumophilia ag if,,,13.9,23.4,58
CPT,87279,"HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT TECHNIQUE; PARAINFLUENZA VIRUS, EA TYPE",70.05,52.54,0.84,63.04,119
CPT,87279,Parainfluenza ag if,,,14.64,24.65,58
CPT,87280,HC RESPIRATORY SYNCYTIAL VI,227.79,170.84,2.73,205.01,119
CPT,87280,Respiratory syncytial ag if,,,11.96,20.13,58
CPT,87281,HC PNEUMOCYSTIS C AG BY IF,205.99,154.49,2.47,185.39,119
CPT,87281,Pneumocystis carinii ag if,,,10.67,17.97,58
CPT,87283,Rubeola ag if,,,54.17,91.2,58
CPT,87285,Treponema pallidum ag if,,,10.85,18.27,58
CPT,87290,HC VARICELLA ZOSTER AG IF,1436.82,1077.62,17.24,1293.14,119
CPT,87290,Varicella zoster ag if,,,11.96,20.13,58
CPT,87299,Antibody detection nos if,,,14.35,24.15,58
CPT,87299,"HC COM CON  INFECTIOUS AGENT AG, NOT SPEC",260.72,195.54,3.13,234.65,119
CPT,87300,Ag detection polyval if,,,10.67,17.97,58
CPT,87300,"HC INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOFLUORESCENT, MULT ORGANISMS, EA POLYVALENT ANTISERUM",289.5,217.12,3.47,260.55,119
CPT,87301,Adenovirus ag ia,,,10.67,17.97,58
CPT,87301,HC VAP CHOLESTEROL,32.44,24.33,0.39,29.2,119
CPT,87305,Aspergillus ag ia,,,10.67,17.97,58
CPT,87305,HC ASPERGILLUS AG EIA,537.59,403.19,6.45,483.83,119
CPT,87320,Chlmyd trach ag ia,,,13.36,49.77,66
CPT,87324,Clostridium ag ia,,,10.67,17.97,58
CPT,87324,HC CLOSTRIDIUM AG EIA,192.68,144.51,2.31,173.41,119
CPT,87327,Cryptococcus neoform ag ia,,,11.96,20.13,58
CPT,87327,HC CRYPTOCOCCAL ANTIGEN,182.97,137.23,2.2,164.67,119
CPT,87328,Cryptosporidium ag ia,,,12.31,20.73,58
CPT,87328,HC CRYPTOSPORIDUM ANTIGEN,166.29,124.72,2.0,149.66,119
CPT,87329,Giardia ag ia,,,10.67,17.97,58
CPT,87329,HC GIARDIA ANTIGEN,176.41,132.31,2.12,158.77,119
CPT,87332,Cytomegalovirus ag ia,,,10.67,17.97,58
CPT,87335,E coli 0157 ag ia,,,11.28,18.99,58
CPT,87336,Entamoeb hist dispr ag ia,,,14.26,24.0,58
CPT,87337,Entamoeb hist group ag ia,,,10.67,17.97,58
CPT,87337,HC ENTAMOEBA ANTIGEN,129.72,97.29,1.56,116.75,119
CPT,87338,HC H PYLORI STOOL,250.67,188.0,3.01,225.6,119
CPT,87338,Hpylori stool ag ia,,,12.81,26.51,66
CPT,87339,H pylori ag ia,,,14.26,24.0,58
CPT,87340,HC HEPATITIS B SURFACE AG EIA,80.24,60.18,0.96,72.22,119
CPT,87340,Hepatitis b surface ag ia,,,9.2,15.5,58
CPT,87341,HC HEPATITIS B SURF AG EIA NEUT,51.23,38.42,0.61,46.11,119
CPT,87341,Hep b surface ag neutrlzj ia,,,9.2,15.5,58
CPT,87350,HC HEPATITIS B E ANTIGEN,97.33,73.0,1.17,87.6,119
CPT,87350,Hepatitis be ag ia,,,10.27,17.3,58
CPT,87380,Hepatitis delta agent ag ia,,,16.36,27.54,58
CPT,87385,HC HISTOPLASMA ANTIGEN,578.85,434.14,6.95,520.96,119
CPT,87385,Histoplasma capsul ag ia,,,11.81,19.88,58
CPT,87389,HC HIV-1 AG W/HIV-1 & HIV-2 AB; SINGLE,165.13,123.85,1.98,148.62,119
CPT,87389,Hiv-1 ag w/hiv-1&-2 ab ag ia,,,13.4,36.12,66
CPT,87390,Hiv-1 ag ia,,,21.44,36.09,58
CPT,87391,Hiv-2 ag ia,,,19.51,32.85,58
CPT,87400,Influenza a/b each ag ia,,,12.57,21.2,66
CPT,87420,HC RSV ANTIGEN,81.94,61.46,0.98,73.75,119
CPT,87420,Resp syncytial virus ag ia,,,12.39,20.87,66
CPT,87425,HC ROTAVIRUS DIRET ANTIGEN,422.27,316.7,5.07,380.04,119
CPT,87425,Rotavirus ag ia,,,10.67,17.97,58
CPT,87426,HC COVID-19/SARS-COV-2 INHOUSE ANTIGEN IA,140.05,105.04,1.68,126.05,119
CPT,87426,Sarscov coronavirus ag ia,,,13.76,77.25,66
CPT,87427,HC SHIGA LIKE TOXIN AG EIA,155.17,116.38,1.86,139.65,119
CPT,87427,Shiga-like toxin ag ia,,,10.67,17.97,58
CPT,87428,HC IAAD IA SARS COV-2 & INFLUENZA VIRUS TYPES A&B,96.39,72.29,1.16,86.75,119
CPT,87428,Sarscov & inf vir a&b ag ia,,,14.1,110.43,30
CPT,87430,HC RAPID STREP SCREEN EIA,182.97,137.23,2.2,164.67,119
CPT,87430,Strep a ag ia,,,13.16,25.22,66
CPT,87449,"HC INFECTIOUS ANTIGEN BY EIA, MULTI-STEP, EACH",1114.15,835.61,13.37,1002.74,119
CPT,87449,HC LEGIONELLA URINE ANTIGEN,318.14,238.6,3.82,286.33,119
CPT,87449,HC STREP PNEUMO URINARY AG,1114.15,835.61,13.37,1002.74,119
CPT,87449,Nos each organism ag ia,,,10.67,19.14,66
CPT,87451,Polyvalent mult org ea ag ia,,,9.36,15.77,58
CPT,87467,Hepatitis b surface ag quan,,,13.81,29.4,58
CPT,87468,Anaplsma phgcytophlm amp prb,,,31.27,52.64,58
CPT,87468,HC IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFED PRB TQ,218.31,163.73,2.62,196.48,119
CPT,87469,Babesia microti amp prb,,,31.27,52.64,58
CPT,87469,HC IADNA BABESIA MICROTI AMPLIFIED PROBE TECHNIQUE,95.01,71.26,1.14,85.51,119
CPT,87471,Bartonella dna amp probe,,,31.27,52.64,58
CPT,87472,Bartonella dna quant,,,38.17,64.26,58
CPT,87475,Lyme dis dna dir probe,,,17.86,66.53,66
CPT,87476,"HC BORRELIA BURGDORFERI, AMP PROB TECH-RL",208.5,156.38,2.5,187.65,119
CPT,87476,Lyme dis dna amp probe,,,31.27,52.64,58
CPT,87478,Borrelia miyamotoi amp prb,,,31.27,52.64,58
CPT,87480,Candida dna dir probe,,,17.86,66.53,66
CPT,87480,"HC CANDIDA, NA DIRECT PROBE",190.46,142.84,2.29,171.41,119
CPT,87481,Candida dna amp probe,,,31.27,116.42,66
CPT,87481,HC CANDIDA NA AMPLIFIED PROBE,2122.53,1591.9,25.47,1910.28,119
CPT,87482,Candida dna quant,,,49.66,83.61,58
CPT,87483,Cns dna amp probe type 12-25,,,371.35,1382.87,66
CPT,87483,HC CNS DNA AMP PROBE TYPE 12-25,569.64,427.23,6.84,512.68,119
CPT,87484,Ehrlicha chaffeensis amp prb,,,31.27,116.42,66
CPT,87484,HC IADNA EHRLICHIA CHAFFEENSIS AMPLIFIED PROBE TQ,218.31,163.73,2.62,196.48,119
CPT,87485,Chlmyd pneum dna dir probe,,,17.86,66.53,66
CPT,87486,Chlmyd pneum dna amp probe,,,31.27,116.42,66
CPT,87486,"HC CHLAMYDIA P, AMPLIF NA PROBE",180.21,135.16,2.16,162.19,119
CPT,87487,Chlmyd pneum dna quant,,,38.17,64.26,58
CPT,87490,Chlmyd trach dna dir probe,,,20.27,34.13,58
CPT,87491,Chlmyd trach dna amp probe,,,13.76,52.64,66
CPT,87491,HC CHLAMYDIA TRACH BY AMP DNA,99.4,74.55,1.19,89.46,119
CPT,87492,Chlmyd trach dna quant,,,47.64,80.21,58
CPT,87493,C diff amplified probe,,,33.21,123.66,66
CPT,87493,HC C DIFF AMPLIFIED PROBE,720.11,540.08,8.64,648.1,119
CPT,87494,Chlmy trch&neisra gonor mult,,,70.18,70.18,9
CPT,87495,Cytomeg dna dir probe,,,26.76,45.05,58
CPT,87496,Cytomeg dna amp probe,,,31.27,116.42,66
CPT,87496,HC CYTOMEGALOVIRUS BY PCR,592.02,444.02,7.1,532.82,119
CPT,87497,Cytomeg dna quant,,,38.17,64.26,58
CPT,87497,HC CYTOMEGALOVIRUS QUANT PCR,1452.68,1089.51,17.43,1307.41,119
CPT,87498,Enterovirus probe&revrs trns,,,31.27,116.42,66
CPT,87498,HC ENTEROVIRUS BY PCR,709.08,531.81,8.51,638.17,119
CPT,87500,Vanomycin dna amp probe,,,31.27,116.42,66
CPT,87501,HC H1N1 BY PCR,1085.24,813.93,13.02,976.72,119
CPT,87501,Influenza dna amp prob 1+,,,45.72,170.25,66
CPT,87502,HC INFLUENZA DNA AMP PROBE,562.69,422.02,6.75,506.42,119
CPT,87502,Influenza dna amp probe,,,14.12,143.7,66
CPT,87503,Influenza dna amp prob addl,,,26.04,43.83,58
CPT,87505,HC COM CON GASTROINTESTINAL PARASITE PANEL BY PCR,874.4,655.8,10.49,786.96,119
CPT,87505,HC INFECTIOUS AGENT ANTIGEN DETECTION,826.34,619.76,9.92,743.71,119
CPT,87505,Nfct agent detection gi,,,114.31,192.44,58
CPT,87506,HC IADNA-DNA/RNA PROBE TQ 6-11; QUAL,968.15,726.11,11.62,871.34,119
CPT,87506,Iadna-dna/rna probe tq 6-11,,,234.32,872.6,66
CPT,87507,HC IADNA-DNA/RNA PROBE TQ 12-25; QUAL,1772.03,1329.02,21.26,1594.83,119
CPT,87507,Iadna-dna/rna probe tq 12-25,,,371.35,1382.87,66
CPT,87510,Gardner vag dna dir probe,,,17.86,66.53,66
CPT,87510,"HC GARDNERELLA, DIR NA PROBE",190.46,142.84,2.29,171.41,119
CPT,87511,Gardner vag dna amp probe,,,31.27,116.42,66
CPT,87512,Gardner vag dna quant,,,37.21,138.56,66
CPT,87513,H pylri clrthmcn rst amp prb,,,35.09,52.64,21
CPT,87516,Hepatitis b dna amp probe,,,31.27,116.42,66
CPT,87517,HC HEPATITIS B DNA QUANT - RL,1633.16,1224.87,19.6,1469.84,119
CPT,87517,Hepatitis b dna quant,,,38.17,64.26,58
CPT,87520,Hepatitis c rna dir probe,,,27.82,46.83,58
CPT,87521,HC HEP C AMPLIF NA PROBE,523.44,392.58,6.28,471.1,119
CPT,87521,Hepatitis c probe&rvrs trnsc,,,13.76,52.64,66
CPT,87522,HC HEPATITIS C RNA  QUANTITATIVE,1087.1,815.32,13.05,978.39,119
CPT,87522,Hepatitis c revrs trnscrpj,,,38.17,64.26,58
CPT,87523,Hepatitis d quantification,,,42.84,64.26,21
CPT,87525,Hepatitis g dna dir probe,,,26.55,44.7,58
CPT,87526,Hepatitis g dna amp probe,,,34.98,58.89,58
CPT,87527,Hepatitis g dna quant,,,37.21,138.56,66
CPT,87528,Hsv dna dir probe,,,17.86,66.53,66
CPT,87529,HC HERPES SIMPLEX VIRUS BY PCR,754.21,565.66,9.05,678.79,119
CPT,87529,Hsv dna amp probe,,,31.27,116.42,66
CPT,87530,Hsv dna quant,,,38.17,64.26,58
CPT,87531,Hhv-6 dna dir probe,,,51.68,87.0,58
CPT,87532,HC HERPES VIRUS 6 AMPLIFIED NA PROBE,606.26,454.7,7.28,545.63,119
CPT,87532,Hhv-6 dna amp probe,,,31.27,116.42,66
CPT,87533,HC HERPES 6 NA QUAN,1245.47,934.1,14.95,1120.92,119
CPT,87533,Hhv-6 dna quant,,,37.21,138.56,66
CPT,87534,Hiv-1 dna dir probe,,,19.53,32.88,58
CPT,87535,HC HIV-1 PROBE&REVERSE TRNSCRP J,253.5,190.12,3.04,228.15,119
CPT,87535,Hiv-1 probe&reverse trnscrpj,,,31.27,116.42,66
CPT,87536,HC HIV 1 RNA BY PCR,1540.0,1155.0,18.48,1386.0,119
CPT,87536,HC HIV-1 QUANT&REVRSE TRNSCRP J,756.19,567.14,9.07,680.57,119
CPT,87536,Hiv-1 quant&revrse trnscrpj,,,75.82,127.65,58
CPT,87537,Hiv-2 dna dir probe,,,19.53,32.88,58
CPT,87538,HC IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIP,253.5,190.12,3.04,228.15,119
CPT,87538,Hiv-2 probe&revrse trnscripj,,,31.27,116.42,66
CPT,87539,Hiv-2 quant&revrse trnscripj,,,52.23,194.5,66
CPT,87540,Legion pneumo dna dir prob,,,17.86,66.53,66
CPT,87541,"HC LEGIONELLA, AMPLIF NA PROBE",709.62,532.22,8.52,638.66,119
CPT,87541,Legion pneumo dna amp prob,,,31.27,116.42,66
CPT,87542,Legion pneumo dna quant,,,37.21,138.56,66
CPT,87550,Mycobacteria dna dir probe,,,17.86,66.53,66
CPT,87551,HC MYCOBACTERIA DNA AMP PROBE,733.36,550.02,8.8,660.02,119
CPT,87551,Mycobacteria dna amp probe,,,42.98,160.06,66
CPT,87552,Mycobacteria dna quant,,,38.17,64.26,58
CPT,87555,M.tuberculo dna dir probe,,,23.95,40.32,58
CPT,87556,HC MYCOBACTERIA T AMPLIF NA PROBE,740.96,555.72,8.89,666.86,119
CPT,87556,M.tuberculo dna amp probe,,,37.14,62.52,58
CPT,87557,M.tuberculo dna quant,,,38.17,64.26,58
CPT,87560,M.avium-intra dna dir prob,,,24.32,90.55,66
CPT,87561,M.avium-intra dna amp prob,,,31.27,116.42,66
CPT,87562,M.avium-intra dna quant,,,38.17,64.26,58
CPT,87563,HC IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH,211.66,158.74,2.54,190.49,119
CPT,87563,M. genitalium amp probe,,,13.76,52.64,66
CPT,87564,HC IADNA MTB RIFAMPIN RESISTANCE AMP PRB TQ,207.86,155.9,2.49,187.07,119
CPT,87564,Mtb rifampin rst amp prb tq,,,76.77,254.72,29
CPT,87580,M.pneumon dna dir probe,,,17.86,66.53,66
CPT,87581,"HC MYCOPLASMA PNEUMONIE,AMPLIF NA PROBE",658.99,494.24,7.91,593.09,119
CPT,87581,M.pneumon dna amp probe,,,31.27,116.42,66
CPT,87582,M.pneumon dna quant,,,269.63,1004.09,66
CPT,87590,N.gonorrhoeae dna dir prob,,,23.95,40.32,58
CPT,87591,HC N. GONORRHOEAE (GC) BY AMP DNA,99.4,74.55,1.19,89.46,119
CPT,87591,N.gonorrhoeae dna amp prob,,,13.76,52.64,66
CPT,87592,N.gonorrhoeae dna quant,,,38.17,64.26,58
CPT,87593,HC ORTHOPOXVIRUS AMP PRB EACH,189.07,141.8,2.27,170.16,119
CPT,87593,Orthopoxvirus amp prb each,,,51.31,76.76,22
CPT,87594,HC IADNA PNEUMOCYSTIS JIROVECII AMPLIFIED PROBE TQ,207.86,155.9,2.49,187.07,119
CPT,87594,Pneumcysts jirovecii amp prb,,,35.09,52.64,21
CPT,87623,HC HPV LOW-RISK TYPES; IA,333.7,250.28,4.0,300.33,119
CPT,87623,Hpv low-risk types,,,31.27,116.42,66
CPT,87624,HC HPV HIGH RISK TYPES POOLED RSLT,294.05,220.54,3.53,264.65,119
CPT,87624,Hpv hi-risk typ pooled rslt,,,31.27,116.42,67
CPT,87625,HC HPV TYPES 16 & 18 ONLY,392.06,294.04,4.7,352.85,119
CPT,87625,Hpv types 16 & 18 only,,,36.13,60.83,59
CPT,87626,Hpv sep hi-rsk typ&pool rslt,,,70.2,105.3,21
CPT,87627,Jt spc pthgn&rx rsist gen26+,,,679.77,679.77,9
CPT,87631,HC IA RESP VIRUS 3-5 TARGETS,541.9,406.42,6.5,487.71,119
CPT,87631,Resp virus 3-5 targets,,,14.24,213.95,66
CPT,87632,HC RESP VIRUS 6-11 TARGETS,1128.09,846.07,13.54,1015.28,119
CPT,87632,Resp virus 6-11 targets,,,194.29,723.52,66
CPT,87633,HC IA RESP VIRUS 12-25 TARGETS,1346.02,1009.52,16.15,1211.42,119
CPT,87633,Resp virus 12-25 targets,,,19.49,625.17,66
CPT,87634,Rsv dna/rna amp probe,,,14.02,105.3,66
CPT,87635,HC COVID-19/SARS-COV-2 CPT 87635 INF AGENT DET W/WO RESP CDC SITE U0001,202.53,151.9,2.43,182.28,119
CPT,87635,Sars-cov-2 covid-19 amp prb,,,13.96,76.97,66
CPT,87636,HC SARSCOV2 & INF A&B AMP PRB,431.23,323.42,5.17,388.11,119
CPT,87636,Sarscov2 & inf a&b amp prb,,,19.16,214.07,66
CPT,87637,HC IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,483.16,362.37,5.8,434.84,119
CPT,87637,Sarscov2&inf a&b&rsv amp prb,,,14.26,214.07,66
CPT,87640,HC STAPH A DNA AMP PROBE,453.56,340.17,5.44,408.2,119
CPT,87640,Staph a dna amp probe,,,31.27,116.42,66
CPT,87641,HC MR-STAPH DNA AMP PROBE,405.0,303.75,4.86,364.5,119
CPT,87641,Mr-staph dna amp probe,,,31.27,116.42,66
CPT,87650,Strep a dna dir probe,,,13.24,30.08,66
CPT,87651,HC STREP A DNA AMP PROBE,366.63,274.97,4.4,329.97,119
CPT,87651,Strep a dna amp probe,,,18.08,52.64,66
CPT,87652,Strep a dna quant,,,37.21,138.56,66
CPT,87653,HC STREP B DNA AMP PROBE,625.66,469.24,7.51,563.09,119
CPT,87653,Strep b dna amp probe,,,31.27,52.64,58
CPT,87660,"HC TRICHOMONAS VAGIN, DIR PROBE",190.46,142.84,2.29,171.41,119
CPT,87660,Trichomonas vagin dir probe,,,17.86,30.08,58
CPT,87661,HC TRICHOMONAS VAGINALIS AMPLIF,130.36,97.77,1.56,117.32,119
CPT,87661,Trichomonas vaginalis amplif,,,31.27,52.64,58
CPT,87662,HC ZIKA VIRUS DNA/RNA AMP PROBE,280.17,210.13,3.36,252.15,119
CPT,87662,Zika virus dna/rna amp probe,,,45.72,76.97,58
CPT,87797,Detect agent nos dna dir,,,26.76,45.05,58
CPT,87798,Detect agent nos dna amp,,,31.27,52.64,58
CPT,87798,HC BORDETELLA PARAPETUSSIS PERTUSSIS,331.52,248.64,3.98,298.37,119
CPT,87798,"HC COM CONN BABESIA SPECIES BY PCR, 87798",593.4,445.05,7.12,534.06,119
CPT,87798,HC DETECT AGENT NOS DNA AMP,453.56,340.17,5.44,408.2,119
CPT,87798,HC ENTEROVIRUS PCR,331.52,248.64,3.98,298.37,119
CPT,87798,HC HUMAN PARVOVIRUS BY PCR,453.56,340.17,5.44,408.2,119
CPT,87798,"HC INFECTIOUS AGENT; NOS,AMPLIF PROBE, EA ORG",453.56,340.17,5.44,408.2,119
CPT,87798,HC NOROVIRUS 1&2 BY PCR,660.42,495.32,7.93,594.38,119
CPT,87798,HC P. JIROVECII DNA,365.0,273.75,4.38,328.5,119
CPT,87798,HC PERTUSSIS BY PCR,453.56,340.17,5.44,408.2,119
CPT,87798,HC PNEUMOCYSTIS BY PCR,487.8,365.85,5.85,439.02,119
CPT,87798,HC VARICELLA ZOSTER BY PCR,118.07,88.55,1.42,106.26,119
CPT,87799,Detect agent nos dna quant,,,38.17,64.26,58
CPT,87799,HC EBV QUANT PCR - RL,539.29,404.47,6.47,485.36,119
CPT,87799,"HC QUANTIFICATION, EA ORGANISM",845.76,634.32,10.15,761.18,119
CPT,87800,Detect agnt mult dna direc,,,38.91,144.9,66
CPT,87801,Detect agnt mult dna ampli,,,14.07,105.3,66
CPT,87801,HC DNA RNA MULTIPLE ORG AMP PROBE,972.72,729.54,11.67,875.45,119
CPT,87802,Strep b assay w/optic,,,11.34,19.1,58
CPT,87803,Clostridium toxin a w/optic,,,14.26,24.0,58
CPT,87804,HC INFLUENZA A/B ANTIGEN,472.12,354.09,5.67,424.91,119
CPT,87804,Influenza assay w/optic,,,13.04,24.83,66
CPT,87806,HC HIV ANTIGEN W/HIV ANTIBODIES,41.91,31.43,0.5,37.72,119
CPT,87806,Hiv ag w/hiv1&2 antb w/optic,,,13.76,49.16,66
CPT,87807,HC RSV I/A W DIR OBSERV,115.84,86.88,1.39,104.26,119
CPT,87807,Rsv assay w/optic,,,11.67,19.65,66
CPT,87808,Trichomonas assay w/optic,,,12.68,22.94,66
CPT,87809,Adenovirus assay w/optic,,,18.0,32.64,66
CPT,87810,Chlmyd trach assay w/optic,,,31.44,52.94,58
CPT,87811,Sars-cov-2 covid19 w/optic,,,13.96,160.94,66
CPT,87812,Sarscov2&inf typ a&b w/optic,,,74.48,74.48,9
CPT,87850,N. gonorrhoeae assay w/optic,,,21.88,36.84,58
CPT,87880,HC STREP A ASSAY W/OPTIC,182.97,137.23,2.2,164.67,119
CPT,87880,HC STREP A ASSAY W/OPTIC POC,182.97,137.23,2.2,164.67,119
CPT,87880,Strep a assay w/optic,,,12.9,24.8,66
CPT,87899,Agent nos assay w/optic,,,14.32,24.11,66
CPT,87899,"HC INFECTIOUS ANTIGEN DETECT IMMUNOASSAY W DIRECT OPT OBS, NOS",539.29,404.47,6.47,485.36,119
CPT,87899,HC MALARIA ANTIGEN SCREEN,539.29,404.47,6.47,485.36,119
CPT,87899,HC SHIGELLA TOXIN,539.29,404.47,6.47,485.36,119
CPT,87900,HC PHENOTYPE INFECT AGENT DRUG,480.58,360.44,5.77,432.52,119
CPT,87900,Phenotype infect agent drug,,,116.14,195.53,58
CPT,87901,HC HIV 1  GENOTYPE ANALYSIS NUC ACID-RL,2412.49,1809.37,28.95,2171.24,119
CPT,87901,Nfct agt gntyp alys hiv1 rev,,,229.39,854.22,66
CPT,87902,HC HEP C GENOTYPING BY SEQUENCIN,1208.55,906.41,14.5,1087.7,119
CPT,87902,Nfct agt gntyp alys hep c,,,229.39,854.22,66
CPT,87903,Phenotype dna hiv w/culture,,,435.4,1621.38,66
CPT,87904,Phenotype dna hiv w/clt add,,,23.23,39.11,58
CPT,87905,Ia nzmtc actv oth/thn virus,,,10.89,18.33,66
CPT,87906,HC GENOTYPE DNA/RNA HIV,358.59,268.94,4.3,322.73,119
CPT,87906,Nfct agt gntyp alys hiv1,,,114.7,193.1,58
CPT,87910,HC GENOTYPE CYTOMEGALOVIRUS,949.2,711.9,11.39,854.28,119
CPT,87910,Nfct agt gntyp alys cmv,,,229.39,854.22,66
CPT,87912,HC GENOTYPE DNA HEPATITIS B VIRUS,519.13,389.35,6.23,467.22,119
CPT,87912,Nfct agt gntyp alys hep b,,,229.39,854.22,66
CPT,87913,Nfct agt gntyp alys sarscov2,,,229.39,854.22,66
CPT,87999,HC COM CON ENVIRONMENTAL CULTURE,414.77,311.08,4.98,373.29,119
CPT,87999,Unlisted microbiology px,,,0.5,0.5,3
CPT,88000,Autopsy (necropsy) gross,,,315.62,315.62,3
CPT,88005,Autopsy (necropsy) gross,,,368.48,368.48,3
CPT,88007,Autopsy (necropsy) gross,,,385.74,385.74,3
CPT,88012,Autopsy (necropsy) gross,,,315.62,315.62,3
CPT,88014,Autopsy (necropsy) gross,,,289.44,289.44,3
CPT,88016,Autopsy (necropsy) gross,,,403.55,403.55,3
CPT,88020,Autopsy (necropsy) complete,,,543.81,543.81,3
CPT,88025,Autopsy (necropsy) complete,,,526.02,526.02,3
CPT,88027,Autopsy (necropsy) complete,,,561.08,561.08,3
CPT,88028,Autopsy (necropsy) complete,,,315.62,315.62,3
CPT,88029,Autopsy (necropsy) complete,,,315.62,315.62,3
CPT,88036,Limited autopsy,,,158.07,158.07,3
CPT,88037,Limited autopsy,,,140.27,140.27,3
CPT,88040,Forensic autopsy (necropsy),,,876.69,876.69,3
CPT,88045,Coroners autopsy (necropsy),,,87.93,87.93,3
CPT,88099,Unlisted necropsy (autopsy),,,0.5,0.5,3
CPT,88104,Cytopath fl nongyn smears,,,26.17,244.34,102
CPT,88104,HC CYTOPATH FLUIDS NONGYN SMEARS,248.94,186.7,2.99,224.05,119
CPT,88106,Cytopath fl nongyn filter,,,18.48,215.93,102
CPT,88106,HC CYTOPATH FL NONGYN FILTER,329.28,246.96,3.95,296.35,119
CPT,88108,Cytopath concentrate tech,,,21.48,50.76,94
CPT,88108,HC FLUID CYTOLOGY FILTER/INTERP,263.4,197.55,3.16,237.06,119
CPT,88112,Cytopath cell enhance tech,,,26.49,207.31,102
CPT,88112,HC CYTOPATH CELL ENHANCE TECH,263.4,197.55,3.16,237.06,119
CPT,88120,Cytp urne 3-5 probes ea spec,,,56.0,506.07,102
CPT,88121,Cytp urine 3-5 probes cmptr,,,46.4,436.89,102
CPT,88125,Forensic cytopathology,,,13.18,74.64,94
CPT,88130,Sex chromatin identification,,,16.02,59.66,66
CPT,88140,Sex chromatin identification,,,7.12,11.99,58
CPT,88141,Cytopath c/v interpret,,,21.97,76.98,48
CPT,88142,Cytopath c/v thin layer,,,18.05,30.39,59
CPT,88142,HC CERV/VAG THIN PREP CYTO SCREEN,250.86,188.14,3.01,225.77,119
CPT,88143,Cytopath c/v thin layer redo,,,20.53,34.56,59
CPT,88147,Cytopath c/v automated,,,45.05,167.76,66
CPT,88148,Cytopath c/v auto rescreen,,,15.82,24.0,58
CPT,88150,Cytopath c/v manual,,,15.82,22.73,58
CPT,88152,Cytopath c/v auto redo,,,24.63,91.71,66
CPT,88153,Cytopath c/v redo,,,21.41,36.05,58
CPT,88155,Cytopath c/v index add-on,,,13.05,48.6,66
CPT,88160,Cytopath smear other source,,,23.47,78.2,102
CPT,88160,HC CYTO SMR SCREEN & INTERPRET,220.03,165.02,2.64,198.03,119
CPT,88161,Cytopath smear other source,,,23.47,255.92,102
CPT,88161,HC CYTOPATHOLOGY PREP SCRN INTERP/TOUCH PREP,220.03,165.02,2.64,198.03,119
CPT,88162,Cytopath smear other source,,,37.66,75.27,94
CPT,88164,Cytopath tbs c/v manual,,,15.82,22.73,59
CPT,88165,Cytopath tbs c/v redo,,,37.62,63.33,59
CPT,88166,Cytopath tbs c/v auto redo,,,15.82,22.73,58
CPT,88167,Cytopath tbs c/v select,,,15.82,22.73,58
CPT,88172,Cytp dx eval fna 1st ea site,,,19.43,223.74,95
CPT,88172,HC FINE NEEDLE ASPIRATION EVAL,263.4,197.55,3.16,237.06,119
CPT,88173,Cytopath eval fna report,,,51.22,159.0,103
CPT,88173,HC EVAL OF FNA; INTERP & REPORT,263.4,197.55,3.16,237.06,119
CPT,88174,Cytopath c/v auto in fluid,,,22.6,38.06,59
CPT,88174,"HC CYTOPATHOLOGY,CERV/VAG,AUTO THIN LAYER, UNDER MD SUPERVISION",177.61,133.21,2.13,159.85,119
CPT,88175,Cytopath c/v auto fluid redo,,,23.71,39.92,59
CPT,88175,HC PAP THIN LAYER AUTO PREP & SCREEN,319.99,239.99,3.84,287.99,119
CPT,88177,Cytp fna eval ea addl,,,7.53,92.14,84
CPT,88177,HC CYTP C/V AUTO THIN LYR ADDL,303.66,227.74,3.64,273.29,119
CPT,88182,Cell marker study,,,37.37,114.45,102
CPT,88182,HC DNA ANALYSIS,232.47,174.35,2.79,209.22,119
CPT,88184,Flowcytometry/ tc 1 marker,,,69.62,436.89,58
CPT,88184,HC FLOW CYTOMETRY-FIRST MARKER,320.05,240.04,3.84,288.04,119
CPT,88185,Flowcytometry/tc add-on,,,22.28,34.55,39
CPT,88185,HC FLOW CYTOMETRY EA ADDTL MARKER,240.05,180.04,2.88,216.04,119
CPT,88187,Flowcytometry/read 2-8,,,34.41,111.45,47
CPT,88187,HC COM CON FLOWCYTOMETRY/READ 2-8,723.75,542.81,8.68,651.38,119
CPT,88188,Flowcytometry/read 9-15,,,60.0,94.22,39
CPT,88189,Flowcytometry/read 16 & >,,,81.29,257.54,47
CPT,88189,HC COM CON FLOWCYTOMETRY/READ 16 & >,422.97,317.23,5.08,380.67,119
CPT,88199,Unlisted cytopathology px,,,51.22,74.64,22
CPT,88230,HC TISSUE CX NON NEOPLASTIC DIS LYMPHO,1319.48,989.61,15.83,1187.53,119
CPT,88230,Tissue culture lymphocyte,,,103.79,174.74,58
CPT,88233,HC CULTURE TISSUE SKIN,1737.4,1303.05,20.85,1563.66,119
CPT,88233,Tissue culture skin/biopsy,,,125.39,466.95,66
CPT,88235,HC TISSUE CULTURE; AMNIOTIC FLUID,1673.52,1255.14,20.08,1506.17,119
CPT,88235,Tissue culture placenta,,,133.92,498.7,66
CPT,88237,HC  TISSUE CULTURE BLOOD CELLS,1636.72,1227.54,19.64,1473.05,119
CPT,88237,Tissue culture bone marrow,,,128.08,215.63,58
CPT,88239,HC TISSUE CULTRE SOLID TUMOR,1754.24,1315.68,21.05,1578.82,119
CPT,88239,Tissue culture tumor,,,131.44,489.47,66
CPT,88240,Cell cryopreserve/storage,,,11.65,43.37,66
CPT,88240,HC CRYOPRESERVATION,119.61,89.71,1.44,107.65,119
CPT,88241,Frozen cell preparation,,,10.77,18.14,58
CPT,88245,Chromosome analysis 20-25,,,154.29,574.58,66
CPT,88248,Chromosome analysis 50-100,,,154.29,574.58,66
CPT,88249,Chromosome analysis 100,,,154.29,574.58,66
CPT,88261,Chromosome analysis 5,,,235.53,877.08,66
CPT,88262,Chromosome analysis 15-20,,,111.81,188.24,58
CPT,88262,HC  CHROMOSOME ANALYSIS,1536.93,1152.7,18.44,1383.24,119
CPT,88263,Chromosome analysis 45,,,133.91,498.67,66
CPT,88263,HC CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE,1503.16,1127.37,18.04,1352.84,119
CPT,88264,Chromosome analysis 20-25,,,128.85,216.92,58
CPT,88264,HC CHROMOSOME ANALYSIS 20 25,1615.19,1211.39,19.38,1453.67,119
CPT,88267,Chromosome analys placenta,,,168.02,625.67,66
CPT,88267,HC CHROMOSOME ANALYSIS TISSUE,535.92,401.94,6.43,482.33,119
CPT,88269,Chromosome analys amniotic,,,154.73,576.21,66
CPT,88269,HC CHROMOSOME ANALYS AMNIOTIC,1715.97,1286.98,20.59,1544.37,119
CPT,88271,Cytogenetics dna probe,,,19.09,71.07,66
CPT,88271,HC ADDITIONAL BANDING-FISH,57.99,43.49,0.7,52.19,119
CPT,88271,HC BCR/ABL BY FISH,640.09,480.07,7.68,576.08,119
CPT,88271,HC DNA PROBE FISH,640.07,480.05,7.68,576.06,119
CPT,88271,HC MCG; DNA PROBE EA,290.3,217.72,3.48,261.27,119
CPT,88272,Cytogenetics 3-5,,,36.26,61.05,58
CPT,88273,Cytogenetics 10-30,,,31.02,52.22,58
CPT,88273,HC CYTOGENETICS 10-30 CELLS,1377.18,1032.88,16.53,1239.46,119
CPT,88274,Cytogenetics 25-99,,,37.76,63.57,58
CPT,88274,HC CYTOGENETICS 25-99,114.74,86.06,1.38,103.27,119
CPT,88275,Cytogenetics 100-300,,,45.61,169.85,66
CPT,88275,HC CYTOGENETICS 100 - 300,793.59,595.19,9.52,714.23,119
CPT,88280,Chromosome karyotype study,,,29.82,50.21,58
CPT,88280,HC CHROM ANALY ADDL KARYOT EA STUDY,427.14,320.36,5.13,384.43,119
CPT,88283,Chromosome banding study,,,61.12,227.62,66
CPT,88285,Chromosome count additional,,,23.98,40.37,58
CPT,88289,Chromosome study additional,,,30.68,51.65,58
CPT,88291,Cyto/molecular report,,,31.39,50.78,40
CPT,88299,Unlisted cytogenetic study,,,51.22,74.64,22
CPT,88300,HC SURG PATH LEVEL-I GROSS EXAM ONLY,163.05,122.29,1.96,146.74,119
CPT,88300,Surgical path gross,,,4.26,50.63,102
CPT,88302,HC LEVEL II SURG PATH GROSS/MICRO,275.43,206.57,3.31,247.89,119
CPT,88302,Tissue exam by pathologist,,,6.58,43.69,94
CPT,88304,HC SURG PATH LEVEL-III GROSS & MICRO,300.47,225.35,3.61,270.42,119
CPT,88304,Tissue exam by pathologist,,,10.89,74.64,94
CPT,88305,HC SURG PATH LEVEL-IV GROSS & MICRO,325.51,244.13,3.91,292.96,119
CPT,88305,Tissue exam by pathologist,,,32.61,94.56,103
CPT,88307,HC SURG PATH LEVEL-V GROSS & MICRO,532.71,399.53,6.39,479.44,119
CPT,88307,Tissue exam by pathologist,,,78.9,436.89,103
CPT,88309,HC SURG PATH LEVEL-VI GROSS & MICRO,570.76,428.07,6.85,513.68,119
CPT,88309,Tissue exam by pathologist,,,69.38,984.23,102
CPT,88311,Decalcify tissue,,,7.82,13.08,75
CPT,88311,HC DECALCIFICATION PROCEDURE,109.14,81.86,1.31,98.23,119
CPT,88312,"HC SPECIAL STAINS; GROUP 1, EACH",336.69,252.52,4.04,303.02,119
CPT,88312,Special stains group 1,,,25.5,80.94,94
CPT,88313,"HC SPECIAL STAINS; GROUP 2, EACH",336.69,252.52,4.04,303.02,119
CPT,88313,Special stains group 2,,,11.56,248.05,102
CPT,88314,HC HISTOCHEMICAL STAIN ADD-ON,3075.56,2306.67,36.91,2768.0,119
CPT,88314,Histochemical stains add-on,,,19.94,260.56,83
CPT,88319,Enzyme histochemistry,,,25.78,984.23,94
CPT,88319,HC ENZYME HISTOCHEMICAL STAIN,919.4,689.55,11.03,827.46,119
CPT,88321,Consltj&reprt sld prep elswr,,,37.63,93.98,58
CPT,88321,HC PATH CONSULT SENDOUT,705.17,528.88,8.46,634.65,119
CPT,88323,Consltj&reprt matrl prep sld,,,26.34,84.27,102
CPT,88323,HC SLIDE REV/CON RPT COMPREHSIV,250.4,187.8,3.0,225.36,119
CPT,88325,Consltj compre rvw rec reprt,,,129.91,491.1,66
CPT,88329,Path consltj drg surg,,,34.23,168.02,66
CPT,88331,HC TISSUE 1ST FROZEN SECTION EXAM,262.19,196.64,3.15,235.97,119
CPT,88331,Path consltj surg 1 blk 1spc,,,38.58,223.74,103
CPT,88332,HC TISSUE ADDL FROZEN SECT EXAM,262.19,196.64,3.15,235.97,119
CPT,88332,Path consltj surg ea add blk,,,23.2,78.31,84
CPT,88333,HC TOUCH PREP SURG CONSULT 1ST SITE,268.64,201.48,3.22,241.78,119
CPT,88333,Path consltj surg cyto xm 1,,,30.1,984.23,102
CPT,88334,HC TOUCH PREP-SURG CONSULT-ADDL,423.27,317.45,5.08,380.94,119
CPT,88334,Path consltj surg cyto xm ea,,,18.2,79.73,83
CPT,88341,HC IMMUNOHISTO AB SLIDE; PER SPEC; SINGLE STAIN,291.35,218.51,3.5,262.22,119
CPT,88341,Imhchem/imcytchm ea add antb,,,27.11,97.88,76
CPT,88342,HC IMMUNO; PER SPEC INIT SGLE AB,384.96,288.72,4.62,346.46,119
CPT,88342,Imhchem/imcytchm 1st antb,,,33.43,223.74,95
CPT,88344,HC IMMUNOHISTO ANTIBODY SLIDE; PER SPEC; MULTIPLEX AB STAIN,653.85,490.39,7.85,588.46,119
CPT,88344,Imhchem/imcytchm ea mlt antb,,,36.74,523.22,102
CPT,88346,HC IMMUNOFLUORESCENCE PER SPEC AB 1ST STAIN,310.08,232.56,3.72,279.07,119
CPT,88346,Imfluor 1st 1antb stain px,,,34.47,438.9,102
CPT,88348,Electron microscopy dx,,,74.04,1488.82,102
CPT,88348,HC ELECTRON MICROSCOPY,1945.5,1459.12,23.35,1750.95,119
CPT,88350,HC IMMUNOFLUOR PER SPEC AB ADDITIONAL,310.08,232.56,3.72,279.07,119
CPT,88350,Imfluor ea addl 1antb stn px,,,27.82,121.95,75
CPT,88355,M/phmtrc alys skeletal musc,,,56.76,223.74,102
CPT,88356,Analysis nerve,,,51.22,119.63,102
CPT,88358,Analysis tumor,,,47.53,223.74,102
CPT,88360,HC TUMOR IMM MAN PER SPEC/EA AB,307.89,230.92,3.69,277.1,119
CPT,88360,Tumor immunohistochem/manual,,,38.52,223.74,103
CPT,88361,HC IMMUNO EA SGLE AB COMPUTER,1865.15,1398.86,22.38,1678.64,119
CPT,88361,Tumor immunohistochem/comput,,,42.21,436.89,95
CPT,88362,Nerve teasing preparations,,,106.09,984.23,102
CPT,88363,Xm archive tissue molec anal,,,18.77,37.01,57
CPT,88364,HC INSITU HYBRIDIZATION (FISH); PER SPEC; EA ADDTL SINGLE PROBE,751.32,563.49,9.02,676.19,119
CPT,88364,Insitu hybridization (fish),,,32.8,164.34,75
CPT,88365,HC TISSUE ISH SNGL PROBE PER SPEC,1865.15,1398.86,22.38,1678.64,119
CPT,88365,Insitu hybridization (fish),,,41.41,529.02,102
CPT,88366,HC INSITU HYBRIDIZATION (FISH) EA MULTIPLEX PROBE,2117.49,1588.12,25.41,1905.74,119
CPT,88366,Insitu hybridization (fish),,,59.55,436.89,102
CPT,88367,HC INSITU HYBRIDIZATION AUTO,1865.15,1398.86,22.38,1678.64,119
CPT,88367,Insitu hybridization auto,,,32.25,436.89,94
CPT,88368,HC MORPH ISH SNGL PER SPEC/MAN,3185.59,2389.19,38.23,2867.03,119
CPT,88368,Insitu hybridization manual,,,40.16,436.89,102
CPT,88369,M/phmtrc alysishquant/semiq,,,31.86,128.76,75
CPT,88371,Protein western blot tissue,,,18.48,33.35,39
CPT,88372,Protein analysis w/probe,,,17.22,39.33,39
CPT,88373,HC  M/PHMTRC ANALYS ISH QUANT/SEMIQ COMPUTER-ASSIST EACH ADDTL SINGLE PROBE,1633.79,1225.34,19.61,1470.41,119
CPT,88373,M/phmtrc alys ishquant/semiq,,,24.36,70.67,75
CPT,88374,HC M/PHMTRC ANALYS ISH QUANT/SEMIQ COMPUTR-ASSIST EA MULTIPLEX PROBE,2213.01,1659.76,26.56,1991.71,119
CPT,88374,M/phmtrc alys ishquant/semiq,,,41.22,244.74,102
CPT,88375,Optical endomicroscpy interp,,,46.13,145.73,47
CPT,88377,HC M/PHMTRC ANALYS ISH QUANT/SEMIQ; MANUAL EA MULTIPLEX PROBE,472.12,354.09,5.67,424.91,119
CPT,88377,M/phmtrc alys ishquant/semiq,,,61.54,312.5,102
CPT,88380,HC MICRODISSECTION LASER,1481.09,1110.82,17.77,1332.98,119
CPT,88380,Microdissection laser,,,51.16,118.29,83
CPT,88381,HC MICRODISSECTION MANUAL,651.23,488.42,7.81,586.11,119
CPT,88381,Microdissection manual,,,22.96,587.58,83
CPT,88387,Macroscopic xm dsj&prep tiss,,,7.2,26.01,75
CPT,88388,Tiss ex molecul study add-on,,,12.84,22.45,72
CPT,88399,Unlisted surgical path px,,,51.22,74.64,22
CPT,88720,Bilirubin total transcut,,,4.47,7.53,58
CPT,88720,HC BILIRUBIN TOTAL TRANSCUTANEOUS POC,65.78,49.34,0.79,59.2,119
CPT,88738,Hgb quant transcutaneous,,,4.47,7.53,58
CPT,88740,Transcutaneous carboxyhb,,,8.35,31.09,66
CPT,88741,Transcutaneous methb,,,8.35,31.09,66
CPT,88749,Unlisted in vivo lab service,,,0.5,0.5,3
CPT,89049,Chct for mal hyperthermia,,,60.58,881.19,66
CPT,89050,Body fluid cell count,,,4.21,7.08,58
CPT,89050,"HC CELL COUNT, BODY FLUIDS, EXCEPT BLOOD",165.92,124.44,1.99,149.33,119
CPT,89050,"HC EOSINOPHILS, URINE",12.78,9.59,0.15,11.5,119
CPT,89050,HC URINE SMEAR FOR EOSINOPHILS,165.92,124.44,1.99,149.33,119
CPT,89051,Body fluid cell count,,,4.99,8.4,58
CPT,89051,HC CELL COUNT OTHER FLUIDS W/DIFF,225.29,168.97,2.7,202.76,119
CPT,89051,HC CELL COUNT SPINAL FLUID W/DIF,225.29,168.97,2.7,202.76,119
CPT,89055,HC LEUKOCYTE SMEAR FECAL,649.53,487.15,7.79,584.58,119
CPT,89055,Leukocyte assessment fecal,,,3.8,6.41,58
CPT,89060,Exam synovial fluid crystals,,,7.33,17.22,57
CPT,89060,HC CRYSTALS FLUID,203.92,152.94,2.45,183.53,119
CPT,89060,HC CRYSTALS FLUID POC,190.67,143.0,2.29,171.6,119
CPT,89125,Specimen fat stain,,,5.24,8.82,58
CPT,89160,Exam feces for meat fibers,,,4.32,7.28,58
CPT,89160,"HC MEAT FIBERS, FECES",68.26,51.2,0.82,61.43,119
CPT,89190,HC NASAL SMEAR FOR EOSINOPHILS,184.98,138.74,2.22,166.48,119
CPT,89190,Nasal smear for eosinophils,,,5.16,8.69,58
CPT,89220,"HC SPUTUM, OBTAINING SPECIMEN AEROSOL INDUCED POC",463.96,347.97,5.57,417.56,119
CPT,89220,Sputum specimen collection,,,16.92,223.74,58
CPT,89230,Collect sweat for test,,,2.49,74.64,58
CPT,89230,HC COLLECT SWEAT FOR TEST,922.06,691.54,11.06,829.85,119
CPT,89240,HC UNLISTED MISCELLANEOUS PATHOLOGY TEST,330.06,247.54,3.96,297.05,119
CPT,89240,Unlisted misc path test,,,51.22,74.64,22
CPT,89250,Cultr oocyte/embryo <4 days,,,164.28,223.74,21
CPT,89251,Cultr oocyte/embryo <4 days,,,164.28,223.74,21
CPT,89253,Embryo hatching,,,164.28,223.74,21
CPT,89254,Oocyte identification,,,164.28,223.74,21
CPT,89255,Prepare embryo for transfer,,,51.22,74.64,21
CPT,89257,Sperm identification,,,51.22,74.64,21
CPT,89258,Cryopreservation embryo(s),,,783.13,984.23,21
CPT,89259,Cryopreservation sperm,,,164.28,223.74,21
CPT,89260,HC SPERM ISOLATION SIMPLE PREP,1042.53,781.9,12.51,938.28,119
CPT,89260,Sperm isolation simple,,,51.22,74.64,21
CPT,89261,Sperm isolation complex,,,51.22,74.64,21
CPT,89264,Identify sperm tissue,,,51.22,74.64,21
CPT,89268,Insemination of oocytes,,,164.28,223.74,21
CPT,89272,Extended culture of oocytes,,,783.13,984.23,21
CPT,89280,Assist oocyte fertilization,,,783.13,984.23,21
CPT,89281,Assist oocyte fertilization,,,164.28,223.74,21
CPT,89290,Biopsy oocyte polar body <5,,,164.28,223.74,21
CPT,89291,Biopsy oocyte polar body,,,164.28,223.74,21
CPT,89300,Semen analysis w/huhner,,,8.77,14.76,66
CPT,89310,HC SEMEN MOTILITY/COUNT,191.9,143.93,2.3,172.71,119
CPT,89310,Semen analysis w/count,,,7.67,12.92,58
CPT,89320,HC SEMEN ANALYSIS  COMPLETE,275.05,206.29,3.3,247.54,119
CPT,89320,Semen anal vol/count/mot,,,10.97,18.47,58
CPT,89321,HC SPERM COUNT POST-VASECTOMY,234.51,175.88,2.81,211.06,119
CPT,89321,Semen anal sperm detection,,,10.74,18.08,66
CPT,89322,HC SEMEN ANALYSIS WHO 5,401.27,300.95,4.82,361.14,119
CPT,89322,HC SEMEN ANL STRICT CRITERIA,540.27,405.2,6.48,486.24,119
CPT,89322,Semen anal strict criteria,,,13.81,23.25,58
CPT,89325,HC SPERM ANTIBODIES,332.45,249.34,3.99,299.2,119
CPT,89325,Sperm antibody test,,,9.51,16.01,58
CPT,89329,Sperm evaluation test,,,17.45,29.39,58
CPT,89330,Evaluation cervical mucus,,,9.25,15.57,58
CPT,89331,Retrograde ejaculation anal,,,17.45,29.39,58
CPT,89335,Cryopreserve testicular tiss,,,51.22,74.64,21
CPT,89337,Cryopreservation oocyte(s),,,164.28,223.74,21
CPT,89342,Storage/year embryo(s),,,164.28,223.74,21
CPT,89343,Storage/year sperm/semen,,,164.28,223.74,21
CPT,89344,Storage/year reprod tissue,,,164.28,223.74,21
CPT,89346,Storage/year oocyte(s),,,164.28,436.89,21
CPT,89352,Thawing cryopresrved embryo,,,164.28,223.74,21
CPT,89353,Thawing cryopresrved sperm,,,51.22,74.64,21
CPT,89354,Thaw cryoprsvrd reprod tiss,,,164.28,223.74,21
CPT,89356,Thawing cryopresrved oocyte,,,164.28,223.74,21
CPT,89398,Unlisted reprod med lab proc,,,51.22,74.64,22
CPT,90281,Human ig im,,,112.37,112.37,8
CPT,90283,Human ig iv,,,76.55,76.55,8
CPT,90284,Human ig sc,,,15.31,15.31,8
CPT,90287,Botulinum antitoxin,,,,,0
CPT,90288,Botulism ig iv,,,51570.0,51570.0,8
CPT,90291,Cmv ig iv,,,1897.4,1897.4,8
CPT,90296,Diphtheria antitoxin,,,,,0
CPT,90371,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,367.07,275.3,4.4,330.36,119
CPT,90371,"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",3123.83,2342.87,37.49,2811.45,119
CPT,90371,Hep b ig im,,,128.05,163.69,63
CPT,90375,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,5226.225,3919.665,31.36,7055.4,238
CPT,90375,Rabies ig im/sc,,,278.23,336.56,63
CPT,90376,Rabies ig heat treated,,,320.86,488.77,63
CPT,90377,Rabies ig ht&sol human im/sc,,,222.25,310.59,63
CPT,90378,Rsv mab im 50mg,,,436.75,1856.48,27
CPT,90380,NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,1986.065,1489.55,23.04,1846.92,238
CPT,90380,Rsv monoc antb seasn .5ml im,,,561.33,561.33,8
CPT,90381,NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE,1995.84,1496.88,23.95,1796.26,119
CPT,90381,Rsv monoc antb seasn 1 ml im,,,561.33,561.33,8
CPT,90384,Rh ig full-dose im,,,89.46,89.46,8
CPT,90385,Rh ig minidose im,,,32.23,80.0,17
CPT,90386,Rh ig iv,,,38.87,38.87,8
CPT,90389,Tetanus ig im,,,701.1,701.1,8
CPT,90393,Vaccina ig im,,,,,0
CPT,90396,Varicella-zoster ig im,,,2252.28,2742.07,27
CPT,90399,Unlisted immune globulin,,,,,0
CPT,90460,HC VFC IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,22.44,16.83,0.27,20.2,119
CPT,90460,Im admin 1st/only component,,,21.58,60.05,44
CPT,90461,Im admin each addl component,,,9.84,23.18,44
CPT,90471,HC ADMIN HEPATITIS B VACCINE,38.41,28.81,0.46,34.57,119
CPT,90471,HC ADMIN INFLUENZA VACCINE,153.13,114.85,1.84,137.82,119
CPT,90471,HC ADMIN PNEUMOCOCCAL VACCINE,18.72,14.04,0.22,16.85,119
CPT,90471,HC IMMUNIZATION ADMIN;ONE VACCINE,35.27,26.45,0.42,31.74,119
CPT,90471,HC VFC-ADMIN IMMUNIZATION 1 VACCINE,22.44,16.83,0.27,20.2,119
CPT,90471,Immunization admin,,,19.23,79.22,63
CPT,90472,HC ADMIN HEPATITIS B AS SECOND VACCINE,20.27,15.2,0.24,18.24,119
CPT,90472,HC ADMIN INFLUENZA AS SECOND VACCINE,20.27,15.2,0.24,18.24,119
CPT,90472,HC IMMUNIZATION ADMIN EACH ADDL VACC,30.96,23.22,0.37,27.86,119
CPT,90472,HC VFC-ADMIN IMMUNIZTN EA ADDL VACCINE,22.44,16.83,0.27,20.2,119
CPT,90472,Immunization admin each add,,,13.85,38.27,44
CPT,90473,HC ADMIN IMMUNE ORAL/NASAL 1 VACCINE,117.88,88.41,1.41,106.09,119
CPT,90473,HC VFC-ADMIN IMNZTN ORAL/NASAL 1 VAC,117.88,88.41,1.41,106.09,119
CPT,90473,Immune admin oral/nasal,,,15.78,79.22,63
CPT,90474,HC ADMIN IMMUNIZATION ORAL/NASAL ADDL VACC,42.64,31.979999999999997,0.51,38.58,238
CPT,90474,HC VFC-ADMIN IMMUNZTN ORAL/NASAL ADDL VACC,42.87,32.15,0.51,38.58,119
CPT,90474,Immune admin oral/nasal addl,,,11.34,31.49,44
CPT,90476,Adenovirus vaccine type 4,,,,,0
CPT,90477,Adenovirus vaccine type 7,,,,,0
CPT,90480,Admn sarscov2 vac 1/only cmp,,,39.8,112.28,27
CPT,90480,HC IMM ADMN SARSCOV2 VACCINE SINGLE DOSE,117.88,88.41,1.41,106.09,119
CPT,90480,HC VFC-ADMN SARSCOV2 VACC 1 DOSE,15.27,11.45,0.18,13.74,119
CPT,90581,Anthrax vaccine sc or im,,,106.92,106.92,8
CPT,90584,Dengue vacc quad 2 dose subq,,,,,0
CPT,90585,Bcg vaccine percut,,,176.42,176.42,8
CPT,90586,Bcg vaccine intravesical,,,143.2,174.93,44
CPT,90587,Dengue vacc quad 3 dose subq,,,71.28,71.28,8
CPT,90589,Chikungunya vaccine live im,,,148.5,148.5,8
CPT,90611,Smallpox&monkeypox vac 0.5ml,,,0.01,291.6,27
CPT,90619,Menacwy-tt vaccine im,,,180.21,180.21,8
CPT,90620,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",907.68,680.76,10.89,816.91,238
CPT,90620,Menb-4c vaccine im,,,241.52,241.52,8
CPT,90621,Menb-fhbp vacc 2/3 dose im,,,205.34,205.34,8
CPT,90621,"N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE",793.22,594.92,9.52,713.9,238
CPT,90622,Vaccinia vrs vac 0.3 ml perq,,,0.01,0.01,19
CPT,90623,Menacwy-tt menb-fhbp vacc im,,,249.08,249.08,8
CPT,90624,Menb-4c&menacwy vacc im,,,,,0
CPT,90625,Cholera vaccine live oral,,,297.0,297.0,8
CPT,90626,Tic-brn enceph vac 0.25ml im,,,312.59,312.59,8
CPT,90627,Tic-brn enceph vac 0.5ml im,,,312.59,312.59,8
CPT,90630,Flu vacc iiv4 no preserv id,,,,,0
CPT,90632,"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",354.42,265.81,4.25,318.98,238
CPT,90632,Hepa vaccine adult im,,,70.16,82.44,44
CPT,90633,Hepa vacc ped/adol 2 dose im,,,40.91,40.91,8
CPT,90634,Hepa vacc ped/adol 3 dose,,,,,0
CPT,90636,HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE,543.36,407.52,6.52,489.02,238
CPT,90636,Hep a/hep b vacc adult im,,,136.03,136.03,8
CPT,90637,Vacc qirv mrna 30mcg/.5ml im,,,,,0
CPT,90638,Vacc qirv mrna 60mcg/.5ml im,,,,,0
CPT,90644,Hib-mency vacc 6wk-18m0 im,,,,,0
CPT,90647,Hib prp-omp vacc 3 dose im,,,32.89,32.89,8
CPT,90648,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN,60.0,45.0,0.72,54.0,238
CPT,90648,Hib prp-t vaccine 4 dose im,,,13.69,13.69,8
CPT,90649,4vhpv vaccine 3 dose im,,,,,0
CPT,90650,2vhpv vaccine 3 dose im,,,,,0
CPT,90651,9vhpv vaccine 2/3 dose im,,,332.08,332.08,8
CPT,90651,"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",1178.34,883.76,14.14,1060.51,119
CPT,90653,Iiv adjuvant vaccine im,,,97.67,97.67,8
CPT,90654,Flu vacc iiv3 no preserv id,,,,,0
CPT,90655,Iiv3 vacc no prsv 0.25 ml im,,,,,0
CPT,90656,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,39.48,29.61,0.47,35.53,238
CPT,90656,Iiv3 vacc no prsv 0.5 ml im,,,26.15,26.15,8
CPT,90657,Iiv3 vaccine splt 0.25 ml im,,,12.78,12.78,8
CPT,90658,Iiv3 vaccine splt 0.5 ml im,,,25.57,25.57,8
CPT,90660,Laiv3 vaccine intranasal,,,33.77,33.77,8
CPT,90661,Cciiv3 vac abx fr 0.5 ml im,,,43.11,43.11,8
CPT,90662,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,156.84,117.63,1.88,141.16,119
CPT,90662,Iiv no prsv increased ag im,,,69.94,97.67,44
CPT,90664,Laiv vacc pandemic intranasl,,,,,0
CPT,90666,Flu vac pandem prsrv free im,,,,,0
CPT,90667,Iiv vacc pandemic adjuvt im,,,,,0
CPT,90668,Iiv vaccine pandemic im,,,,,0
CPT,90670,Pcv13 vaccine im,,,257.98,301.8,44
CPT,90671,Pcv15 vaccine im,,,246.19,296.62,44
CPT,90672,Laiv4 vaccine intranasal,,,26.33,26.87,44
CPT,90673,Riv3 vaccine no preserv im,,,97.67,97.67,8
CPT,90674,Cciiv4 vac no prsv 0.5 ml im,,,32.27,32.37,44
CPT,90675,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1668.9,1251.68,20.03,1502.01,119
CPT,90675,Rabies vaccine im,,,313.68,409.6,63
CPT,90676,Rabies vaccine id,,,236.86,307.05,19
CPT,90677,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,556.31,417.235,6.57,508.43,238
CPT,90677,Pcv20 vaccine im,,,283.71,348.65,44
CPT,90678,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1178.11,883.58,14.14,1060.3,119
CPT,90678,Rsv vacc pref bivalent im,,,318.6,318.6,8
CPT,90679,Rsv vacc pref recomb adjt im,,,317.52,317.52,8
CPT,90680,"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",441.31,330.98,5.3,397.18,238
CPT,90680,Rv5 vacc 3 dose live oral,,,106.59,106.59,8
CPT,90681,Rv1 vacc 2 dose live oral,,,135.85,149.71,9
CPT,90682,Riv4 vacc recombinant dna im,,,69.54,69.94,44
CPT,90683,Rsv vacc mrna lipid nano im,,,313.2,313.2,8
CPT,90684,PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,574.0,430.5,6.89,516.6,238
CPT,90684,Pcv21 vaccine im,,,383.57,383.57,8
CPT,90685,Iiv4 vacc no prsv 0.25 ml im,,,20.5,20.5,8
CPT,90686,Iiv4 vacc no prsv 0.5 ml im,,,21.18,21.51,44
CPT,90687,Iiv4 vaccine splt 0.25 ml im,,,9.89,10.24,44
CPT,90688,Iiv4 vaccine splt 0.5 ml im,,,19.78,20.48,44
CPT,90689,Vacc iiv4 no prsrv 0.25ml im,,,,,0
CPT,90690,Typhoid vaccine oral,,,28.8,28.8,8
CPT,90691,Typhoid vaccine im,,,104.21,104.21,8
CPT,90694,Vacc aiiv4 no prsrv 0.5ml im,,,71.68,73.29,44
CPT,90696,Dtap-ipv vaccine 4-6 yrs im,,,65.43,65.43,8
CPT,90697,Dtap-ipv-hib-hepb vaccine im,,,162.11,162.11,8
CPT,90698,Dtap-ipv/hib vaccine im,,,123.01,123.01,8
CPT,90700,"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",113.47,85.1,1.36,102.12,119
CPT,90700,Dtap vaccine < 7 yrs im,,,30.69,30.69,8
CPT,90702,Dt vaccine under 7 yrs im,,,67.79,67.79,8
CPT,90707,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",385.75,289.31,4.63,347.18,238
CPT,90707,Mmr vaccine sc,,,99.49,99.49,8
CPT,90710,Mmrv vaccine sc,,,299.87,299.87,8
CPT,90713,Poliovirus ipv sc/im,,,45.92,45.92,8
CPT,90714,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,169.11,126.83,2.03,152.2,119
CPT,90714,Td vacc no presv 7 yrs+ im,,,27.78,38.03,44
CPT,90715,"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",192.96,144.72,2.32,173.66,238
CPT,90715,Tdap vaccine 7 yrs/> im,,,37.49,45.06,44
CPT,90716,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",756.35,567.26,9.08,680.72,119
CPT,90716,Var vaccine live subq,,,197.51,197.51,8
CPT,90717,Yellow fever vaccine subq,,,151.91,151.91,8
CPT,90723,Dtap-hep b-ipv vaccine im,,,122.65,122.65,8
CPT,90723,HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE,414.46,310.85,4.97,373.01,238
CPT,90732,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,234.16,175.62,2.81,210.74,119
CPT,90732,Ppsv23 vacc 2 yrs+ subq/im,,,133.47,156.14,44
CPT,90733,Mpsv4 vaccine subq,,,,,0
CPT,90734,"MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)",688.89,516.67,8.27,620.0,119
CPT,90734,Menacwyd/menacwycrm vacc im,,,169.8,169.8,8
CPT,90736,Hzv vaccine live subq,,,,,0
CPT,90738,Inactivated je vacc im,,,310.61,310.61,8
CPT,90739,HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE,598.08,448.56,7.18,538.27,238
CPT,90739,Hepb vacc 2/4 dose adult im,,,152.07,196.88,44
CPT,90740,Hepb vacc 3 dose immunsup im,,,146.32,185.01,44
CPT,90743,Hepb vacc 2 dose adolesc im,,,73.84,87.91,44
CPT,90744,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,118.28,88.71,1.42,106.45,238
CPT,90744,Hepb vacc 3 dose ped/adol im,,,29.89,35.99,44
CPT,90746,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,296.68,222.51,3.56,267.01,238
CPT,90746,Hepb vaccine 3 dose adult im,,,70.37,82.33,44
CPT,90747,Hepb vacc 4 dose immunsup im,,,140.75,164.65,44
CPT,90748,Hib-hepb vaccine im,,,,,0
CPT,90749,Unlisted vaccine/toxoid,,,,,0
CPT,90750,Hzv vacc recombinant im,,,213.72,213.72,8
CPT,90750,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",830.0,622.5,9.96,747.0,119
CPT,90750,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,830.0,622.5,9.96,747.0,119
CPT,90756,Cciiv4 vacc abx free im,,,30.58,30.67,44
CPT,90758,Zaire ebolavirus vac live im,,,,,0
CPT,90759,Hep b vac 3ag 10mcg 3 dos im,,,73.81,86.35,44
CPT,90785,Psytx complex interactive,,,13.04,39.36,44
CPT,90791,PBB PSYCHIATRIC DIAGNOSTIC EVALUATION,354.47,265.85,4.25,319.02,119
CPT,90791,Psych diagnostic evaluation,,,149.06,461.61,63
CPT,90792,Psych diag eval w/med srvcs,,,154.03,518.73,63
CPT,90832,HC PSYTX PT&/FAMILY 30 MINUTES,158.59,118.94,1.9,142.73,119
CPT,90832,PBB PSYCHOTHERAPY W/PATIENT 30 MINUTES,158.59,118.94,1.9,142.73,119
CPT,90832,Psytx w pt 30 minutes,,,65.68,218.54,63
CPT,90833,Psytx w pt w e/m 30 min,,,61.06,201.06,44
CPT,90834,"HC PSYTX, 45 MIN WITH PATIENT",394.31,295.73,4.73,354.88,119
CPT,90834,PBB PSYCHOTHERAPY W/PATIENT 45 MINUTES,224.17,168.13,2.69,201.75,119
CPT,90834,Psytx w pt 45 minutes,,,87.08,288.38,63
CPT,90836,Psytx w pt w e/m 45 min,,,77.4,255.54,44
CPT,90837,PBB PSYCHOTHERAPY W/PATIENT 60 MINUTES,396.57,297.43,4.76,356.91,119
CPT,90837,Psytx w pt 60 minutes,,,128.0,427.19,63
CPT,90838,Psytx w pt w e/m 60 min,,,102.69,339.39,44
CPT,90839,Psytx crisis initial 60 min,,,123.43,410.71,63
CPT,90840,Psytx crisis ea addl 30 min,,,61.65,201.06,44
CPT,90845,Psychoanalysis,,,82.65,274.73,63
CPT,90846,Family psytx w/o pt 50 min,,,94.05,275.04,63
CPT,90846,HC FAMILY PSYTX W/O PT 50 MIN,208.45,156.34,2.5,187.6,119
CPT,90847,Family psytx w/pt 50 min,,,98.07,286.74,63
CPT,90849,Multiple family group psytx,,,28.11,179.72,63
CPT,90853,Group psychotherapy,,,23.09,102.96,63
CPT,90853,HC GROUP THERAPY,138.68,104.01,1.66,124.81,119
CPT,90863,Pharmacologic mgmt w/psytx,,,55.83,66.61,8
CPT,90865,Narcosynthesis,,,120.78,425.75,63
CPT,90867,Tcranial magn stim tx plan,,,218.63,588.88,27
CPT,90868,Tcranial magn stim tx deli,,,218.63,346.59,27
CPT,90869,Tcran magn stim redetemine,,,218.63,546.74,27
CPT,90870,Electroconvulsive therapy,,,103.65,869.49,63
CPT,90875,Psychophysiological therapy,,,130.68,155.93,8
CPT,90876,Psychophysiological therapy,,,231.03,275.66,8
CPT,90880,Hypnotherapy,,,86.33,274.06,62
CPT,90885,Psy evaluation of records,,,104.6,124.8,8
CPT,90887,Interpj/explnaj rslt psyc xm,,,190.47,227.26,8
CPT,90899,Unlisted psyc svc/therapy,,,28.56,37.93,19
CPT,90901,Biofeedback train any meth,,,16.19,106.11,63
CPT,90901,HC PT BIOFEEDBACK TRAINING,411.27,308.45,4.94,370.14,119
CPT,90901,HC ST BIOFEEDBACK TRAINING,265.65,199.24,3.19,239.08,119
CPT,90912,Bfb training 1st 15 min,,,36.9,209.31,63
CPT,90912,HC PT BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,370.27,277.7,4.44,333.24,119
CPT,90913,Bfb training ea addl 15 min,,,20.74,85.41,63
CPT,90913,HC PT BFB TRAING W/EMG&/MANOMETRY EACH ADDL 15 MIN CNTCT,370.27,277.7,4.44,333.24,119
CPT,90935,HC HEMODIALYSIS INP,2931.63,2198.72,35.18,2638.47,119
CPT,90935,HC HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,2931.63,2198.72,35.18,2638.47,119
CPT,90935,HC NON-ROUTINE/NON-ESRD DIALYSIS OP,2931.63,2198.72,35.18,2638.47,119
CPT,90935,Hemodialysis one evaluation,,,69.72,778.79,63
CPT,90937,Hemodialysis repeated eval,,,98.49,271.02,45
CPT,90945,Dialysis one evaluation,,,82.78,473.94,63
CPT,90945,HC CAPD-CONT AMBULATORY PERITONEAL DIALYSIS,920.54,690.4,11.05,828.49,119
CPT,90945,HC CCPD-CONTINUOUS CYCLING PERITONEAL DIALYSIS,1292.68,969.51,15.51,1163.41,119
CPT,90945,HC CCPD-CONTINUOUS CYCLING PERITONEAL DIALYSIS OP/HOME,1292.68,969.51,15.51,1163.41,119
CPT,90945,HC PERITONEAL DIALYSIS CAPD OP/HOME,1001.54,751.16,12.02,901.39,119
CPT,90945,HC PERITONEAL DIALYSIS NON-CAPD,1346.81,1010.11,16.16,1212.13,119
CPT,90947,Dialysis repeated eval,,,119.23,323.61,44
CPT,90947,HC CONTINUOUS RENAL REPLACMT THERAPY,3530.26,2647.7,42.36,3177.23,119
CPT,90951,Esrd serv 4 visits p mo <2yr,,,1132.11,3083.81,45
CPT,90954,Esrd serv 4 vsts p mo 2-11,,,971.27,2658.44,45
CPT,90955,Esrd srv 2-3 vsts p mo 2-11,,,504.02,1385.9,45
CPT,90956,Esrd srv 1 visit p mo 2-11,,,335.59,925.3,45
CPT,90957,Esrd srv 4 vsts p mo 12-19,,,742.49,2036.23,45
CPT,90958,Esrd srv 2-3 vsts p mo 12-19,,,482.84,1325.39,45
CPT,90959,Esrd serv 1 vst p mo 12-19,,,314.4,863.95,45
CPT,90960,Esrd srv 4 visits p mo 20+,,,341.16,941.37,45
CPT,90961,Esrd srv 2-3 vsts p mo 20+,,,283.1,780.92,45
CPT,90962,Esrd serv 1 visit p mo 20+,,,194.9,538.06,45
CPT,90963,Esrd home pt serv p mo <2yrs,,,585.92,1603.02,45
CPT,90964,Esrd home pt serv p mo 2-11,,,502.01,1373.57,45
CPT,90965,Esrd home pt serv p mo 12-19,,,481.75,1322.41,45
CPT,90966,Esrd home pt serv p mo 20+,,,283.1,780.92,45
CPT,90967,Esrd svc pr day pt <2,,,16.93,46.29,45
CPT,90968,Esrd svc pr day pt 2-11,,,16.6,45.39,45
CPT,90969,Esrd svc pr day pt 12-19,,,16.26,44.46,45
CPT,90970,Esrd svc pr day pt 20+,,,9.1,25.73,45
CPT,90989,HC OP DIALYSIS TRAINING COMPLETE,5289.61,3967.21,63.48,4760.65,119
CPT,90993,HC HOME DIALYSIS TRAINING CAPD PER TRAINING SESSION,353.48,265.11,4.24,318.13,119
CPT,90993,HC HOME DIALYSIS TRAINING CCPD PER TRAINING SESSION,339.29,254.47,4.07,305.36,119
CPT,90993,HC HOME DIALYSIS TRAINING HD PER TRAINING SESSION,339.29,254.47,4.07,305.36,238
CPT,90993,HC OP DIALYSIS TRAINING RE-EVALUATION,326.39,244.79,3.92,293.75,119
CPT,90997,Hemoperfusion,,,85.66,233.7,44
CPT,90999,HC HEMO-DIALYSIS TREATMENT,1860.36,1395.27,22.32,1674.32,119
CPT,90999,HC OP/HOME HEMO-DIALYSIS TREATMENT,1582.14,1186.6,18.99,1423.93,119
CPT,90999,Unlisted dialysis procedure,,,235.0,235.0,1
CPT,91010,Esophagus motility study,,,62.39,590.56,99
CPT,91010,HC ESOPHAGEAL MOTILITY,2711.37,2033.53,32.54,2440.23,119
CPT,91013,Esophgl motil w/stim/perfus,,,8.9,64.77,80
CPT,91020,Gastric motility studies,,,70.05,694.1,99
CPT,91022,Duodenal motility study,,,70.05,590.56,99
CPT,91022,HC DUODENAL MANOMETRY,3118.07,2338.55,37.42,2806.26,119
CPT,91030,Acid perfusion of esophagus,,,44.56,590.56,99
CPT,91034,Gastroesophageal reflux test,,,48.12,590.56,99
CPT,91034,HC PH MONITORING GERD,1507.62,1130.71,18.09,1356.86,119
CPT,91035,G-esoph reflx tst w/electrod,,,78.74,1123.01,99
CPT,91035,HC BRAVO REFLUX W MUCOSAL PH,2516.69,1887.52,30.2,2265.02,119
CPT,91037,Esoph imped function test,,,47.22,426.27,99
CPT,91038,Esoph imped funct test > 1hr,,,53.51,990.98,99
CPT,91038,HC ESOPHAGEAL IMPED FUNCT TEST>1H,2231.03,1673.27,26.77,2007.93,119
CPT,91040,Esoph balloon distension tst,,,47.79,1262.78,99
CPT,91065,Breath hydrogen/methane test,,,9.58,218.63,99
CPT,91110,Gi trc img intral esoph-ile,,,108.71,1787.71,99
CPT,91110,HC CAPSULE ENDOSCOPY ESOPH THROUGH ILEUM,4559.73,3419.8,54.72,4103.76,119
CPT,91111,Gi trc img intral esophagus,,,43.91,2115.84,99
CPT,91112,Gi wireless capsule measure,,,102.38,3892.97,99
CPT,91112,HC GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,129.05,96.79,1.55,116.15,119
CPT,91113,Gi trc img intral colon i&r,,,117.28,2183.63,99
CPT,91113,HC CAPSULE GI TRACT IMAGING INTRALUMINAL COLON I&R,126.55,94.91,1.52,113.9,119
CPT,91117,Colon motility 6 hr study,,,131.29,357.16,63
CPT,91117,HC COLONIC MANOMETRY,1801.45,1351.09,21.62,1621.3,119
CPT,91120,Rectal sensation test,,,46.59,1222.01,90
CPT,91122,Anorectal manometry,,,85.19,704.6,90
CPT,91122,HCD ANORECTAL MANOMETRY,1801.45,1351.09,21.62,1621.3,119
CPT,91124,Rct snsatn tone&cmplianc std,,,218.63,218.63,9
CPT,91125,Anrct mano rct snsatn&balo,,,377.83,377.83,9
CPT,91132,Electrogastrography,,,25.42,1065.58,99
CPT,91133,Electrogastrography w/test,,,32.05,1119.07,99
CPT,91200,HC US SHEER WAVE ELAST LIVER,534.8,401.1,6.42,481.32,119
CPT,91200,Liver elastography,,,10.23,174.14,99
CPT,91299,Unlisted dx gi procedure,,,130.29,174.14,19
CPT,91304,Sarscov2 vac 5mcg/0.5ml im,,,188.97,188.97,8
CPT,91308,N/A,,,0.03,0.03,8
CPT,91309,N/A,,,0.03,0.03,8
CPT,91311,N/A,,,0.03,0.03,8
CPT,91312,N/A,,,0.03,0.03,8
CPT,91313,N/A,,,0.03,0.03,8
CPT,91314,N/A,,,0.03,0.03,8
CPT,91315,N/A,,,0.03,0.03,8
CPT,91318,Sarscov2 vac 3mcg trs-suc im,,,76.68,76.68,8
CPT,91319,Sarscv2 vac 10mcg trs-suc im,,,102.69,102.69,8
CPT,91320,COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE,292.49,219.37,3.51,263.24,119
CPT,91320,Sarscv2 vac 30mcg trs-suc im,,,182.37,182.37,8
CPT,91321,Sarscov2 vac 25 mcg/.25ml im,,,172.03,172.03,8
CPT,91322,Sarscov2 vac 50 mcg/0.5ml im,,,189.1,189.1,8
CPT,91323,Sarscov2 vac 10 mcg/0.2ml im,,,,,0
CPT,92002,Intrm oph exam new patient,,,44.53,218.54,63
CPT,92004,Compre oph exam new pt 1/>,,,91.4,386.44,63
CPT,92012,Intrm oph exam est patient,,,48.98,229.79,63
CPT,92014,Compre oph exam est pt 1/>,,,73.77,326.26,63
CPT,92015,Determine refractive state,,,42.5,50.7,8
CPT,92018,Compl oph exam general anes,,,134.09,2596.59,63
CPT,92019,Lmtd oph exam general anes,,,69.41,2596.59,63
CPT,92020,Gonioscopy,,,19.73,143.47,63
CPT,92025,Cptrized corneal topography,,,15.98,94.69,99
CPT,92060,Sensorimotor examination,,,25.08,166.43,99
CPT,92065,Orthop traing pfrmd phys/qhp,,,7.82,105.39,80
CPT,92066,Orthop traing supvj phys/qhp,,,24.14,67.94,62
CPT,92071,Contact lens fitting for tx,,,46.95,95.42,44
CPT,92072,Fitg c-lens keratoconus 1st,,,92.13,326.22,44
CPT,92081,Limited visual field xm,,,15.48,86.75,99
CPT,92082,Intermediate visual field xm,,,20.12,121.34,99
CPT,92083,Extended visual field xm,,,26.02,163.55,99
CPT,92100,Serial tonometry,,,31.3,219.44,44
CPT,92132,Cptrzd oph dx img ant sgm,,,14.41,77.35,99
CPT,92133,Cptrzd oph dx img pst sgm on,,,14.41,80.0,99
CPT,92134,Cptrz oph dx img pst sgm rta,,,14.73,84.34,99
CPT,92136,Ophthalmic biometry,,,15.98,143.47,135
CPT,92137,Cptrz oph img pst sg rta oct,,,128.53,346.59,27
CPT,92145,Corneal hysteresis deter,,,5.25,66.11,98
CPT,92201,HC ROP EYE EXAM,234.31,175.73,2.81,210.88,238
CPT,92201,Opscpy extnd rta draw uni/bi,,,21.67,66.11,63
CPT,92202,Opscpy extnd on/mac draw,,,14.12,66.11,63
CPT,92227,Img rta detcj/mntr ds staff,,,15.67,66.11,63
CPT,92228,HC REMOTE IMG MGMT OF RETINAL DS,147.67,110.75,1.77,132.9,119
CPT,92228,Img rta detc/mntr ds phy/qhp,,,11.9,77.52,99
CPT,92229,Img rta detc/mntr ds poc aly,,,42.34,114.64,63
CPT,92230,Fluorescein angioscopy i&r,,,33.43,590.56,63
CPT,92235,Fluorescein angrph mltiframe,,,40.77,405.42,99
CPT,92240,Icg angiography i&r uni/bi,,,45.46,606.13,99
CPT,92242,Fluorescein&icg angiography,,,52.51,831.25,99
CPT,92250,Fundus photography w/i&r,,,15.36,143.47,99
CPT,92250,HC FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,1587.83,1190.87,19.05,1429.05,119
CPT,92260,Ophthalmodynamometry,,,10.21,49.61,63
CPT,92265,Ndl oculoelectromyography 1+,,,38.89,226.58,99
CPT,92270,Electro-oculography w/i&r,,,40.61,310.66,99
CPT,92273,Full field erg w/i&r,,,35.29,346.59,99
CPT,92274,Multifocal erg w/i&r,,,31.95,231.32,99
CPT,92283,Extnd color vision xm,,,8.56,139.46,99
CPT,92284,Dx dark adaptation exam i&r,,,43.28,452.32,63
CPT,92285,External ocular photography,,,2.93,58.89,99
CPT,92286,Ant sgm img i&r speclr mic,,,16.61,143.47,99
CPT,92287,Ant sgm img ir flrscn angrph,,,34.56,337.88,99
CPT,92310,Contact lens fitting ou,,,55.09,258.49,9
CPT,92311,Contact lens fitg aphakia 1,,,50.7,452.32,63
CPT,92312,Contact lens fitg aphakia ou,,,58.68,319.36,63
CPT,92313,C-lens fitg corneosclrl lens,,,42.14,253.6,63
CPT,92314,C-lens fitg tech ou,,,32.59,222.44,9
CPT,92315,C-lens fitg tech aphakia 1,,,20.56,209.11,63
CPT,92316,C-lens fitg tech aphakia ou,,,30.87,258.92,63
CPT,92317,C-lens fitg tech corneosclrl,,,20.56,220.14,63
CPT,92325,Modification of contact lens,,,42.34,143.47,63
CPT,92326,Replacement of contact lens,,,36.38,97.67,63
CPT,92340,Fit spectacles monofocal,,,75.92,90.58,8
CPT,92341,Fit spectacles bifocal,,,87.09,103.92,8
CPT,92342,Fit spectacles multifocal,,,93.82,111.94,8
CPT,92352,Fit aphakia spectcl monofocl,,,56.94,110.95,26
CPT,92353,Fit aphakia spectcl multifoc,,,56.94,127.87,26
CPT,92354,Fitg spect low vis 1system,,,29.88,43.69,26
CPT,92355,Fitg spect lw vis cmpnd lens,,,37.63,55.21,26
CPT,92358,Aphakia prosth service temp,,,24.9,66.11,26
CPT,92370,Rpr&refitg spect xcp aphakia,,,66.39,79.21,8
CPT,92371,Rpr&refit spct prsth aphakia,,,25.61,66.11,26
CPT,92499,Unlisted oph svc/procedure,,,23.47,29.28,19
CPT,92502,Ear and throat examination,,,91.76,566.8,63
CPT,92504,Ear microscopy examination,,,9.22,74.12,44
CPT,92507,HC ST TRTMT SPEECH LANG VOICE INDIV,534.38,400.78,6.41,480.94,119
CPT,92507,Tx sp lang voice comm indiv,,,72.83,204.94,63
CPT,92508,HC ST TRTMT SPEECH/LANG/VOICE GRP,196.56,147.42,2.36,176.9,119
CPT,92508,Tx sp lang voice comm group,,,22.75,64.02,63
CPT,92511,HC NASOPHARYNGOSCOPY W/ENDO,1124.76,843.57,13.5,1012.28,119
CPT,92511,Nasopharyngoscopy,,,36.59,297.55,63
CPT,92512,Nasal function studies,,,26.71,346.59,63
CPT,92516,Facial nerve function test,,,22.33,346.59,63
CPT,92517,HC VEMP W/ INT & RPT CERVICAL,463.37,347.53,5.56,417.03,119
CPT,92517,Vemp test i&r cervical,,,41.15,197.65,62
CPT,92518,Vemp test i&r ocular,,,41.46,198.5,62
CPT,92519,Vemp tst i&r cervical&ocular,,,62.23,346.59,62
CPT,92520,HC ST LARYNGEAL FUNCTION STUDIES,362.69,272.02,4.35,326.42,119
CPT,92520,Laryngeal function studies,,,38.83,234.72,63
CPT,92521,Evaluation of speech fluency,,,126.77,356.73,63
CPT,92521,HC ST EVAL SPEECH FLUENCY,705.48,529.11,8.47,634.93,119
CPT,92522,Evaluate speech production,,,105.56,297.05,63
CPT,92522,HC ST EVAL SPEECH SOUND PRODUCTION,495.78,371.84,5.95,446.2,119
CPT,92523,HC ST EVAL ST SOUND PROD W/LANG COMP,864.06,648.04,10.37,777.65,119
CPT,92523,Speech sound lang comprehen,,,216.85,610.22,63
CPT,92524,Behavral qualit analys voice,,,103.75,291.95,63
CPT,92524,HC ST EVAL ST BEHAVIORAL ANALYS VOICE/RESN,757.83,568.37,9.09,682.05,119
CPT,92526,"HC OT SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",529.33,397.0,6.35,476.4,119
CPT,92526,"HC PT SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",487.45,365.59,5.85,438.7,119
CPT,92526,"HC ST SWALLOW TREATMENT, INC VITAL STIM WHEN PERFORMED",532.78,399.58,6.39,479.5,119
CPT,92526,Oral function therapy,,,80.16,225.57,63
CPT,92537,Caloric vstblr test w/rec,,,9.08,174.14,99
CPT,92537,HC CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,650.06,487.54,7.8,585.05,119
CPT,92538,Caloric vstblr test w/rec,,,6.26,218.63,99
CPT,92540,Basic vestibular evaluation,,,29.79,275.8,99
CPT,92540,HC BASIC VESTIBULAR EVALUATION,791.04,593.28,9.49,711.94,238
CPT,92541,Spontaneous nystagmus test,,,4.06,143.47,99
CPT,92542,HC POSITIONAL NYSTAGMUS TEST,216.49,162.37,2.6,194.84,119
CPT,92542,Positional nystagmus test,,,4.06,143.47,99
CPT,92544,Optokinetic nystagmus test,,,3.43,174.14,99
CPT,92545,Oscillating tracking test,,,3.43,346.59,99
CPT,92546,Sinusoidal rotational test,,,14.51,338.08,99
CPT,92547,Supplemental electrical test,,,10.04,26.33,44
CPT,92548,Cdp-sot 6 cond w/i&r,,,13.16,143.47,98
CPT,92549,Cdp-sot 6 cond w/i&r mct&adt,,,19.12,170.05,98
CPT,92550,HC TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,117.56,88.17,1.41,105.8,119
CPT,92550,Tympanometry & reflex thresh,,,21.57,218.63,63
CPT,92551,HC SCREENING PURE TONE AIR ONLY,130.62,97.96,1.57,117.56,119
CPT,92551,Pure tone hearing test air,,,11.8,32.28,9
CPT,92552,HC ST PURE TONE AUDIOMETRY AIR ONLY,154.75,116.06,1.86,139.28,119
CPT,92552,Pure tone audiometry air,,,33.24,143.47,63
CPT,92553,Audiometry air & bone,,,40.77,174.14,63
CPT,92553,HC ST PURE TONE AUDIO AIR/BONE,305.05,228.79,3.66,274.54,119
CPT,92555,HC ST SPEECH AUDIOMETRY THRESHOLD,170.18,127.64,2.04,153.16,119
CPT,92555,Speech threshold audiometry,,,25.71,77.27,63
CPT,92556,HC SPEECH AUDIOMTRY THRESHLD W/RECE,238.12,178.59,2.86,214.31,119
CPT,92556,Speech audiometry complete,,,39.83,119.73,63
CPT,92557,Comprehensive hearing test,,,30.96,174.14,63
CPT,92557,HC ST COMPREHENSIVE AUDIOMETRY,480.82,360.62,5.77,432.74,119
CPT,92558,Evoked auditory test qual,,,20.8,28.01,9
CPT,92558,HC EVOKED AUDITORY TST COMPLETE,215.09,161.32,2.58,193.58,119
CPT,92558,HC EVOKED AUDITORY TST COMPLETE COM CONN,215.09,161.32,2.58,193.58,119
CPT,92562,Loudness balance test,,,44.85,346.59,63
CPT,92563,Tone decay hearing test,,,31.05,90.87,63
CPT,92565,Stenger test pure tone,,,18.81,66.11,63
CPT,92567,HC ST TYPANOMETRY,106.76,80.07,1.28,96.08,119
CPT,92567,Tympanometry,,,10.52,43.69,63
CPT,92568,Acoustic refl threshold tst,,,14.81,43.69,63
CPT,92568,HC ST ACOUSTIC REFLEX TESTING,105.46,79.1,1.27,94.91,119
CPT,92570,Acoustic immitance testing,,,28.32,174.14,63
CPT,92571,Filtered speech test,,,28.22,80.68,63
CPT,92572,Staggered spondaic word test,,,44.22,174.14,63
CPT,92575,Sensorineural acuity lvl tst,,,37.63,188.54,63
CPT,92576,Synthetic sentence id test,,,37.32,115.49,63
CPT,92577,Stenger test speech,,,19.12,590.56,63
CPT,92579,Visual audiometry (vra),,,36.23,218.63,63
CPT,92582,Conditioning play audiometry,,,76.86,227.6,63
CPT,92582,HC ST CONDITIONING PLAY AUDIOMETRY,417.64,313.23,5.01,375.88,119
CPT,92583,Select picture audiometry,,,50.81,151.17,63
CPT,92584,Electrocochleography,,,108.49,281.23,63
CPT,92587,Evoked auditory test limited,,,3.74,346.59,99
CPT,92587,HC ST EVOKED OTOACOUSTIC EMISSIONS,439.43,329.57,5.27,395.49,119
CPT,92588,Evoked auditory tst complete,,,5.0,377.83,99
CPT,92588,HC ST EVOKED OTOACOUS EMISSIONS COMP,215.09,161.32,2.58,193.58,119
CPT,92590,Hearing aid xm&slctn monaurl,,,105.73,105.73,1
CPT,92591,HC HEARING AID EXAMINATION & SELECTION BINAURAL,583.57,437.68,7.0,525.21,119
CPT,92591,Hearing aid xm&slctn binaurl,,,481.75,481.75,1
CPT,92592,HC HEARING AID CHECK MONAURAL,89.29,66.97,1.07,80.36,119
CPT,92592,Hearing aid check monaural,,,37.63,37.63,1
CPT,92593,HC HEARING AID CHECK BINAURAL,185.76,139.32,2.23,167.18,119
CPT,92593,Hearing aid check binaural,,,37.63,37.63,1
CPT,92594,Electro hearng aid test one,,,37.63,37.63,1
CPT,92595,Electro hearng aid tst both,,,37.63,37.63,1
CPT,92596,Ear protector evaluation,,,37.63,203.82,63
CPT,92597,HC ST EVAL VOICE PROSTHETIC DEVICE,795.05,596.29,9.54,715.54,119
CPT,92597,Oral speech device eval,,,69.12,194.5,63
CPT,92601,Cochlear implt f/up exam <7,,,119.55,413.99,63
CPT,92602,Reprogram cochlear implt <7,,,67.82,259.31,63
CPT,92603,Cochlear implt f/up exam 7/>,,,116.29,389.94,63
CPT,92604,Reprogram cochlear implt 7/>,,,64.87,234.35,63
CPT,92605,Ex for nonspeech device rx,,,82.78,241.64,9
CPT,92605,HC ST EVAL AUGMNT COM/NON-SPEECH 1ST,386.11,289.58,4.63,347.5,119
CPT,92606,HC ST TRTMNT/MOD ALT COMM/NON-SPEECH,142.95,107.21,1.72,128.66,119
CPT,92606,Non-speech device service,,,65.85,207.25,9
CPT,92607,Ex for speech device rx 1hr,,,116.88,328.9,63
CPT,92607,HC ST EVAL AUGMENT COMM/SPEECH 1ST HR,395.29,296.47,4.74,355.76,119
CPT,92608,Ex for speech device rx addl,,,45.88,129.11,63
CPT,92608,HC ST EVAL AUG SPEECH DEV EACH ADDL 30M,209.76,157.32,2.52,188.78,119
CPT,92609,HC ST TRTMNT/MOD ALT COMM/SPEECH,297.26,222.94,3.57,267.53,119
CPT,92609,Use of speech device service,,,97.41,274.11,63
CPT,92610,Evaluate swallowing function,,,56.91,227.03,63
CPT,92610,HC OT SWALLOWING EVAL FUNCTION,765.93,574.45,9.19,689.34,119
CPT,92610,HC PT EVAL ORAL/PHARYNGEAL FUNC,772.82,579.62,9.27,695.54,119
CPT,92610,HC ST SWALLOWING EVAL FUNCTION,777.57,583.18,9.33,699.81,119
CPT,92611,HC OT SWALLOW STUDY W/RADIOLOGY,864.35,648.26,10.37,777.92,119
CPT,92611,HC ST MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,864.35,648.26,10.37,777.92,119
CPT,92611,HC ST SWALLOW STUDY W/RADIOLOGY,806.69,605.02,9.68,726.02,119
CPT,92611,Motion fluoroscopy/swallow,,,85.89,241.7,63
CPT,92612,Endoscopy swallow (fees) vid,,,53.28,515.58,63
CPT,92612,HC OT FIBEROPTIC SWALLOW EVAL W/CINE VIDEO,750.43,562.82,9.01,675.39,119
CPT,92612,HC ST FIBEROPTIC SWALLOW EVAL W/CINE VIDEO,1017.49,763.12,12.21,915.74,119
CPT,92613,Endoscopy swallow (fees) i&r,,,35.12,96.88,45
CPT,92614,Laryngoscopic sensory vid,,,53.26,390.75,63
CPT,92615,Laryngoscopic sensory i&r,,,31.53,86.23,45
CPT,92616,Fees w/laryngeal sense test,,,78.61,600.82,63
CPT,92616,HC ST FLEX SWALLOW EVAL WITH SENSORY TESTING W/CINE VIDEO,527.4,395.55,6.33,474.66,119
CPT,92617,Fees w/laryngeal sense i&r,,,39.34,107.58,45
CPT,92618,Ex for nonspeech dev rx add,,,30.64,84.64,9
CPT,92618,HC COM CONN AAC EVAL EA ADDL 30MIN,209.62,157.22,2.52,188.66,119
CPT,92618,HC ST AAC EVAL EA ADDL 30MIN,209.62,157.22,2.52,188.66,119
CPT,92620,Auditory function 60 min,,,77.38,235.89,63
CPT,92620,HC EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,499.04,374.28,5.99,449.14,119
CPT,92621,Auditory function + 15 min,,,18.12,57.32,44
CPT,92622,Dx aly aud oi snd prcsr 1st,,,130.29,208.89,27
CPT,92623,Dx aly aud oi snd prcsr each,,,45.09,53.8,8
CPT,92625,Tinnitus assessment,,,59.6,177.7,63
CPT,92626,Eval aud funcj 1st hour,,,72.78,227.63,63
CPT,92626,"HC ST EVAL AUDITORY REHAB, FIRST HOUR",264.91,198.68,3.18,238.42,119
CPT,92627,Eval aud funcj ea addl 15,,,17.12,53.8,44
CPT,92627,"HC ST EVAL AUDITORY REHAB, EACH ADD 15 MINUTES",60.96,45.72,0.73,54.86,119
CPT,92630,Aud rehab pre-ling hear loss,,,289.05,289.05,1
CPT,92630,HC SLP AUD PRE-LING HEAR LOSS,270.77,203.08,3.25,243.69,119
CPT,92633,Aud rehab postling hear loss,,,144.53,144.53,1
CPT,92640,Aud brainstem implt programg,,,91.25,285.87,63
CPT,92650,Aep scr auditory potential,,,25.71,68.61,9
CPT,92650,HC AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,589.93,442.45,7.08,530.94,119
CPT,92651,Aep hearing status deter i&r,,,81.82,346.59,63
CPT,92651,HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R,589.93,442.45,7.08,530.94,119
CPT,92652,Aep thrshld est mlt freq i&r,,,109.66,346.59,63
CPT,92652,HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1415.95,1061.96,16.99,1274.36,119
CPT,92653,Aep neurodiagnostic i&r,,,81.59,346.59,63
CPT,92653,HC AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1415.96,1061.97,16.99,1274.36,119
CPT,92700,HC UNLISTED OTORHINOLARYNGOLOGICAL SERVICE/PX,169.23,126.92,2.03,152.31,119
CPT,92700,HC VIDEO HEAD IMPULSE TEST VHIT,169.23,126.92,2.03,152.31,119
CPT,92700,Unlisted orl service/px,,,23.47,29.28,19
CPT,92920,HC PERQ TRLUML C ANGIOPLASTY 1 MAJ C ART&/BRANCHES,18733.31,14049.98,224.8,16859.98,119
CPT,92920,Prq trluml c angiop 1art&/br,,,503.17,6345.82,63
CPT,92921,HCD REVASC PTCA ADDTL ART/BRNCH,7776.255,5832.1900000000005,86.8,7486.9,238
CPT,92924,PERQ TRLUML C ATHRC ANGIOP 1 MAJ C ART&/BRANCHES,29924.1,22443.08,359.09,26931.69,119
CPT,92924,Prq trluml c athrc 1 art&/br,,,601.09,12622.1,63
CPT,92925,HCD CORONARY ATHERECT EACH ADDL BRANCH-LD,2764.3,2073.22,33.17,2487.87,119
CPT,92925,HCD REVASC ATHER W/ PTCA ADDTL ART/BRNCH,2764.3,2073.22,33.17,2487.87,119
CPT,92928,HC PERQ TCAT PLMT NTRAC ST 1 LES 1+C SEGMENTS,39763.79,29822.84,477.17,35787.41,119
CPT,92928,HC REVASC DES W/ PTCA INITIAL ART/BRNCH,33530.24,25147.68,327.56,35787.41,238
CPT,92928,HCD DRUG-ELUTING STENT/PTCA MAJOR ART OR BRANCH-LM,39763.79,29822.84,477.17,35787.41,119
CPT,92928,Prq tcat plmt ntrac st 1 les,,,560.91,12622.1,63
CPT,92929,HCD DRUG-ELUTING STENT/PTCA EACH ADDL ART OR BRANCH-LD,1599.58,1199.68,19.19,1439.62,119
CPT,92929,HCD REVASC BMS W/ PTCA ADDTL ART/BRNCH,9547.58,7160.685,106.58,9192.32,357
CPT,92929,HCD REVASC DES W/ PTCA ADDTL ART/BRNCH,9547.58,7160.685,106.58,9192.32,238
CPT,92930,Prq tcat plmt ntrac st 2+les,,,18561.26,18561.26,9
CPT,92933,HC PERQ TRLUML C ATHRC ST ANGIOP 1 MAJ C ART&/BRNCH,56195.67,42146.75,674.35,50576.1,119
CPT,92933,HC REVASC DES & ATHER W/ PTCA INITIAL ART/BRNCH,43101.68,32326.26,449.76,50576.1,357
CPT,92933,HCD DRUG-ELUTING STENT/PTCA ATHERECT MAJ ART OR BRANCH-LM,56195.67,42146.75,674.35,50576.1,119
CPT,92933,Prq trlml c athrc st angiop1,,,628.6,19985.91,63
CPT,92934,HCD DRUG-ELUTING STENT/PTCA ATHER EACH ADDL ART OR BRANCH-LD,27655.37,20741.53,331.86,24889.83,119
CPT,92934,HCD REVASC BMS & ATHER W/ PTCA ADDTL ART/BRNCH,27655.37,20741.53,331.86,24889.83,238
CPT,92934,HCD REVASC DES & ATHER W/ PTCA ADDTL ART/BRNCH,27655.37,20741.53,331.86,24889.83,119
CPT,92937,HC BYPASS GRAFT REVASC BMS/PTCA/ATHER INITIAL ART/BRNCH,31140.309999999998,23355.235,369.71,28324.45,238
CPT,92937,HC PERQ TRLUML REVSC OF/-CAB GRF 1 MAJ C ART&/BRNCH,31471.61,23603.71,377.66,28324.45,119
CPT,92937,Prq trluml revsc cab grf 1,,,560.26,12622.1,63
CPT,92938,HCD BYPASS GRAFT REVASC BMS/PTCA/ATHER ADDTL ART/BRNCH,8243.61,6182.71,98.92,7419.25,238
CPT,92938,HCD BYPASS GRAFT REVASC DES W/PTCA/ATHER ADDTL ART/BRNCH,8243.61,6182.71,98.92,7419.25,119
CPT,92941,HC PERQ TRLUML REVSC TOT/STOT OCCLS AMI 1MAJ C ART,31261.24,23445.93,375.13,28135.12,119
CPT,92941,HC REVASC DURING AMI BMS/PTCA/ATHER,31261.24,23445.93,375.13,28135.12,238
CPT,92941,Prq trlml revsc tot occl ami,,,629.32,15039.8,63
CPT,92943,HC PERQ TRLUML REVSC CHRNC TOT OCCLS 1 C ART ANTGRD,37510.5,28132.88,450.13,33759.45,119
CPT,92943,HC PERQ TRLUML REVSC CHRNC TOT OCCLS BMS 1 C ART ANTGRD,39615.85,29711.89,475.39,35654.26,119
CPT,92943,HCD REVASC CTO BMS/PTCA/ATHER INITIAL ART/BRANCH,37524.65,28143.49,450.3,33772.19,119
CPT,92943,Prq trluml revsc ch occ ant,,,629.89,12622.1,63
CPT,92944,HCD REVASC CTO BMS/PTCA/ATHER ADDTL ART/BRANCH,20118.51,15088.88,241.42,18106.66,238
CPT,92944,HCD REVASC CTO DES W/ PTCA/ATHER ADDTL ART/BRANCH,20118.51,15088.88,241.42,18106.66,119
CPT,92945,Prq trl rvs ch occ ant&rtrgr,,,11688.79,11688.79,9
CPT,92950,HC CPR,1721.75,1291.31,20.66,1549.58,119
CPT,92950,Heart/lung resuscitation cpr,,,178.07,838.71,63
CPT,92953,HC TEMP TRANSCUTANEOUS PACING,589.0,441.75,7.07,530.1,119
CPT,92953,Temporary external pacing,,,0.95,728.33,63
CPT,92960,Cardioversion electric ext,,,104.76,728.33,63
CPT,92960,HC CARDIOVERSION ELECTRIC EXTERNAL,1890.17,1417.63,22.68,1701.15,119
CPT,92961,Cardioversion electric int,,,233.68,728.33,63
CPT,92961,HC INTERNAL CARDIOVERSION,1563.74,1172.8,18.76,1407.37,119
CPT,92970,Cardioassist internal,,,179.44,15039.8,63
CPT,92971,Cardioassist external,,,95.55,15039.8,63
CPT,92972,HC PERQ TRLUML CORONRY LITHOTRP,19968.58,14976.44,239.62,17971.72,119
CPT,92972,Perq trluml coronry lithotrp,,,321.88,384.06,8
CPT,92973,HC PERQ TRLUML CORONARY MCHNL ASPIR THROMBECTOMY,3983.02,2987.26,47.8,3584.72,119
CPT,92973,Prq trluml c mchn asp thrmbc,,,167.4,457.16,44
CPT,92974,Cath place cardio brachytx,,,153.33,418.1,44
CPT,92974,HC CATH CORON IV BRACHYTX,994.74,746.06,11.94,895.27,238
CPT,92975,Dissolve clot heart vessel,,,357.89,15039.8,54
CPT,92975,HCD THROMBOLYSIS CORONARY BY IC INFUSION,6229.07,4671.8,74.75,5606.16,119
CPT,92977,Dissolve clot heart vessel,,,49.33,369.17,54
CPT,92978,Endoluminl ivus oct c 1st,,,15.44,90.42,44
CPT,92978,HC INTRA-CORONARY ULTRASOUND INITIAL INCL IV OCT,2825.71,2119.285,31.94,2691.02,238
CPT,92979,Endoluminl ivus oct c ea,,,8.44,72.11,44
CPT,92979,HC INTRA-CORONARY ULTRASOUND EACH ADDL INCL IV OCT,727.53,545.65,8.73,654.78,119
CPT,92986,HC PERC VALVULOPLASTYAORTIC VALVE,17462.43,13096.82,209.55,15716.19,119
CPT,92986,Revision of aortic valve,,,1057.97,6345.82,63
CPT,92987,HC PERC VALVULOPLASTY MITRAL VALVE,32284.35,24213.26,387.41,29055.92,238
CPT,92987,Revision of mitral valve,,,1094.33,12622.1,63
CPT,92990,HC PERQ BALLOON VALVULOPLASTY - PULMONARY VALVE,41022.56,30766.92,492.27,36920.3,119
CPT,92990,Revision of pulmonary valve,,,872.95,12622.1,63
CPT,92997,HC PTA PULMONARY ARTERY SINGLE VESSEL,44229.07,33171.8,530.75,39806.16,119
CPT,92997,Pul art balloon repr percut,,,608.51,12622.1,63
CPT,92998,HC PTA PULMONARY ARTERY ADDITIONAL ARTERY,5301.03,3975.77,63.61,4770.93,119
CPT,92998,Pul art balloon repr percut,,,303.3,828.52,44
CPT,93000,Electrocardiogram complete,,,13.73,37.54,45
CPT,93000,HC EKG W/READ,59.57,44.68,0.71,53.61,119
CPT,93005,Electrocardiogram tracing,,,5.94,66.11,63
CPT,93005,HC EKG 12 LEAD;TRACING ONLY W/O INTERP,242.99,182.24,2.92,218.69,119
CPT,93010,Electrocardiogram report,,,7.94,21.41,44
CPT,93015,Cv stress test supvj i&r,,,67.7,190.53,44
CPT,93016,Cv stress test supvj only,,,20.56,55.41,44
CPT,93017,Cv stress test tracing only,,,33.53,346.59,63
CPT,93017,HC CARDIOVASCULAR STRESS TEST,560.01,420.01,6.72,504.01,119
CPT,93018,Cv stress test i&r only,,,13.6,37.49,44
CPT,93024,Ergonovine provocation test,,,52.01,452.32,99
CPT,93025,Microvolt t-wave assess,,,35.73,329.83,99
CPT,93040,Rhythm ecg with report,,,12.26,34.87,44
CPT,93041,Rhythm ecg tracing,,,5.63,66.11,63
CPT,93042,Rhythm ecg report,,,6.63,17.89,44
CPT,93050,Art pressure waveform analys,,,7.2,42.63,99
CPT,93145,Interrog crtd sins bat ip wo,,,130.29,130.29,9
CPT,93146,Interrog crtd sins bat ip w/,,,130.29,130.29,9
CPT,93150,Therapy activation ipnss,,,88.0,262.49,27
CPT,93151,Interrog&prgrmg ipnss,,,88.0,229.91,27
CPT,93152,Interrog&prgrmg ipnss polysm,,,287.51,369.45,27
CPT,93153,Interrog w/o prgrmg ipnss,,,88.0,136.78,27
CPT,93224,Xtrnl ecg rec up to 48 hrs,,,67.95,181.56,45
CPT,93225,HC HOLTER MONITOR HOOKUP/RECORDING =<48 HRS,515.77,386.83,6.19,464.19,119
CPT,93225,Xtrnl ecg rec<48 hrs rec,,,17.24,143.47,63
CPT,93226,HC HOLTER MONITOR ANALYSIS W/REPORT =<48 HRS,556.46,417.34,6.68,500.81,119
CPT,93226,Xtrnl ecg rec<48 hr scan a/r,,,33.87,87.45,63
CPT,93227,Xtrnl ecg rec<48 hr r&i,,,17.64,48.24,45
CPT,93228,Remote 30 day ecg rev/report,,,24.05,66.61,45
CPT,93229,HC REMOTE 30 DAY TELE MONITOR,2166.0,1624.5,25.99,1949.4,119
CPT,93229,Remote 30 day ecg tech supp,,,298.52,1954.94,63
CPT,93241,Xtrnl ecg rec>48hr<7d,,,248.76,684.99,44
CPT,93242,Ext ecg>48hr<7d recording,,,11.28,43.69,63
CPT,93242,HC HOLTER EPATCH 48HR TO 7 DAY HOOKUP,515.77,386.83,6.19,464.19,119
CPT,93243,Ext ecg>48hr<7d scan a/r,,,123.57,594.46,63
CPT,93243,HC HOLTER MONITOR ANALYSIS W/ REP 48HR TO 7 DAYS,600.98,450.74,7.21,540.88,238
CPT,93244,Ext ecg>48hr<7d rev&interpj,,,22.86,60.78,44
CPT,93245,Ext ecg>7d<15d rec scan a/r,,,262.06,713.32,44
CPT,93246,Ext ecg>7d<15d recording,,,11.28,43.69,63
CPT,93246,HC HOLTER EPATCH 8 TO 15 DAYS OR MORE HOOKUP,193.11,144.83,2.32,173.8,119
CPT,93247,Ext ecg>7d<15d scan a/r,,,123.57,616.55,63
CPT,93248,Ext ecg>7d<15d rev&interpj,,,25.19,67.03,44
CPT,93260,HC PROGRAM DEVICE EVAL SUBQ DEFIB SYS,329.85,247.39,3.96,296.86,119
CPT,93260,Prgrmg dev eval impltbl sys,,,32.93,197.1,99
CPT,93261,HC INTEROGATE SUBQ DEVICE PRE/POST PROCEDURE,112.14,84.1,1.35,100.93,119
CPT,93261,Interrogate subq defib,,,32.61,181.14,99
CPT,93264,Rem mntr wrls p-art prs snr,,,34.25,135.89,63
CPT,93268,Ecg record/review,,,164.21,432.03,45
CPT,93270,HC EVENT MONITOR HOOKUP,171.79,128.84,2.06,154.61,119
CPT,93270,Remote 30 day ecg rev/report,,,7.82,41.5,63
CPT,93271,Ecg/monitoring and analysis,,,88.0,348.18,63
CPT,93271,HC EVENT MONITOR,176.83,132.62,2.12,159.15,119
CPT,93272,Ecg/review interpret only,,,23.2,63.45,45
CPT,93278,Ecg/signal-averaged,,,11.9,82.19,98
CPT,93278,HC SIGNAL AVERAGE EKG,221.86,166.4,2.66,199.67,119
CPT,93279,HC PM DEVICE PROG EVAL SNGL,127.7,95.78,1.53,114.93,119
CPT,93279,Prgrmg dev eval pm/ldls pm,,,30.46,172.95,99
CPT,93280,HC PM DEVICE PROGR EVAL DUAL,119.74,89.8,1.44,107.77,119
CPT,93280,Pm device progr eval dual,,,35.75,201.71,99
CPT,93281,HC PM DEVICE PROGR EVAL MULTI,119.74,89.8,1.44,107.77,119
CPT,93281,Pm device progr eval multi,,,35.75,214.94,99
CPT,93282,HC SINGLE CHAMBER TRANSVENOUS  DEFIB ANAL,119.74,89.8,1.44,107.77,119
CPT,93282,Prgrmg eval implantable dfb,,,35.75,204.75,99
CPT,93283,HC DUAL TRANSVENOUS DEFIB ANALYSIS NO REPROGM,107.76,80.82,1.29,96.98,119
CPT,93283,Prgrmg eval implantable dfb,,,35.75,252.44,99
CPT,93284,HC ICD DEVICE PROGR EVAL MULT LEAD TRANSVENOUS,123.25,92.44,1.48,110.92,119
CPT,93284,Prgrmg eval implantable dfb,,,35.75,272.56,99
CPT,93285,HC ILR PROGRAMMING DEVICE EVAL,273.47,205.1,3.28,246.12,119
CPT,93285,Prgrmg dev eval scrms ip,,,24.8,152.63,99
CPT,93286,HC PERI-PROC EVAL & PROGRAM PCMKR SYS/LDLSS PCMKR SYS IN PERSON,474.68,356.01,5.7,427.21,119
CPT,93286,Peri-px eval pm/ldls pm ip,,,14.22,114.79,80
CPT,93287,HC PERI-PROC EVAL & PROGRAM ICD SYS IN PERSON,571.2,428.4,6.85,514.08,119
CPT,93287,Peri-px device eval & prgr,,,21.5,133.53,80
CPT,93288,HC PM INTERR IN PERSON,102.84,77.13,1.23,92.56,119
CPT,93288,Interrog evl pm/ldls pm ip,,,19.89,143.6,99
CPT,93289,HC DEFIB TRANSVENOUS ANALYSIS W/RPGM,104.12,78.09,1.25,93.71,119
CPT,93289,Interrog device eval heart,,,34.5,184.6,99
CPT,93290,Interrog dev eval icpms ip,,,20.49,135.1,99
CPT,93291,HC ILR DEVICE INTERROGATE IN PERSON,114.58,85.94,1.37,103.12,119
CPT,93291,Interrog dev eval scrms ip,,,17.54,124.55,99
CPT,93292,Wcd device interrogate,,,20.18,130.85,99
CPT,93293,Pm phone r-strip device eval,,,13.94,107.18,99
CPT,93294,Rem interrog evl pm/ldls pm,,,28.35,77.52,45
CPT,93295,Dev interrog remote 1/2/mlt,,,35.19,95.37,45
CPT,93296,HC PM/ICD REMOTE TECH SERVICE,318.56,238.92,3.82,286.7,119
CPT,93296,Rem interrog evl pm/ids,,,21.0,50.96,63
CPT,93297,Rem interrog dev eval icpms,,,25.07,156.04,63
CPT,93298,Rem interrog dev eval scrms,,,25.38,259.62,63
CPT,93303,Echo transthoracic,,,59.66,610.26,99
CPT,93303,HC TTE CONGENITAL COMPLETE,2292.85,1719.64,27.51,2063.56,119
CPT,93303,HC TTE CONGENITAL COMPLETE W/CONTRAST,2292.98,1719.74,27.52,2063.68,119
CPT,93304,Echo transthoracic,,,35.06,610.26,99
CPT,93304,HC TTE CONGENITAL LIMITED W/ CONTRAST,1461.01,1095.76,17.53,1314.91,119
CPT,93304,HC TTE CONGENITAL LIMITED W/O CONTRAST,1461.01,1095.76,17.53,1314.91,119
CPT,93306,HC TTE COMP W/DPLR & COLOR W/CONTRAST,2293.73,1720.3,27.52,2064.36,119
CPT,93306,HC TTE COMP W/DPLR & COLOR W/O CONTRAST,2201.14,1650.86,26.41,1981.03,119
CPT,93306,Tte w/doppler complete,,,66.65,1036.0,120
CPT,93307,HC TTE COMP W/O DOPPLER OR COLOR FLOW,1167.25,875.44,14.01,1050.53,119
CPT,93307,HC TTE COMP W/O DOPPLER OR COLOR FLOW W/CONTRAST,1167.25,875.44,14.01,1050.53,119
CPT,93307,Tte w/o doppler complete,,,42.39,349.56,99
CPT,93308,HC 2D TTE LIMITED W/CONTRAST,1166.53,874.9,14.0,1049.88,119
CPT,93308,HC 2D TTE LIMITED W/O CONTRAST,1166.53,874.9,14.0,1049.88,119
CPT,93308,Tte f-up or lmtd,,,24.19,269.03,99
CPT,93312,Echo transesophageal,,,103.51,610.26,99
CPT,93312,HC TEE TRANSEOPHAG W/CONTRAST,3196.45,2397.34,38.36,2876.8,119
CPT,93312,HC TEE TRANSEOPHAG W/O CONTRAST,2876.82,2157.61,34.52,2589.14,119
CPT,93313,Echo transesophageal,,,10.97,610.26,63
CPT,93313,"HC ECHO, TEE FOR PLACEMT TRANSESOPHAGEAL PROBE ONLY",1283.64,962.73,15.4,1155.28,119
CPT,93314,Echo transesophageal,,,86.8,577.69,80
CPT,93315,Echo transesophageal,,,122.64,610.26,63
CPT,93315,HC TEE FOR CONGENITAL CARDIAC ANOMALIES,3997.36,2998.02,47.97,3597.62,119
CPT,93316,Echo transesophageal,,,24.96,610.26,63
CPT,93317,Echo transesophageal,,,85.37,85.37,36
CPT,93317,HC US TEE CONGENIT IMG AND REPORT ONLY,1473.1,1104.82,17.68,1325.79,119
CPT,93318,Echo transesophageal intraop,,,98.97,610.26,55
CPT,93318,HC ECHO TEE FOR OR MONITORING,5838.27,4378.7,70.06,5254.44,119
CPT,93319,3d echo img cgen car anomal,,,23.45,139.78,44
CPT,93319,HC ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,1319.54,989.66,15.83,1187.59,119
CPT,93320,Doppler echo complete,,,17.25,129.7,80
CPT,93320,HC DOPPLER W/SPECTRAL COMPLETE,613.71,460.28,7.36,552.34,119
CPT,93321,Doppler echo f-up/lmtd std,,,6.95,63.77,80
CPT,93321,HC DOPPLER W/SPECTRAL LIMITED,362.32,271.74,4.35,326.09,119
CPT,93325,Doppler echo color flow mapg,,,3.0,58.17,80
CPT,93325,HC DOPPLER COLOR FLOW,489.48,367.11,5.87,440.53,119
CPT,93350,Stress tte only,,,66.65,610.26,99
CPT,93351,HC US TTE STRESS AND ECG W/PHYS COMPLETE W CONTRAST,2416.22,1812.16,28.99,2174.6,119
CPT,93351,HC US TTE STRESS AND ECG W/PHYS COMPLETE W/O CONTRAST,2416.22,1812.16,28.99,2174.6,119
CPT,93351,Stress tte complete,,,80.2,610.26,99
CPT,93352,Admin ecg contrast agent,,,32.13,90.33,45
CPT,93355,Echo transesophageal (tee),,,217.21,588.83,44
CPT,93355,HC ECHO TEE FOR INTERVENTION GUIDANCE,5755.58,4316.69,69.07,5180.02,119
CPT,93356,HC MYOCRD STRAIN IMG SPCKL TRCK,137.28,102.96,1.65,123.55,119
CPT,93356,Myocrd strain img spckl trck,,,11.23,94.02,44
CPT,93451,HC RT HEART CATH W/O2 SAT,6944.06,5208.04,83.33,6249.65,119
CPT,93451,Right heart cath,,,124.86,3579.88,99
CPT,93452,HC LT HEART CATH W/VGRAM,10199.53,7649.65,122.39,9179.58,119
CPT,93452,Left hrt cath w/ventrclgrphy,,,224.89,3579.88,99
CPT,93453,HC RT/LT HEART CATH W/LT VGRAM,10548.78,7911.58,126.59,9493.9,119
CPT,93453,R&l hrt cath w/ventriclgrphy,,,300.79,3579.88,99
CPT,93454,Coronary artery angio s&i,,,227.13,3579.88,99
CPT,93454,HC CORONARY ANGIOS ONLY,9255.25,6941.44,111.06,8329.72,119
CPT,93455,Coronary art/grft angio s&i,,,264.81,3579.88,99
CPT,93455,HC CORONARIES BY-PASS GRAFT,10022.42,7516.82,120.27,9020.18,119
CPT,93456,HC CORONARIES AND RT HEART CATH,10546.61,7909.96,126.56,9491.95,119
CPT,93456,R hrt coronary artery angio,,,295.92,3579.88,99
CPT,93457,HC CORONARY/BYPASS GRATS RT HRT,12083.445,9062.585,134.88,11633.83,238
CPT,93457,R hrt art/grft angio,,,332.34,3579.88,99
CPT,93458,HC LT HEART/CORONARY LVGRAM,10378.36,7783.77,124.54,9340.52,119
CPT,93458,L hrt artery/ventricle angio,,,280.21,3579.88,99
CPT,93459,HC LT HEART/CORONARY LV GRAM/GRFT,11073.61,8305.21,132.88,9966.25,119
CPT,93459,L hrt art/grft angio,,,317.89,3579.88,99
CPT,93460,HC LT/RT HEART LV GRAM CORONARY,11724.96,8793.72,140.7,10552.46,119
CPT,93460,R&l hrt art/ventricle angio,,,355.88,3579.88,99
CPT,93461,HC LT/RT HRT/CORONARY LVGRM/GFT,12377.28,9282.96,148.53,11139.55,119
CPT,93461,R&l hrt art/ventricle angio,,,393.24,3579.88,99
CPT,93462,HC LT HEART CATH TRANSSEPTL PUNCT,10463.48,7847.61,125.56,9417.13,238
CPT,93462,L hrt cath trnsptl puncture,,,199.39,537.17,44
CPT,93463,Drug admin & hemodynmic meas,,,94.72,255.87,44
CPT,93463,HC DRUG ADMIN HEMODYNAMIC MEAS,3653.91,2740.43,43.85,3288.52,238
CPT,93464,Exercise w/hemodynamic meas,,,85.25,557.0,80
CPT,93464,HC EXERCISE W/HEMODYNAMIC MEAS,1191.4,893.55,14.3,1072.26,119
CPT,93503,HC SWAN GAN CATH INSERTION,3469.3900000000003,2602.045,38.81,3334.51,238
CPT,93503,Insert/place heart catheter,,,85.6,1728.99,63
CPT,93505,Endomyocardial biopsy,,,215.89,3503.18,99
CPT,93505,HC ENDOMYOCARDIAL BIOPSY,8614.19,6460.64,103.37,7752.77,119
CPT,93563,HC INJ CARDIAC CATH CONGNTL HEART,1503.73,1127.8,18.04,1353.36,119
CPT,93563,Njx cgen car cth slctv c ang,,,49.85,134.28,44
CPT,93564,HC INJ CARDIAC CATH 1+ COR ARTER,3256.84,2442.63,39.08,2931.16,119
CPT,93564,Njx cgen car cath slctv opac,,,52.63,143.8,44
CPT,93565,HC INJ CARDIAC CATH LT VEN/ATRIAL,2198.09,1648.57,26.38,1978.28,119
CPT,93565,Njx car cth slctv lv/la ang,,,25.8,70.94,44
CPT,93566,HC INJ CARDIAC CATH RT VEN/ATRIAL,987.8,740.85,11.85,889.02,119
CPT,93566,Njx car cth slctv rv/ra ang,,,25.52,67.57,44
CPT,93567,HC INJ CARDIAC CATH SUPRVAL AORTG,3436.085,2577.065,38.43,3302.5,238
CPT,93567,Njx car cth sprvlv aortgrphy,,,36.24,97.65,44
CPT,93568,HC INJ CARDIAC CATH PULM ANGIO,5665.65,4249.24,67.99,5099.08,119
CPT,93568,Njx car cth nslc p-art angrp,,,45.12,121.67,44
CPT,93569,HC PULMONARY ANGIO W/ HEART CATH SELECTIVE UNILAT,5992.36,4494.27,71.91,5393.12,119
CPT,93569,Njx cth slct p-art angrp uni,,,36.66,98.15,44
CPT,93571,HC IV DOP VEL&/PRESS C/FLO RSRV MEAS 1ST VESSEL,6445.155,4833.865,72.09,6194.58,238
CPT,93571,Iv dop vel&/press c flo 1st,,,69.15,524.08,44
CPT,93572,HC IV DOP VEL&/PRESS C/FLO RSRV MEAS EA ADDL VSL,1783.94,1337.955,19.95,1714.58,238
CPT,93572,Iv dop vel&/press c flo ea,,,50.13,50.13,36
CPT,93573,HC PULMONARY ANGIO W/ HEART CATH SELECTIVE BILAT,6264.74,4698.56,75.18,5638.27,119
CPT,93573,Njx cath slct p-art angrp bi,,,61.11,163.33,44
CPT,93574,HC PULMONARY VEIN ANGIO W/HEARTCATH SELECTIVE EACH,10895.2,8171.4,130.74,9805.68,119
CPT,93574,Njx cath slct pulm vn angrph,,,67.42,182.01,44
CPT,93575,HC AORTOPULMONARY ANGIO W/CONGENITAL HEARTCATH EA,10895.2,8171.4,130.74,9805.68,119
CPT,93575,Njx cath slct p angrph mapca,,,90.19,241.8,44
CPT,93580,HC TRANSCATH ASD REPAIR,48374.14,36280.61,580.49,43536.73,119
CPT,93580,Transcath closure of asd,,,928.18,19985.91,63
CPT,93581,HC PERQ CLOSE VENTRICULR DEF,18648.35,13986.26,223.78,16783.52,119
CPT,93581,Transcath closure of vsd,,,1259.79,19985.91,63
CPT,93582,HC PERC TRANSCATH CLOSURE PDA,62820.47,47115.35,753.85,56538.42,119
CPT,93582,Perq transcath closure pda,,,630.14,19985.91,63
CPT,93583,HC PERC TRANSCATH SEPTAL REDUX INCL PMKR,45392.04,34044.03,544.7,40852.84,119
CPT,93583,Perq transcath septal reduxn,,,705.7,15039.8,63
CPT,93584,HC VNGRPH CHD ANOM/PERSIST SVC,5349.68,4012.26,64.2,4814.71,119
CPT,93584,Vngrph chd anom/persist svc,,,129.24,154.2,8
CPT,93585,HC VNGRPH CHD AZYGS/HEMIAZYGS,5349.68,4012.26,64.2,4814.71,119
CPT,93585,Vngrph chd azygs/hemiazygs,,,121.77,145.29,8
CPT,93586,HC VENOGRAPHY CHD CORONARY SINUS,2878.57,2158.93,34.54,2590.71,119
CPT,93586,Vngrph chd coronary sinus,,,154.62,184.49,8
CPT,93587,HC VENOGRAPHY CONGENITAL VENOVENOUS ABOVE HEART,4349.9,3262.42,52.2,3914.91,119
CPT,93587,Vngrph chd vnvn cltrl at/abv,,,226.41,270.14,8
CPT,93588,HC VENOGRAPHY CONGENITAL VENOVENOUS BELOW HEART,11443.6,8582.7,137.32,10299.24,119
CPT,93588,Vngrph chd vnvn cltrl below,,,229.35,273.66,8
CPT,93590,"HC CLOSURE PARAVALVULAR LEAK PERC; INITIAL, MITRAL VALVE",46945.26,35208.94,563.34,42250.73,119
CPT,93590,Perq transcath cls mitral,,,165.13,19985.91,63
CPT,93591,"HC PERIVALVULAR LEAK INITIAL DEVICE, AORTIC VALVE",52155.92,39116.94,625.87,46940.33,119
CPT,93591,Perq transcath cls aortic,,,527.58,19985.91,63
CPT,93592,HC PERIVALVULAR LEAK EA ADDTL DEVICE,7539.86,5654.9,90.48,6785.87,119
CPT,93592,Perq transcath closure each,,,60.13,1008.28,44
CPT,93593,HC HEART CATH CONGENITAL RIGHT SIDE - NORMAL NATIVE,9363.34,7022.5,112.36,8427.01,119
CPT,93593,R hrt cath chd nml nt cnj,,,182.93,3579.88,55
CPT,93594,HC HEART CATH CONGENITAL RIGHT SIDE - ABNORMAL NATIVE,9403.39,7052.54,112.84,8463.05,119
CPT,93594,R hrt cath chd abnl nt cnj,,,284.56,3579.88,55
CPT,93595,HC HEART CATH CONGENITAL LEFT SIDE - NORM/ABNORM NATIVE,10410.49,7807.87,124.93,9369.44,119
CPT,93595,L hrt cath chd nm/abn nt cnj,,,256.42,3579.88,55
CPT,93596,HC HEART CATH CONGENITAL RIGHT/LEFT SIDE - NORM NATIVE,9379.79,7034.84,112.56,8441.81,119
CPT,93596,R&l hrt cath chd nml nt cnj,,,313.28,3579.88,55
CPT,93597,HC HEART CATH CONGENITAL RIGHT/LEFT SIDE - ABNORM NATIVE,9386.65,7039.99,112.64,8447.98,119
CPT,93597,R&l hrt cath chd abnl nt cnj,,,413.81,3579.88,55
CPT,93598,Car outp meas drg cath chd,,,67.54,67.54,36
CPT,93598,HC CONGENITAL HEART CATH OUTPUT MEASURES/DILUTION,1451.86,1088.9,17.42,1306.67,119
CPT,93600,Bundle of his recording,,,8.44,8445.59,63
CPT,93600,HC HIS BUNDLE,1234.9,926.18,14.82,1111.41,119
CPT,93602,HC INTRA-ATRIAL RECORDING,14913.09,11184.82,178.96,13421.78,119
CPT,93602,Intra-atrial recording,,,4.53,8445.59,63
CPT,93603,HC RT VENTRICULAR RECORDING,747.01,560.26,8.96,672.31,119
CPT,93603,Right ventricular recording,,,7.03,1351.18,63
CPT,93609,HC MAPPING NOT 3-D,5968.47,4476.35,71.62,5371.62,119
CPT,93609,Intra-vntr mapg tchycar site,,,10.92,262.61,44
CPT,93610,HC INTRA-ATRIAL PACING,20385.36,15289.02,244.62,18346.82,119
CPT,93610,Intra-atrial pacing,,,6.44,8445.59,63
CPT,93612,HC INTRAVENTRICULAR PACING,15734.69,11801.02,188.82,14161.22,119
CPT,93612,Intraventricular pacing,,,7.03,8445.59,63
CPT,93613,HC 3D MAPPING,8678.96,6509.22,104.15,7811.06,238
CPT,93613,Intracardiac ephys 3d mapg,,,280.6,754.29,44
CPT,93615,Esophageal recording,,,1.25,1351.18,63
CPT,93616,Esophageal recording w/pacg,,,56.69,1351.18,55
CPT,93616,HC ESOPHAGEAL PACING,2453.88,1840.41,29.45,2208.49,119
CPT,93618,HC INDUCTION ARRYTH BY ELEC PACING,3154.55,2365.91,37.85,2839.1,238
CPT,93618,Indctj arrhythmia elec pacg,,,15.44,1351.18,63
CPT,93619,Comprehensive ep evaluation,,,30.25,8445.59,63
CPT,93619,HC COMP EP W/O ARRYTHMIA INDUCTN,13193.07,9894.8,158.32,11873.76,119
CPT,93620,Comp ep evl r at ven pac&rec,,,594.23,8445.59,55
CPT,93620,HC COMP EP W/ARRYTHMIA INDUCTN,16169.93,12127.45,194.04,14552.94,119
CPT,93621,Comp ep evl l pac&rec c sins,,,78.83,78.83,36
CPT,93621,HC LA/CORON/SINUS W/EP,16308.79,12231.59,195.71,14677.91,119
CPT,93622,Comp ep eval l ventr pac&rec,,,162.84,162.84,36
CPT,93622,HC COMPLETE EP/LV,13994.17,10495.63,167.93,12594.75,119
CPT,93623,HC STIM AFTER DRUG,3369.14,2526.86,40.43,3032.23,238
CPT,93623,Prgrmd stimj&pacg iv rx nfs,,,78.63,78.63,36
CPT,93624,Ep f-up study pacg&rec,,,237.15,8445.59,55
CPT,93624,HC EP FOLLOW-UP STUDY,6484.11,4863.08,77.81,5835.7,119
CPT,93631,Ntraop epicar&endcar pac&map,,,378.72,378.72,36
CPT,93640,Ep eval 1/2chmbr pacg cvdfb,,,26.95,168.87,44
CPT,93640,HC EVAL ICD LEADS,3606.55,2704.91,43.28,3245.9,119
CPT,93641,Ep evl 1/2chmb pac cvdfb tst,,,26.95,296.01,44
CPT,93641,HC ICD LEADS/GEN EVALUATION,6283.12,4712.34,75.4,5654.81,119
CPT,93642,Ep evl 1/2chmb trnsvns cvdfb,,,77.42,1351.18,99
CPT,93642,HC EP EVAL TRANSVENOUS ICD RE-CHECK,3471.74,2603.8,41.66,3124.57,119
CPT,93644,Ep eval subq impl dfb,,,47.36,499.18,80
CPT,93644,HC EP EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,4855.55,3641.66,58.27,4370.0,119
CPT,93650,HC ATRIOVENTRIC NOTED ABLATION,18236.94,13677.7,218.84,16413.25,238
CPT,93650,Icar cath abltj av node func,,,560.69,8445.59,63
CPT,93653,Compre ep eval tx svt,,,805.81,27304.55,63
CPT,93653,HC EP & ABLATE SUPRAVENT ARRYTH,84959.97,63719.98,1019.52,76463.97,238
CPT,93654,Compre ep eval tx vt,,,971.25,27304.55,63
CPT,93654,HC EP & ABLATE VENTRICULAR TACHYCARDIA,93711.57,70283.68,1124.54,84340.41,238
CPT,93655,HC ABLATE ARRYTHMIA ADD ON,19403.15,14552.36,232.84,17462.84,238
CPT,93655,Icar cath abltj dscrt arrhyt,,,295.59,795.83,44
CPT,93656,Compre ep eval abltj atr fib,,,913.76,27304.55,63
CPT,93656,HC TX ATRIAL FIB ABLATE PULM VEIN ISOL,90864.19,68148.14,1090.37,81777.77,238
CPT,93657,HC TX LEFT/RIGHT ATRIAL FIB ADDL,18456.04,13842.03,221.47,16610.44,238
CPT,93657,Tx l/r atrial fib addl,,,295.59,796.67,44
CPT,93660,HC TILT TABLE CV EVALUATION,1200.0,900.0,14.4,1080.0,119
CPT,93660,Tilt table evaluation,,,65.81,590.56,99
CPT,93662,HC INTRACARDIAC ULTRASOUND,17813.93,13360.45,213.77,16032.54,238
CPT,93662,Intracardiac ecg (ice),,,71.31,71.31,36
CPT,93668,HC PERIPHERAL VASCULAR REHAB (PAD),152.3,114.22,1.83,137.07,119
CPT,93668,Peripheral vascular rehab,,,13.47,66.11,63
CPT,93701,Bioimpedance cv analysis,,,24.77,143.47,63
CPT,93702,Bis xtracell fluid analysis,,,120.46,301.47,62
CPT,93724,Elec alys antitchycar pm sys,,,43.6,735.44,99
CPT,93740,Temperature gradient studies,,,17.2,174.14,26
CPT,93745,Set-up cardiovert-defibrill,,,44.29,333.8,27
CPT,93750,HC INTERROGATION OF VAD,392.62,294.46,4.71,353.36,119
CPT,93750,Interrogation vad in person,,,38.66,135.32,63
CPT,93770,Determination venous press,,,17.2,20.52,8
CPT,93784,Ambl bp mntr w/software,,,43.57,119.51,45
CPT,93786,Ambl bp mntr w/sw rec only,,,21.0,143.47,63
CPT,93786,HC AMBULATORY BLOOD PRESSURE MONITORING - HOOKUP/RECORD,322.52,241.89,3.87,290.27,119
CPT,93788,Ambl bp mntr w/sw a/r,,,5.0,143.47,63
CPT,93788,HC AMBULATORY BLOOD PRESSURE MONITORING - SCAN,367.55,275.66,4.41,330.8,238
CPT,93790,Ambl bp mntr w/sw i&r,,,17.3,47.33,45
CPT,93792,Pt/caregiver traing home inr,,,65.81,174.95,44
CPT,93793,Anticoag mgmt pt warfarin,,,11.1,29.97,44
CPT,93797,HC CARDIAC PHASE II ROUTINE WO ECG,293.21,219.91,3.52,263.89,119
CPT,93797,Phys/qhp op car rhab wo ecg,,,8.59,140.13,63
CPT,93798,HC CARDIAC PHASE II ROUTINE W/ECG,305.21,228.91,3.66,274.69,119
CPT,93798,Phys/qhp op car rhab w/ecg,,,13.21,140.13,63
CPT,93799,HC AQUIRED ASD CLOSURE,54873.35,41155.01,658.48,49386.02,119
CPT,93799,HC BASILICA,10210.63,7657.97,122.53,9189.57,119
CPT,93799,HC BASILICA-DIVISION OF LEAFLETS,17417.13,13062.85,209.01,15675.42,119
CPT,93799,HC CLOSURE OF FISTULA,53930.12,40447.59,647.16,48537.11,119
CPT,93799,HC CONSOLE IMPELLA ASSIST DAILY CHECK,1584.59,1188.44,19.02,1426.13,119
CPT,93799,HC CONSOLE VAD ASSIST DAILY CHECK,1439.68,1079.76,17.28,1295.71,119
CPT,93799,HC DIVISION OF CORONARY LEAFLETS,10210.63,7657.97,122.53,9189.57,119
CPT,93799,HC ECMO DAILY MGMT,5102.2,3826.65,61.23,4591.98,119
CPT,93799,HC EP PROVOCATIVE DRUG STUDY  (PROCAINAMIDE),2739.76,2054.82,32.88,2465.78,119
CPT,93799,HC IFR W/O PHARMACOLOGIC STRESS,6617.96,4963.47,79.42,5956.16,119
CPT,93799,HC IFR/RFR INITIAL VESSEL,6617.96,4963.47,79.42,5956.16,119
CPT,93799,HC IFR/RFR INITIAL VESSEL W/ 1 ADDITIONAL VESSEL,9395.89,7046.92,112.75,8456.3,119
CPT,93799,HC IFR/RFR INITIAL VESSEL W/ 2+ ADDITIONAL VESSELS,9894.45,7420.84,118.73,8905.01,119
CPT,93799,HC INTRACARDIAC ECHO,15917.78,11938.34,191.01,14326.0,119
CPT,93799,HC LAMPOON-RF DIVISION OF LEAFLETS,17417.13,13062.85,209.01,15675.42,119
CPT,93799,HC PERICARDIOTOMY,3277.93,2458.45,39.34,2950.14,119
CPT,93799,HC RF PEREFERATION OF PULMONARY VALVE,20705.45,15529.09,248.47,18634.91,119
CPT,93799,Unlisted cv svc/procedure,,,130.29,174.14,19
CPT,93880,Extracranial bilat study,,,37.32,482.12,99
CPT,93880,HC US DUPLEX SCAN CAROTID BILATERAL S&I,1298.32,973.74,15.58,1168.49,119
CPT,93882,Extracranial uni/ltd study,,,23.39,315.57,99
CPT,93882,HC US DUPLEX SCAN CAROTID UNILATERAL,697.03,522.77,8.36,627.33,119
CPT,93886,HC US TRANSCRANIAL DOPPLER COMPLT,1442.69,1082.02,17.31,1298.42,119
CPT,93886,Intracranial complete study,,,44.25,657.69,99
CPT,93888,HC US TRANSCRANIAL DOPPLER LIMITED,932.42,699.32,11.19,839.18,119
CPT,93888,Intracranial limited study,,,24.39,414.61,99
CPT,93890,Tcd vasoreactivity study,,,48.87,750.86,80
CPT,93892,HC TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,957.97,718.48,11.5,862.17,119
CPT,93892,HC US INTRACRANIAL DOPPLER EMBOLI,957.97,718.48,11.5,862.17,119
CPT,93892,Tcd emboli detect w/o inj,,,57.05,751.79,99
CPT,93893,HC TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,1074.23,805.67,12.89,966.81,119
CPT,93893,Tcd std icr art ven-art shnt,,,57.95,857.08,99
CPT,93896,Vsrctv std tcd icr art compl,,,384.91,459.27,8
CPT,93897,Emboli detcj wo iv mbubb njx,,,482.72,575.97,8
CPT,93898,Ven-artl shunt det mbubb njx,,,506.11,603.89,8
CPT,93922,HC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,1014.1,760.58,12.17,912.69,119
CPT,93922,HC UPR/L EXTREMITY ART 1-2 LEVELS BILATERAL,1390.07,1042.55,16.68,1251.06,119
CPT,93922,HC UPR/L EXTREMITY ART 1-2 LEVELS UNILATERAL,695.04,521.28,8.34,625.54,119
CPT,93922,Upr/l xtremity art 2 levels,,,11.84,209.59,99
CPT,93923,HC UPR/LXTR ART STDY 3+ LVLS UNILATERAL,831.13,623.35,9.97,748.02,119
CPT,93923,HC UPR/LXTR ART STDY 3+LVLS BILATERAL,1662.25,1246.69,19.95,1496.02,119
CPT,93923,Upr/lxtr art stdy 3+ lvls,,,21.09,333.06,99
CPT,93924,HC N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,881.84,661.38,10.58,793.66,119
CPT,93924,HC NIVA LOWER EXTREMITY W/STRESS,881.84,661.38,10.58,793.66,119
CPT,93924,Lwr xtr vasc stdy bilat,,,23.41,408.11,99
CPT,93925,HC DOPPLER LOWER EXTREMTIY BILATERAL,1111.55,833.66,13.34,1000.4,119
CPT,93925,Lower extremity study,,,36.4,606.11,99
CPT,93926,HC DOPPLER LOWER EXTREM UNILATERAL OR LIMITED,1000.39,750.29,12.0,900.35,119
CPT,93926,Lower extremity study,,,22.2,363.96,99
CPT,93930,HC US DOPPLER EXTREM UPPER BILATERAL,1290.31,967.73,15.48,1161.28,119
CPT,93930,Upper extremity study,,,36.99,505.9,99
CPT,93931,HC DOPPLER EXTREM UPPER UNILATERAL,1030.59,772.94,12.37,927.53,119
CPT,93931,Upper extremity study,,,22.51,313.85,99
CPT,93970,Extremity study,,,32.38,473.88,99
CPT,93970,HC DOPPLER EXTREM COMPLETE BILATERAL,1687.75,1265.81,20.25,1518.98,119
CPT,93970,HC DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1687.75,1265.81,20.25,1518.98,119
CPT,93971,Extremity study,,,20.81,303.38,99
CPT,93971,HC DOPPLER EXTREMITY VEINS UNILATERAL,1142.46,856.84,13.71,1028.21,119
CPT,93971,HC DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,1142.46,856.84,13.71,1028.21,119
CPT,93975,HC US DUPLEX VASCULAR SCAN COMPLETE,1579.75,1184.81,18.96,1421.78,119
CPT,93975,Vascular study,,,54.16,670.3,99
CPT,93976,HC DUPLEX VASCULAR SCAN LIMITED,946.36,709.77,11.36,851.72,119
CPT,93976,Vascular study,,,37.07,406.54,99
CPT,93978,"HC DUPLEX A,IVC, IL/BPG; COMPL",1492.12,1119.09,17.91,1342.91,119
CPT,93978,Vascular study,,,36.94,461.72,99
CPT,93979,HC US DUPLX AORT IVC ILAC GRF LIMITED,654.07,490.55,7.85,588.66,119
CPT,93979,Vascular study,,,22.51,299.41,99
CPT,93980,HC DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,596.86,447.64,7.16,537.17,119
CPT,93980,Penile vascular study,,,53.95,304.84,99
CPT,93981,HC DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,583.17,437.38,7.0,524.85,119
CPT,93981,HC US DUPLEX SCAN PENILE LIMITED,1392.24,1044.18,16.71,1253.02,119
CPT,93981,Penile vascular study,,,20.79,181.87,99
CPT,93985,Dup-scan hemo compl bi std,,,36.9,631.58,99
CPT,93985,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1372.88,1029.66,16.47,1235.59,119
CPT,93986,Dup-scan hemo compl uni std,,,23.07,370.74,99
CPT,93986,HC DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,988.82,741.62,11.87,889.94,119
CPT,93986,HC US DUP-SCAN HEMO COMPL UNILATERAL STD,1098.69,824.02,13.18,988.82,119
CPT,93990,Doppler flow testing,,,22.74,371.58,99
CPT,93990,HC DUPLEX HEMODIALYSIS ACCESS,1195.71,896.78,14.35,1076.14,119
CPT,93990,HC DUPLEX SCAN HEMODIALYSIS ACCESS,1195.77,896.83,14.35,1076.19,119
CPT,93998,HC TCOM ONLY EXTREMITY STUDY,622.61,466.96,7.47,560.35,119
CPT,93998,HC UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,622.61,466.96,7.47,560.35,119
CPT,93998,Unlistd noninvas vasc dx std,,,23.47,29.28,19
CPT,94002,HC VENTILATOR 1ST DAY,1999.51,1499.63,23.99,1799.56,119
CPT,94002,Vent mgmt inpat init day,,,89.36,735.81,63
CPT,94003,HC VENTILATOR SUBSEQUENT DAY,2712.82,2034.62,32.55,2441.54,119
CPT,94003,Vent mgmt inpat subq day,,,62.52,735.81,63
CPT,94004,Vent mgmt nf per day,,,46.27,124.97,44
CPT,94005,Home vent mgmt supervision,,,200.53,239.27,8
CPT,94010,Breathing capacity test,,,7.94,218.63,99
CPT,94010,HC SPIROMETRY,259.55,194.66,3.11,233.6,119
CPT,94011,Spirometry up to 2 yrs old,,,82.9,223.8,63
CPT,94012,Spirmtry w/brnchdil inf-2 yr,,,134.47,363.83,63
CPT,94013,Meas lung vol thru 2 yrs,,,18.52,590.56,63
CPT,94014,Patient recorded spirometry,,,52.7,452.32,63
CPT,94015,Patient recorded spirometry,,,28.85,346.59,63
CPT,94016,Review patient spirometry,,,22.85,64.3,63
CPT,94060,Evaluation of wheezing,,,9.94,377.83,99
CPT,94060,HC SPIROMETRY BEFORE/AFTER B.D.,564.05,423.04,6.77,507.64,119
CPT,94070,Evaluation of wheezing,,,26.88,377.83,99
CPT,94070,HC BRONCHIAL PROVOCATION,971.64,728.73,11.66,874.48,119
CPT,94150,HC BEDSIDE VITAL CAPACITY,217.29,162.97,2.61,195.56,119
CPT,94150,Vital capacity test,,,54.45,174.14,27
CPT,94200,HC MAXIMUM VOLUNTARY VENTILATION,419.18,314.38,5.03,377.26,119
CPT,94200,Lung function test (mbc/mvv),,,2.62,66.11,99
CPT,94375,HC FLOW VOLUME LOOP,396.64,297.48,4.76,356.98,119
CPT,94375,Respiratory flow volume loop,,,13.94,346.59,99
CPT,94450,Breathing response hypoxia,,,19.16,225.77,99
CPT,94452,Hast w/i&r phys/qhp,,,13.62,143.47,99
CPT,94453,Hast w/suppl oxygen titrj,,,17.91,173.11,99
CPT,94610,HC ADMIN SURFACTANT THRU ET TUBE,341.7,256.27,4.1,307.53,119
CPT,94610,Intrapulm surfactant admn,,,54.83,226.38,63
CPT,94617,Exercise tst brncspsm w/ecg,,,30.92,231.85,99
CPT,94617,HC BRONCHOSPASM EXERCISE TEST,988.54,741.4,11.86,889.69,119
CPT,94618,HC PULMONARY STRESS TEST (6-MIN WALK) - FOR PULM REHAB,560.98,420.74,6.73,504.88,119
CPT,94618,Pulmonary stress testing,,,10.96,143.47,99
CPT,94619,Exercise tst brncspsm wo ecg,,,21.9,169.43,99
CPT,94619,HC EXERCISE TEST FOR BRONCHOSPA (EIB) W/O ELECT RECOR,988.54,741.4,11.86,889.69,119
CPT,94621,Cardiopulm exercise testing,,,65.84,404.38,99
CPT,94621,HC CARDIOPULMONARY EXERCISE TESTING,1282.06,961.54,15.38,1153.85,119
CPT,94625,HC PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,480.64,360.48,5.77,432.58,119
CPT,94625,Phy/qhp op pulm rhb w/o mntr,,,16.51,199.21,63
CPT,94626,HC PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,480.64,360.48,5.77,432.58,119
CPT,94626,Phy/qhp op pulm rhb w/mntr,,,26.43,217.41,63
CPT,94640,Airway inhalation treatment,,,8.45,226.38,63
CPT,94640,HC AIRWAY INHALATION TREATMENT,149.82,112.36,1.8,134.84,119
CPT,94642,Aerosol inhalation treatment,,,82.05,226.38,27
CPT,94642,HC PENTAMDINE TREATMENT,357.28,267.96,4.29,321.55,119
CPT,94642,HC SPAG NEBULIZER,337.1,252.82,4.05,303.39,119
CPT,94644,Cont inhlj tx 1st hour,,,55.83,146.92,63
CPT,94645,Cont inhlj tx each addl hour,,,14.73,43.31,44
CPT,94645,HC CONTINUOUS IEOP DAILY,6387.86,4790.9,76.65,5749.07,119
CPT,94645,HC CONTINUOUS NEB MED ADDL DAILY,511.56,383.67,6.14,460.4,119
CPT,94645,HC CONTINUOUS NEB MED EACH ADDL HR,175.87,131.9,2.11,158.28,119
CPT,94660,Cpap initiation&mgmt,,,35.99,226.38,63
CPT,94660,HC CPAP LIMITED,328.83,246.62,3.95,295.95,119
CPT,94660,HC POS AIRWAY PRESSURE CPAP/BIPAP,1064.86,798.64,12.78,958.37,119
CPT,94660,HC THERAPY MONITORING OF HOME CPAP DEVICE DAILY,335.11,251.33,4.02,301.6,119
CPT,94660,HC THERAPY MONITORING OF VENTILATION HOME DEVICE DAILY,2759.81,2069.86,33.12,2483.83,119
CPT,94662,Neg press ventilation cnp,,,34.1,735.81,54
CPT,94664,Demo&/eval pt use inhaler,,,15.98,226.38,63
CPT,94664,HC EVALUATE PT USE OF INHALER,356.05,267.04,4.27,320.44,119
CPT,94667,HC MANIPULATION CHEST WALL INITIAL,181.48,136.11,2.18,163.33,119
CPT,94667,Mnpj chest wall 1st,,,21.92,143.47,63
CPT,94668,HC MANIPULATION CHEST WALL SUSQNT,181.38,136.04,2.18,163.24,119
CPT,94668,Mnpj chest wall sbsq,,,34.16,143.47,63
CPT,94669,HC CHEST WALL OSCILLATION,281.59,211.19,3.38,253.43,119
CPT,94669,Mechanical chest wall oscill,,,18.16,226.38,63
CPT,94680,O2 uptk rst&xers dir simple,,,12.22,174.14,99
CPT,94681,O2 uptk co2 outp % o2 xtrc,,,9.27,377.83,99
CPT,94690,HC METABOLIC NUTRITIONAL ASSMNT,72.27,54.2,0.87,65.04,119
CPT,94690,O2 uptk rest indirect,,,3.61,123.56,99
CPT,94726,HC PFT PLETHYSMOGRAPHY,300.46,225.34,3.61,270.41,119
CPT,94726,Plethysmography lung volumes,,,11.61,377.83,99
CPT,94727,Gas dil/wshot deter lng vol,,,11.61,218.63,99
CPT,94727,HC PFT NITROGEN WASHOUT,253.36,190.02,3.04,228.02,119
CPT,94728,Airwy resist by oscillometry,,,11.93,174.14,99
CPT,94728,HC PFT AIRFLOW RESISTANCE,676.88,507.66,8.12,609.19,119
CPT,94729,Diffusing capacity,,,8.61,143.82,80
CPT,94729,HC PFT LUNG DIFFUSION,324.01,243.01,3.89,291.61,119
CPT,94760,HC PULSE OXIMETRY SINGLE,46.72,35.04,0.56,42.05,119
CPT,94760,N-invas ear/pls oximetry 1,,,2.18,9.35,44
CPT,94761,HC NEWBORN CCHD PULSE OXIMETRY MULTIPLE,182.41,136.81,2.19,164.17,119
CPT,94761,HC PULSE OXIMETRY MULTIPLE,182.41,136.81,2.19,164.17,119
CPT,94761,N-invas ear/pls oximetry mlt,,,3.43,10.19,44
CPT,94762,HC NOCTURNAL DESAT STUDY,358.23,268.67,4.3,322.41,119
CPT,94762,HC PULSE OXIMETRY CONTINUOUS,264.62,198.46,3.18,238.16,119
CPT,94762,N-invas ear/pls oximtry cont,,,23.83,174.14,63
CPT,94772,Circadian respir pattern rec,,,377.83,590.56,19
CPT,94775,Ped home apnea mntr att only,,,130.29,174.14,19
CPT,94776,Ped home apnea mntr dl&alys,,,130.29,174.14,19
CPT,94780,Cars/bd tst inft-12mo 60 min,,,23.09,138.79,62
CPT,94780,HC CAR SEAT/BD AIRWAY TESTING W/INTERP 60 MIN INFT-12 MO,191.7,143.78,2.3,172.53,119
CPT,94781,Cars/bd tst inft-12mo +30min,,,7.94,56.23,44
CPT,94781,HC CAR SEAT/BD AIRWAY TESTING W/INTERP EA ADDTL 30 MIN INFT-12 MO,191.7,143.78,2.3,172.53,119
CPT,94799,HC HYPERCAPNIC DRIVE,229.68,172.26,2.76,206.71,119
CPT,94799,HC MIP MEP TESTING,229.68,172.26,2.76,206.71,119
CPT,94799,HC TRACH/VENT SPEAKING VALVE-INITIAL,68.7,51.52,0.82,61.83,119
CPT,94799,Unlisted pulmonary svc/px,,,130.29,174.14,19
CPT,95004,Perq tests w/alrgnc xtrcs,,,3.77,1132.36,63
CPT,95012,HC EXHALED NITRIC OXYGEN MEASUREMENT,221.17,165.88,2.65,199.05,119
CPT,95012,Nitric oxide exp gas deter,,,17.55,47.55,62
CPT,95017,All tstg perq&iq w/venoms,,,3.61,29.28,63
CPT,95018,All tstg perq&iq drugs/biol,,,6.92,50.96,63
CPT,95024,Iq tests w/allergenic xtrcs,,,0.95,66.11,63
CPT,95027,Iq tsts seql&incrl airborne,,,4.71,29.28,63
CPT,95028,Iq tsts allergy delayed rxn,,,11.9,43.69,63
CPT,95044,Patch/application tests,,,4.69,1132.36,63
CPT,95052,Photo patch tests,,,5.94,66.11,63
CPT,95056,Photo tests,,,47.66,143.47,63
CPT,95060,Oph mucous membrane tests,,,35.12,143.47,63
CPT,95065,Dir nsl mucous membrane test,,,26.02,74.74,63
CPT,95070,HC INHALATION OF METHACHOLINE,68.23,51.17,0.82,61.41,119
CPT,95070,Inhlj brncl challenge tstg,,,32.28,590.56,63
CPT,95076,Ingest challenge ini 120 min,,,71.73,590.56,63
CPT,95079,Ingest challenge addl 60 min,,,66.1,227.51,44
CPT,95115,Immunotherapy one injection,,,9.39,51.35,63
CPT,95117,Immunotherapy injections,,,10.96,51.35,63
CPT,95120,Immunotherapy one injection,,,67.45,67.45,1
CPT,95125,Immunotherapy 2/> injections,,,96.35,96.35,1
CPT,95130,Immntx 1 sting insect,,,77.08,77.08,1
CPT,95131,Immntx 2 sting insects,,,105.99,105.99,1
CPT,95132,Immntx 3 sting insects,,,120.44,120.44,1
CPT,95133,Immntx 4 sting insects,,,186.27,186.27,1
CPT,95134,Immntx 5 sting insects,,,216.79,216.79,1
CPT,95144,Antigen therapy services,,,3.27,51.35,63
CPT,95145,Antigen therapy services,,,2.95,89.54,63
CPT,95146,Antigen therapy services,,,2.95,164.28,63
CPT,95147,Antigen therapy services,,,2.95,158.32,63
CPT,95148,Antigen therapy services,,,2.95,234.75,63
CPT,95149,Antigen therapy services,,,2.95,312.05,63
CPT,95165,Antigen therapy services,,,3.27,51.35,63
CPT,95170,Antigen therapy services,,,2.95,51.35,63
CPT,95180,Rapid desensitization,,,99.33,452.32,63
CPT,95199,Unlisted all/immlg svc/px,,,23.47,29.28,19
CPT,95249,Cont gluc mntr pt prov eqp,,,56.94,168.14,63
CPT,95250,Cont gluc mntr phys/qhp eqp,,,123.54,366.02,63
CPT,95251,Cont gluc mntr analysis i&r,,,33.68,91.74,44
CPT,95700,Eeg cont rec w/vid eeg tech,,,149.99,680.23,27
CPT,95700,HC EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS (IN PERSON),856.6,642.45,10.28,770.94,119
CPT,95705,Eeg w/o vid 2-12 hr unmntr,,,218.63,612.18,27
CPT,95705,HC EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,693.02,519.76,8.32,623.72,119
CPT,95706,Eeg wo vid 2-12hr intmt mntr,,,218.63,996.1,27
CPT,95706,HC EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,971.13,728.35,11.65,874.02,119
CPT,95707,Eeg w/o vid 2-12hr cont mntr,,,218.63,1042.84,27
CPT,95707,HC EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,946.64,709.98,11.36,851.98,119
CPT,95708,Eeg wo vid ea 12-26hr unmntr,,,377.83,765.78,27
CPT,95708,HC EEG W/O VID BY TECH EA INCR 12-26HRUNMONITORED,1329.6,997.2,15.96,1196.64,119
CPT,95709,Eeg w/o vid ea 12-26hr intmt,,,377.83,1915.41,27
CPT,95709,HC EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,2084.78,1563.58,25.02,1876.3,119
CPT,95710,Eeg w/o vid ea 12-26hr cont,,,377.83,2433.54,27
CPT,95710,HC EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3996.54,2997.4,47.96,3596.89,119
CPT,95711,HC VEEG BY TECH 2-12 HOURS UNMONITORED,831.6,623.7,9.98,748.44,119
CPT,95711,Veeg 2-12 hr unmonitored,,,218.63,612.18,27
CPT,95712,HC VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,3591.6,2693.7,43.1,3232.44,119
CPT,95712,Veeg 2-12 hr intmt mntr,,,298.52,1149.63,27
CPT,95713,HC VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,4809.17,3606.88,57.71,4328.25,119
CPT,95713,Veeg 2-12 hr cont mntr,,,377.83,1390.79,27
CPT,95714,HC VEEG BY TECH 12-26 HOURS UNMONITORED,1595.53,1196.65,19.15,1435.98,119
CPT,95714,Veeg ea 12-26 hr unmntr,,,377.83,765.78,27
CPT,95715,HC VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,2068.85,1551.64,24.83,1861.96,119
CPT,95715,Veeg ea 12-26hr intmt mntr,,,377.83,2143.7,27
CPT,95716,HC VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,4973.62,3730.22,59.68,4476.26,119
CPT,95716,Veeg ea 12-26hr cont mntr,,,869.49,2954.5,27
CPT,95717,Eeg phys/qhp 2-12 hr w/o vid,,,97.96,284.75,44
CPT,95718,Eeg phys/qhp 2-12 hr w/veeg,,,128.26,358.28,44
CPT,95719,Eeg phys/qhp ea incr w/o vid,,,151.41,428.4,44
CPT,95720,Eeg phy/qhp ea incr w/veeg,,,198.28,550.0,44
CPT,95721,Eeg phy/qhp>36<60 hr w/o vid,,,197.36,550.0,44
CPT,95722,Eeg phy/qhp>36<60 hr w/veeg,,,240.41,668.04,44
CPT,95723,Eeg phy/qhp>60<84 hr w/o vid,,,241.51,675.98,44
CPT,95724,Eeg phy/qhp>60<84 hr w/veeg,,,304.71,847.5,44
CPT,95725,Eeg phy/qhp>84 hr w/o vid,,,275.65,775.91,44
CPT,95726,Eeg phy/qhp>84 hr w/veeg,,,386.83,1078.75,44
CPT,95782,HC POLYSOM <6 YRS 4> PARAMTRS LESS THAN 7 HRS,5439.26,4079.44,65.27,4895.33,119
CPT,95782,Polysom <6 yrs 4/> paramtrs,,,119.95,2491.31,99
CPT,95783,HC POLYSOM <6 YRS CPAP/BILVL,7473.41,5605.06,89.68,6726.07,119
CPT,95783,Polysom <6 yrs cpap/bilvl,,,130.84,2640.49,99
CPT,95800,Slp stdy unattended,,,39.39,332.14,99
CPT,95801,Slp stdy unatnd w/anal,,,39.39,253.14,99
CPT,95803,Actigraphy testing,,,41.44,337.54,99
CPT,95803,"HC ACTIGRAPHY TESTING, 14 DAYS",768.32,576.24,9.22,691.49,119
CPT,95805,HC MLT SLEEP LATENCY OR MAINT OF WAKEFULNESS TSTG,2860.73,2145.55,34.33,2574.66,119
CPT,95805,Multiple sleep latency test,,,55.33,1942.0,120
CPT,95806,HC SLEEP STUDY UNATTENDED,870.98,653.24,10.45,783.88,119
CPT,95806,HC SLEEP STUDY UNATTENDED LIMITED,870.98,653.24,10.45,783.88,119
CPT,95806,Sleep study unatt&resp efft,,,42.73,250.25,99
CPT,95807,HC SLEEP STUDY; ATTENDED,1896.67,1422.5,22.76,1707.0,476
CPT,95807,Sleep study attended,,,57.41,1942.0,101
CPT,95808,Polysom any age 1-3> param,,,80.49,1942.0,120
CPT,95810,HC BASELINE SLEEP STUDY,4937.95,3703.46,59.26,4444.16,119
CPT,95810,Polysom 6/> yrs 4/> param,,,114.95,1942.0,120
CPT,95811,HC SLEEP APNEA STUDY W/CPAP TITR,5843.23,4382.42,70.12,5258.91,119
CPT,95811,HC SLEEP APNEA STUDY W/CPAP TITR LESS THAN 6 HRS,5945.7,4459.27,71.35,5351.13,119
CPT,95811,Polysom 6/>yrs cpap 4/> parm,,,119.28,1942.0,120
CPT,95812,Eeg 41-60 minutes,,,54.4,891.47,99
CPT,95812,HC EEG UP TO 1 HOUR,1094.81,821.11,13.14,985.33,119
CPT,95813,Eeg extnd mntr 61-119 min,,,82.39,1138.57,99
CPT,95813,HC EEG GREATER THAN 1 HOUR,681.27,510.95,8.18,613.14,119
CPT,95816,Eeg awake and drowsy,,,54.4,993.39,99
CPT,95816,HC EEG AWAKE/DROWSY,844.83,633.62,10.14,760.35,119
CPT,95819,Eeg awake and asleep,,,54.4,1155.6,99
CPT,95819,HC EEG AWAKE/ASLEEP,922.26,691.7,11.07,830.03,119
CPT,95822,Eeg coma or sleep only,,,54.72,1068.98,99
CPT,95822,HC EEG COMA OR SLEEP ONLY,684.76,513.57,8.22,616.28,119
CPT,95824,Eeg cerebral death only,,,37.55,590.56,55
CPT,95824,HC EEG CEREBRAL SILENCE,1041.45,781.09,12.5,937.3,238
CPT,95829,HC ELECTROCORTICOGRAM DURING SURGERY,2011.3,1508.48,24.14,1810.17,119
CPT,95829,Surgery electrocorticogram,,,318.16,4467.36,80
CPT,95830,Insert electrodes for eeg,,,88.38,1690.14,44
CPT,95836,Ecog impltd brn npgt <30 d,,,35.75,279.54,62
CPT,95851,Range of motion measurements,,,6.59,62.98,63
CPT,95852,Range of motion measurements,,,4.92,53.33,63
CPT,95857,Cholinesterase challenge,,,27.61,346.59,63
CPT,95860,HC EMG 1 EXTREMITY,577.29,432.97,6.93,519.56,119
CPT,95860,Needle emg 1 extremity,,,48.77,286.94,99
CPT,95861,HC EMG 2 EXTREMITIES,878.87,659.15,10.55,790.98,119
CPT,95861,Needle emg 2 extremities,,,75.92,401.73,99
CPT,95863,Needle emg 3 extremities,,,95.21,544.71,99
CPT,95864,Needle emg 4 extremities,,,101.43,576.0,99
CPT,95865,HC NEEDLE ELECTROMYOGRAPHY; LARYNX,293.33,220.0,3.52,264.0,119
CPT,95865,Needle emg larynx,,,64.62,379.84,99
CPT,95866,Needle emg hemidiaphragm,,,59.91,337.96,135
CPT,95867,Ndl emg cranial nrv musc uni,,,40.18,346.59,99
CPT,95868,HC EMG CRANIAL NERVE BILATERAL,846.1,634.58,10.15,761.49,119
CPT,95868,Ndl emg cranial nrv musc bi,,,59.67,346.59,99
CPT,95869,HC EMG THORACIC PARASPINAL MUSCLE,265.31,198.98,3.18,238.78,119
CPT,95869,Ndl emg thrc paraspinal musc,,,19.09,346.59,99
CPT,95870,Ndl emg lmtd std musc 1 xtr,,,18.77,206.07,99
CPT,95872,HC EMG SINGLE FIBER,712.01,534.01,8.54,640.81,119
CPT,95872,Ndl emg single fiber eltrd,,,46.73,482.91,99
CPT,95873,Guide nerv destr elec stim,,,18.79,175.51,80
CPT,95874,Guide nerv destr needle emg,,,18.79,189.11,80
CPT,95874,HC GUIDE NERV DESTR NEEDLE EMG,337.78,253.34,4.05,304.0,119
CPT,95875,Limb exercise test,,,55.71,312.41,99
CPT,95885,HC MUSC TST DONE W/NERV TST LIMITED,531.78,398.84,6.38,478.6,119
CPT,95885,HC NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,605.34,454.0,7.26,544.81,119
CPT,95885,Musc tst done w/nerv tst lim,,,17.49,154.15,116
CPT,95886,HC MUSC TEST DONE W/N TEST COMPLETE,447.16,335.37,5.37,402.44,119
CPT,95886,HC NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,719.91,539.93,8.64,647.92,119
CPT,95886,Musc test done w/n test comp,,,43.81,243.01,116
CPT,95887,HC MUSC TST DONE W/N TST NONEXT,435.0,326.25,5.22,391.5,119
CPT,95887,Musc tst done w/n tst nonext,,,35.9,211.53,116
CPT,95905,Motor &/ sens nrve cndj test,,,2.62,452.32,99
CPT,95907,HC NERVE CONDUCTION STUDIES 1-2 STUDIES,1050.67,788.0,12.61,945.6,119
CPT,95907,HC NRV CNDJ TST 1-2 STUDIES,367.97,275.98,4.42,331.17,119
CPT,95907,Nvr cndj tst 1-2 studies,,,35.44,231.15,99
CPT,95908,HC NRV CNDJ TST 3-4 STUDIES,541.74,406.3,6.5,487.57,119
CPT,95908,Nrv cndj tst 3-4 studies,,,43.91,346.59,99
CPT,95909,HC NERVE CONDUCTION STUDIES 5-6 STUDIES,1505.02,1128.77,18.06,1354.52,119
CPT,95909,HC NRV CNDJ TST 5-6 STUDIES,880.2,660.15,10.56,792.18,119
CPT,95909,Nrv cndj tst 5-6 studies,,,52.7,346.59,99
CPT,95910,HC NERVE CONDUCTION STUDIES 7-8 STUDIES,1926.33,1444.75,23.12,1733.7,119
CPT,95910,HC NRV CNDJ TEST 7-8 STUDIES,1165.88,874.41,13.99,1049.29,119
CPT,95910,Nrv cndj test 7-8 studies,,,67.45,452.94,99
CPT,95911,HC NERVE CONDUCTION STUDIES 9-10 STUDIES,2196.42,1647.32,26.36,1976.78,119
CPT,95911,HC NRV CNDJ TEST 9-10 STUDIES,1484.29,1113.22,17.81,1335.86,119
CPT,95911,Nrv cndj test 9-10 studies,,,77.49,590.56,99
CPT,95912,HC NERVE CONDUCTION STUDIES 11-12 STUDIES,2438.17,1828.63,29.26,2194.35,119
CPT,95912,HC NRV CNDJ TEST 11-12 STUDIES,1743.28,1307.46,20.92,1568.95,119
CPT,95912,Nrv cndj test 11-12 studies,,,87.19,634.81,99
CPT,95913,HC NRV CNDJ TEST 13/> STUDIES,2982.12,2236.59,35.79,2683.91,119
CPT,95913,Nrv cndj test 13/> studies,,,96.29,743.52,99
CPT,95919,Quan puplmtry phy/qhp uni/bi,,,5.31,143.47,98
CPT,95921,Autonomic nrv parasym inervj,,,40.77,225.42,99
CPT,95922,Autonomic nrv adrenrg inervj,,,44.69,231.74,99
CPT,95923,Autonomic nrv syst funj test,,,43.28,305.27,99
CPT,95923,HC TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,3776.43,2832.32,45.32,3398.79,119
CPT,95924,Ans parasymp & symp w/tilt,,,61.78,385.04,99
CPT,95925,HC SOMATOSENSORY EVOK POT UP EXTR,1853.79,1390.34,22.25,1668.41,119
CPT,95925,Somatosensory testing,,,27.32,393.93,99
CPT,95926,Somatosensory testing,,,26.42,360.81,99
CPT,95927,Somatosensory testing,,,26.1,452.52,99
CPT,95928,C motor evoked uppr limbs,,,76.1,1132.36,99
CPT,95929,C motor evoked lwr limbs,,,75.81,611.26,99
CPT,95930,HC VIS EVOKED POTENTIAL PER TEST,1239.37,929.53,14.87,1115.43,119
CPT,95930,Visual ep test cns w/i&r,,,17.8,346.59,99
CPT,95933,Blink reflex test,,,30.27,207.42,99
CPT,95933,HC BLINK REFLEX TEST,519.44,389.58,6.23,467.5,119
CPT,95937,HC EMG NEUROMUSCULA JUNCTION TEST,1005.13,753.85,12.06,904.62,119
CPT,95937,Neuromuscular junction test,,,33.24,262.12,99
CPT,95938,Somatosensory testing,,,43.49,953.83,99
CPT,95939,C motor evoked upr&lwr limbs,,,113.69,1418.34,99
CPT,95940,Ionm in operatng room 15 min,,,31.23,85.18,44
CPT,95954,Eeg monitoring/giving drugs,,,105.7,992.36,99
CPT,95955,Eeg during surgery,,,51.09,468.13,80
CPT,95955,HC EEG DURING SURGERY,2248.75,1686.56,26.98,2023.88,119
CPT,95957,Eeg digital analysis,,,98.0,751.74,80
CPT,95957,HC EEG DIGITAL ANALYSIS,2000.2,1500.15,24.0,1800.18,238
CPT,95958,Eeg monitoring/function test,,,215.78,1832.99,99
CPT,95958,HC WADA TESTING NEUROSTIM,2171.22,1628.42,26.05,1954.1,119
CPT,95961,Electrode stimulation brain,,,144.93,1132.36,99
CPT,95961,HC FUNCTION CORTICAL MAP 1ST HOUR,4267.04,3200.28,51.2,3840.34,119
CPT,95962,Electrode stim brain add-on,,,95.35,736.26,80
CPT,95965,Meg spontaneous,,,398.06,1132.36,55
CPT,95966,Meg evoked single,,,202.93,1132.36,55
CPT,95967,Meg evoked each addl,,,177.85,177.85,36
CPT,95970,Alys npgt w/o prgrmg,,,18.05,143.47,63
CPT,95971,Alys smpl sp/pn npgt w/prgrm,,,37.9,126.18,63
CPT,95972,Alys cplx sp/pn npgt w/prgrm,,,39.45,149.23,63
CPT,95972,HC NEUROSTIM ANAL COMPLEX W/PRORAM,644.92,483.69,7.74,580.43,119
CPT,95976,Alys smpl cn npgt prgrmg,,,35.75,100.4,63
CPT,95977,Alys cplx cn npgt prgrmg,,,50.55,134.15,63
CPT,95980,Io anal gast n-stim init,,,43.98,118.64,44
CPT,95981,Io anal gast n-stim subsq,,,17.26,102.88,63
CPT,95982,Io ga n-stim subsq w/reprog,,,35.27,156.8,63
CPT,95983,Alys brn npgt prgrmg 15 min,,,47.89,131.22,63
CPT,95984,Alys brn npgt prgrmg addl 15,,,42.01,114.42,44
CPT,95990,Spin/brain pump refil & main,,,84.01,369.17,63
CPT,95991,Spin/brain pump refil & main,,,39.07,328.55,63
CPT,95992,Canalith repositioning proc,,,29.38,112.42,63
CPT,95992,HC OT CANALITH RESPOSIONING PER DAY,121.13,90.85,1.45,109.02,119
CPT,95992,HC PT CANALITH REPOSITIONING PER DAY,174.83,131.12,2.1,157.35,119
CPT,95999,Unlisted neurological dx px,,,130.29,174.14,19
CPT,96000,Motion analysis video/3d,,,81.58,590.56,63
CPT,96001,Motion test w/ft press meas,,,107.34,1132.36,63
CPT,96002,Dynamic surface emg,,,21.03,346.59,63
CPT,96003,Dynamic fine wire emg,,,16.28,45.14,44
CPT,96004,Phys review of motion tests,,,103.83,282.22,45
CPT,96020,Functional brain mapping,,,154.85,435.75,44
CPT,96020,HC FUNCTIONAL BRAIN MAPPING,956.39,717.29,11.48,860.75,119
CPT,96040,Genetic counseling 30 min,,,113.51,135.44,8
CPT,96041,Genetic counseling svc ea 30,,,110.3,131.61,8
CPT,96041,HC GENETIC COUNSELING SVC EA 30,340.2,255.15,4.08,306.18,119
CPT,96105,Assessment of aphasia,,,91.31,256.95,63
CPT,96105,HC ST ASSESS APHASIA/REPORT PER HR,737.28,552.96,8.85,663.55,119
CPT,96110,Developmental screen w/score,,,24.9,298.52,9
CPT,96112,Devel tst phys/qhp 1st hr,,,122.23,349.34,63
CPT,96112,HC OT NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,1044.8,783.6,12.54,940.32,119
CPT,96112,HC PT NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,946.36,709.77,11.36,851.72,119
CPT,96112,HC ST NEURODEVELOPMENT EVAL INITIAL 1ST HOUR,833.01,624.76,10.0,749.71,119
CPT,96113,Devel tst phys/qhp ea addl,,,54.87,147.2,44
CPT,96113,HC PT NEURODEVELOPMENT EVAL EACH ADDL 30 MINS,512.48,384.36,6.15,461.23,119
CPT,96116,HC NEUROBEHAVIORAL EXAM,366.15,274.61,4.39,329.54,119
CPT,96116,Nubhvl xm phys/qhp 1st hr,,,78.87,346.59,63
CPT,96121,Nubhvl xm phy/qhp ea addl hr,,,66.34,201.51,44
CPT,96125,Cognitive test by hc pro,,,96.63,271.92,63
CPT,96125,HC OT COGNITIVE EVAL/REPORT PER HR,747.43,560.57,8.97,672.69,119
CPT,96125,HC ST COGNITIVE EVAL/REPORT PER HR,161.83,121.37,1.94,145.65,119
CPT,96127,Brief emotional/behav assmt,,,4.37,43.69,63
CPT,96127,HC BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,162.45,121.84,1.95,146.2,119
CPT,96130,Psycl tst eval phys/qhp 1st,,,106.94,346.59,63
CPT,96131,Psycl tst eval phys/qhp ea,,,75.75,229.34,44
CPT,96132,Nrpsyc tst eval phys/qhp 1st,,,104.43,590.56,63
CPT,96133,Nrpsyc tst eval phys/qhp ea,,,75.75,257.37,44
CPT,96136,PBB PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,124.22,93.16,1.49,111.8,119
CPT,96136,Psycl/nrpsyc tst phy/qhp 1st,,,22.99,143.47,63
CPT,96137,PBB PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,114.01,85.51,1.37,102.61,119
CPT,96137,Psycl/nrpsyc tst phy/qhp ea,,,17.76,97.05,44
CPT,96138,Psycl/nrpsyc tech 1st,,,31.67,452.32,63
CPT,96139,Psycl/nrpsyc tst tech ea,,,32.61,88.34,44
CPT,96146,Psycl/nrpsyc tst auto result,,,2.18,29.28,63
CPT,96156,HC HLTH BHV ASSMT/REASSESSMENT,248.03,186.02,2.98,223.23,119
CPT,96156,Hlth bhv assmt/reassessment,,,83.28,273.88,63
CPT,96158,HC HLTH BHV INVTJ INDIV 1ST 30 MINS,169.55,127.16,2.03,152.6,119
CPT,96158,Hlth bhv ivntj indiv 1st 30,,,56.58,188.03,63
CPT,96159,HC HLTH BHV INVTJ INDIV EACH ADDL 15 MINS,60.26,45.2,0.72,54.23,119
CPT,96159,Hlth bhv ivntj indiv ea addl,,,19.43,64.5,44
CPT,96160,Pt-focused hlth risk assmt,,,2.51,37.93,63
CPT,96161,Caregiver health risk assmt,,,2.51,37.93,63
CPT,96164,Hlth bhv ivntj grp 1st 30,,,8.66,37.93,63
CPT,96165,Hlth bhv ivntj grp ea addl,,,4.02,13.42,44
CPT,96167,Hlth bhv ivntj fam 1st 30,,,28.56,199.74,63
CPT,96168,Hlth bhv ivntj fam ea addl,,,21.13,71.59,44
CPT,96170,Hlth bhv ivntj fam wo pt 1st,,,172.78,206.16,8
CPT,96171,Hlth bhv ivntj fam w/o pt ea,,,62.54,74.62,8
CPT,96202,Mlt fam grp bhv train 1st 60,,,17.17,63.77,27
CPT,96203,Mlt fam grp bhv train ea add,,,4.94,16.01,27
CPT,96360,HC IV INFUSN HYDRATION INITIAL HR,734.9,551.17,8.82,661.41,119
CPT,96360,Hydration iv infusion init,,,30.84,234.5,63
CPT,96361,HC IV INFUSN HYDRATION EACH ADDL HR,455.25,341.44,5.46,409.72,119
CPT,96361,Hydrate iv infusion add-on,,,12.13,51.35,63
CPT,96365,HC IV INFUSION THERAP INITIAL HR,695.8,521.85,8.35,626.22,119
CPT,96365,Ther/proph/diag iv inf init,,,60.38,234.5,63
CPT,96366,HC IV INFUSION THERAP EACH ADDL HR,400.39,300.29,4.8,360.35,119
CPT,96366,Ther/proph/diag iv inf addon,,,19.57,51.35,63
CPT,96367,HC IV INFUSION THERAP SEQ 1 HR,535.84,401.88,6.43,482.26,119
CPT,96367,Tx/proph/dg addl seq iv inf,,,27.44,79.22,63
CPT,96368,HC IV INFUSION THERAP CONCURRENT,571.19,428.39,6.85,514.07,119
CPT,96368,Ther/diag concurrent inf,,,18.92,32.75,44
CPT,96369,HC SUBCU THER INFUSION UP TO 1 HR INCL PUMP SET UP,722.08,541.56,8.66,649.87,119
CPT,96369,Sc ther infusion up to 1 hr,,,131.61,234.5,63
CPT,96370,Sc ther infusion addl hr,,,14.87,51.35,63
CPT,96371,Sc ther infusion reset pump,,,52.72,98.43,63
CPT,96372,HC INJECTION IM/SC THERAPEUTIC,231.12,173.34,2.77,208.01,119
CPT,96372,Ther/proph/diag inj sc/im,,,13.59,79.22,63
CPT,96373,Ther/proph/diag inj ia,,,17.35,234.5,63
CPT,96374,HC IVP INITIAL THERAPEUTIC,350.34,262.76,4.2,315.31,119
CPT,96374,Ther/proph/diag inj iv push,,,35.24,234.5,63
CPT,96375,HC IVP ADDL DIFF DRUG THERAP,184.65,138.49,2.22,166.18,119
CPT,96375,Tx/pro/dx inj new drug addon,,,14.66,51.35,63
CPT,96376,HC IVP ADDL SAME DRUG THERAPEUTIC,154.88,116.16,1.86,139.39,119
CPT,96377,Applicaton on-body injector,,,17.66,51.35,63
CPT,96377,HC APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,157.24,117.93,1.89,141.52,119
CPT,96379,Unl ther/prop/diag inj/inf,,,44.23,51.35,19
CPT,96380,Admn rsv monoc antb im cnsl,,,21.66,60.05,9
CPT,96380,HC ADMN RSV MONOC ANTB SEASONAL DOS IM CNSL PHY/QHP,59.57,44.68,0.71,53.61,119
CPT,96381,Admn rsv monoc antb im njx,,,18.7,51.14,9
CPT,96381,HC ADMN RSV MONOCLONAL ANTB SEASONAL DOSE IM NJX,59.57,44.68,0.71,53.61,119
CPT,96381,HC VFC - ADMN RSV MONOCLONAL ANTB SEASONAL DOSE IM NJX,20.72,15.54,0.25,18.65,119
CPT,96401,Chemo anti-neopl sq/im,,,68.22,139.88,63
CPT,96401,HC CHEMO SQ OR IM NON-HORMONAL,459.39,344.54,5.51,413.45,119
CPT,96402,Chemo hormon antineopl sq/im,,,32.13,79.22,63
CPT,96402,HC CHEMO SQ OR IM HORMONAL,277.22,207.92,3.33,249.5,119
CPT,96405,Chemo intralesional up to 7,,,28.21,163.29,63
CPT,96405,HC CHEMO INTRALESIONAL UP TO 7,2042.36,1531.77,24.51,1838.12,119
CPT,96406,Chemo intralesional over 7,,,43.3,255.03,63
CPT,96406,HC CHEMO INTRALESIONAL OVER 7,2781.55,2086.16,33.38,2503.4,119
CPT,96409,Chemo iv push sngl drug,,,94.93,369.17,63
CPT,96409,HC CHEMO IV PUSH INITIAL,683.9,512.92,8.21,615.51,119
CPT,96411,Chemo iv push addl drug,,,52.2,106.24,63
CPT,96411,HC CHEMO IV PUSH EACH ADDL,331.6,248.7,3.98,298.44,119
CPT,96413,Chemo iv infusion 1 hr,,,122.94,369.17,63
CPT,96413,HC CHEMO INFUSION INITIAL 1ST HR,1002.35,751.76,12.03,902.12,119
CPT,96415,Chemo iv infusion addl hr,,,26.79,79.22,63
CPT,96415,HC CHEMO INFUSION EACH ADDL HOUR,573.11,429.83,6.88,515.8,119
CPT,96416,Chemo prolong infuse w/pump,,,120.57,369.17,63
CPT,96416,HC CHEMO PROLONGED WITH PUMP,866.23,649.67,10.39,779.61,119
CPT,96417,Chemo iv infus each addl seq,,,60.69,124.37,63
CPT,96417,HC CHEMO INFUSION SEQNTL 1 HR,571.56,428.67,6.86,514.4,119
CPT,96420,Chemo ia push tecnique,,,96.64,369.17,63
CPT,96420,HC CHEMO INTRA ARTERIAL PUSH,892.09,669.07,10.71,802.88,119
CPT,96422,Chemo ia infusion up to 1 hr,,,148.33,369.17,63
CPT,96423,Chemo ia infuse each addl hr,,,44.23,141.63,63
CPT,96425,Chemotherapy infusion method,,,158.98,369.17,63
CPT,96440,Chmotx admn plrl cav thrcnts,,,128.66,1455.78,63
CPT,96446,Chemotx admn pertl cav impl,,,24.11,369.17,63
CPT,96450,Chemotherapy into cns,,,74.78,369.17,63
CPT,96450,HC CHEMO CNS INTRATHECAL W/LP,1444.22,1083.16,17.33,1299.8,119
CPT,96450,HC CHEMOTHERAPY INTO CNS,1444.22,1083.16,17.33,1299.8,119
CPT,96521,HC REFILL/MAINTAIN PORTABLE PUMP,395.02,296.26,4.74,355.52,119
CPT,96521,Refill/maint portable pump,,,118.68,241.31,63
CPT,96522,Refill/maint pump/resvr syst,,,109.58,234.5,63
CPT,96523,HC VENOUS ACCESS DEVICE IRRIGATION,276.55,207.41,3.32,248.9,119
CPT,96523,Irrig drug delivery device,,,23.93,66.11,63
CPT,96542,Chemotherapy injection,,,40.67,369.17,63
CPT,96542,HC CHEMO INJ VIA SQ RESERVOIR,524.29,393.22,6.29,471.86,119
CPT,96547,Intraop hipec px 1st 60 min,,,805.3,960.87,8
CPT,96548,Ntraop hipec px ea add 30min,,,368.92,440.19,8
CPT,96549,HC CHEMO IV INFUSION CONCURRENT,645.91,484.43,7.75,581.32,119
CPT,96549,Unlisted chemotherapy px,,,44.23,51.35,19
CPT,96567,Pdt dstr prmlg les skn,,,132.09,335.45,63
CPT,96570,Photodynmc tx 30 min add-on,,,53.2,143.4,44
CPT,96571,Photodynamic tx addl 15 min,,,24.52,66.18,44
CPT,96573,Pdt dstr prmlg les phys/qhp,,,190.49,561.73,63
CPT,96574,Dbrdmt prmlg les w/pdt,,,190.49,693.2,63
CPT,96900,Actinotherapy uv light,,,22.89,63.68,63
CPT,96902,Mcrscp xm hair pluck/clipped,,,48.35,57.69,8
CPT,96904,Whole body photography,,,65.88,169.01,44
CPT,96910,Photchmtx tar&uvb/ptrltm&uvb,,,56.94,298.08,63
CPT,96912,Photochemotherapy puva,,,56.94,253.06,63
CPT,96913,Photochemotx sev dermatoses,,,143.05,444.68,63
CPT,96920,Excimer lsr psriasis<250sqcm,,,61.48,364.28,63
CPT,96921,Excimer lsr psriasis 250-500,,,69.66,389.34,63
CPT,96922,Excimer lsr psriasis>500sqcm,,,112.69,486.82,63
CPT,96931,Rcm img acquisj&i&r 1st les,,,162.88,429.5,44
CPT,96932,Rcm img acquisj only 1st les,,,120.16,315.05,44
CPT,96933,Rcm i&r only 1st lesion,,,42.72,114.42,44
CPT,96934,Rcm img acquisj&i&r ea addl,,,113.53,304.42,44
CPT,96935,Rcm img acquisj only ea addl,,,73.11,193.63,44
CPT,96936,Rcm i&r only ea addl lesion,,,40.42,110.79,44
CPT,96999,Unlisted spec derm svc/px,,,190.49,221.16,19
CPT,97007,Mchnl sclp cool meas fitg,,,1437.53,1437.53,9
CPT,97010,Hot or cold packs therapy,,,14.53,17.34,8
CPT,97012,HC PT TRACTION MECHANICAL 1+ AREAS,120.36,90.27,1.44,108.32,119
CPT,97012,Mechanical traction therapy,,,13.6,38.89,63
CPT,97014,Electric stimulation therapy,,,27.97,33.37,8
CPT,97014,HC OT E-STIM UNATTENDED NON-WOUND,97.81,73.36,1.17,88.03,119
CPT,97014,HC PT E-STIM UNATTENDED NON-WOUND,179.04,134.28,2.15,161.14,119
CPT,97016,HC PT VASOPNEUM DEVICE 1+ AREAS,151.05,113.29,1.81,135.95,119
CPT,97016,Vasopneumatic device therapy,,,11.25,31.66,63
CPT,97018,HC OT PARAFFIN BATH THERAPY 1+ AREAS,87.84,65.88,1.05,79.06,119
CPT,97018,HC PT PARAFFIN BATH THERAPY 1+ AREAS,118.91,89.18,1.43,107.02,119
CPT,97018,Paraffin bath therapy,,,5.41,16.49,63
CPT,97022,HC PT WHIRLPOOL 1+ AREAS,284.97,213.73,3.42,256.47,119
CPT,97022,Whirlpool therapy,,,14.85,41.79,63
CPT,97024,Diathermy eg microwave,,,6.77,19.05,63
CPT,97024,HC PT DIATHERMY 1+ AREAS,123.57,92.68,1.48,111.21,119
CPT,97026,HC PT LIGHT THERAPY 1+ AREAS,59.02,44.26,0.71,53.12,119
CPT,97026,Infrared therapy,,,6.35,18.21,63
CPT,97028,Ultraviolet therapy,,,7.72,21.72,63
CPT,97032,Appl modality 1+estim ea 15,,,13.82,38.89,63
CPT,97032,HC OT E-STIM ATTENDED PER 15 MIN,156.46,117.34,1.88,140.81,119
CPT,97032,HC PT E-STIM ATTENDED PER 15 MIN,157.87,118.4,1.89,142.08,119
CPT,97033,App mdlty 1+iontphrsis ea 15,,,18.07,50.85,63
CPT,97033,HC OT IONTOPHORESIS PER 15 MIN,141.36,106.02,1.7,127.22,119
CPT,97033,HC PT IONTOPHORESIS PER 15 MIN,191.36,143.52,2.3,172.22,119
CPT,97034,App mdlty 1+cntrst bth ea 15,,,13.13,36.95,63
CPT,97034,HC OT CONTRAST BATH PER 15 MIN,156.36,117.27,1.88,140.72,119
CPT,97034,HC PT CONTRAST BATH PER 15 MIN,98.25,73.69,1.18,88.42,119
CPT,97035,App mdlty 1+ultrasound ea 15,,,13.43,37.79,63
CPT,97035,HC OT ULTRASOUND PER 15 MIN,77.67,58.25,0.93,69.9,119
CPT,97035,HC PT ULTRASOUND PER 15 MIN,106.52,79.89,1.28,95.87,119
CPT,97036,App mdlty 1+hubbrd tnk ea 15,,,32.6,91.74,63
CPT,97037,Appl modality 1+lllt po pain,,,37.63,43.69,18
CPT,97037,HC OT LOW LEVEL LASER THERAPY 97037,95.34,71.5,1.14,85.81,238
CPT,97039,HC OT FLUIDOTHERAPY,128.41,96.31,1.54,115.57,119
CPT,97039,HC PT FLUIDOTHERAPY,173.83,130.37,2.09,156.45,119
CPT,97110,HC OT THERAPEUTIC EX PER 15 MIN,146.87,110.15,1.76,132.18,119
CPT,97110,HC PT THERAPEUTIC EX PER 15 MIN,136.83,102.62,1.64,123.15,119
CPT,97110,HC ST THERAPEUTIC EXERCISE/15 MIN,148.19,111.14,1.78,133.37,119
CPT,97110,Therapeutic exercises,,,27.83,84.0,84
CPT,97112,HC OT NEUROMUS RE-ED PER 15 MIN,156.29,117.22,1.88,140.66,119
CPT,97112,HC PT NEUROMUS RE-ED PER 15 MIN,157.7,118.28,1.89,141.93,119
CPT,97112,HC ST NEUROMM RE-ED 15 MIN,103.56,77.67,1.24,93.2,119
CPT,97112,Neuromuscular reeducation,,,30.96,87.12,63
CPT,97113,Aquatic therapy/exercises,,,35.14,98.89,63
CPT,97113,HC OT AQUATIC THERAPY/EX PER 15 MIN,151.01,113.26,1.81,135.91,119
CPT,97113,HC PT AQUATIC THERAPY/EX PER 15 MIN,159.0,119.25,1.91,143.1,119
CPT,97116,Gait training therapy,,,27.83,78.31,63
CPT,97116,HC OT GAIT TRAINING 15 MIN,162.07,121.55,1.94,145.86,119
CPT,97116,HC PT GAIT TRAINING 15 MIN,163.53,122.65,1.96,147.18,119
CPT,97124,HC OT THERAPEUTIC MASSAGE PER 15 MIN,145.47,109.1,1.75,130.92,119
CPT,97124,HC PT THERAPEUTIC MASSAGE PER 15 MIN,146.78,110.08,1.76,132.1,119
CPT,97124,HC ST THERAPEUTIC MASSAGE PER 15 MIN,148.66,111.5,1.78,133.79,119
CPT,97124,Massage therapy,,,28.52,80.25,63
CPT,97129,HC OT THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,166.39,124.79,2.0,149.75,119
CPT,97129,HC PT THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,167.89,125.92,2.01,151.1,119
CPT,97129,HC ST THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,161.38,121.04,1.94,145.24,119
CPT,97129,Ther ivntj 1st 15 min,,,21.3,59.93,63
CPT,97130,HC OT THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,166.39,124.79,2.0,149.75,119
CPT,97130,HC PT THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,134.28,100.71,1.61,120.85,119
CPT,97130,HC ST THER IVNTJ COG FUNCJ CNTCT EACH ADDL 15 MINUTES,161.38,121.04,1.94,145.24,119
CPT,97130,Ther ivntj ea addl 15 min,,,20.35,57.27,63
CPT,97139,HC OT UNLISTED THERA PROC EA 15 MIN,177.07,132.8,2.12,159.36,119
CPT,97140,"HC OT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN",155.42,116.56,1.87,139.88,119
CPT,97140,"HC PT MANUAL THERAPY (SOFT TISSUE, MOB, MANIPULATION, TRACTION) PER 15 MIN",156.82,117.62,1.88,141.14,119
CPT,97140,Manual therapy 1/> regions,,,26.11,73.95,63
CPT,97150,Group therapeutic procedures,,,16.92,47.62,63
CPT,97150,HC OT THERAPEUTIC PROC GROUP,211.11,158.33,2.53,190.0,119
CPT,97150,HC PT THERAPEUTIC PROC-GROUP,213.0,159.75,2.56,191.7,119
CPT,97151,Bhv id assmt by phys/qhp,,,88.68,102.96,18
CPT,97152,Bhv id suprt assmt by 1 tech,,,88.68,102.96,18
CPT,97153,Adaptive behavior tx by tech,,,88.68,102.96,18
CPT,97154,Grp adapt bhv tx by tech,,,28.56,37.93,18
CPT,97155,Adapt behavior tx phys/qhp,,,154.03,179.72,18
CPT,97156,Fam adapt bhv tx gdn phy/qhp,,,28.56,37.93,18
CPT,97157,Mult fam adapt bhv tx gdn,,,28.56,37.93,18
CPT,97158,Grp adapt bhv tx by phy/qhp,,,28.56,37.93,18
CPT,97161,HC PT EVAL LOW COMPLEXITY,354.86,266.14,4.26,319.37,119
CPT,97161,Pt eval low complex 20 min,,,94.78,266.71,63
CPT,97162,HC CLIENT ONLY HRH PHYSICAL THERAPY EVALUATION PER SESSION,444.13,333.1,5.33,399.72,119
CPT,97162,HC PT EVAL MODERATE COMPLEXITY,444.13,333.1,5.33,399.72,119
CPT,97162,Pt eval mod complex 30 min,,,94.78,266.71,63
CPT,97163,HC PT EVAL HIGH COMPLEXITY,535.83,401.87,6.43,482.25,119
CPT,97163,Pt eval high complex 45 min,,,94.78,266.71,63
CPT,97164,HC PT RE-EVALUATION,275.27,206.45,3.3,247.74,119
CPT,97164,Pt re-eval est plan care,,,65.15,183.33,63
CPT,97165,HC OT EVAL LOW COMPLEXITY,298.24,223.68,3.58,268.42,119
CPT,97165,Ot eval low complex 30 min,,,97.19,273.49,63
CPT,97166,HC CLIENT ONLY HRH OCCUPATIONAL THERAPY EVAL PER SESSION,585.72,439.29,7.03,527.15,119
CPT,97166,HC OT EVAL MODERATE COMPLEXITY,585.72,439.29,7.03,527.15,119
CPT,97166,Ot eval mod complex 45 min,,,97.19,273.49,63
CPT,97167,HC OT EVAL HIGH COMPLEXITY,726.22,544.66,8.71,653.6,119
CPT,97167,Ot eval high complex 60 min,,,97.19,273.49,63
CPT,97168,HC OT RE-EVALUATION,332.57,249.43,3.99,299.31,119
CPT,97168,Ot re-eval est plan care,,,66.27,188.42,63
CPT,97530,HC OT THERAPEUTIC ACTIVITY 15 MIN,158.84,119.13,1.91,142.96,119
CPT,97530,HC PT THERAPEUTIC ACTIVITY 15 MIN,160.27,120.2,1.92,144.24,119
CPT,97530,HC ST THERAPEUTIC ACTIVITY 15 MIN,149.44,112.08,1.79,134.5,119
CPT,97530,Therapeutic activities,,,33.24,93.53,63
CPT,97533,HC OT SENSORY INTEG ACT PER 15 MIN,157.97,118.48,1.9,142.17,119
CPT,97533,HC PT SENSORY INTEG ACT PER 15 MIN,116.24,87.18,1.39,104.62,119
CPT,97533,HC ST SENSORY INTEG ACT PER 15 MIN,157.88,118.41,1.89,142.09,119
CPT,97533,Sensory integration,,,57.47,161.72,63
CPT,97535,HC OT ADL/SELF CARE PER 15 MIN,181.19,135.89,2.17,163.07,119
CPT,97535,HC PT ADL/SELF CARE PER 15 MIN,182.82,137.12,2.19,164.54,119
CPT,97535,HC ST ADL/SELF CARE PER 15 MIN,163.9,122.92,1.97,147.51,119
CPT,97535,Self care mngment training,,,30.85,86.81,63
CPT,97537,Community/work reintegration,,,30.61,86.13,62
CPT,97537,HC OT COMMUNITY/WORK/TRAINING 15 MIN,223.48,167.61,2.68,201.13,119
CPT,97537,HC PT COMMUNITY/WORK/TRAINING 15 MIN,178.08,133.56,2.14,160.27,119
CPT,97542,HC OT WHEELCHAIR MGMT 15 MIN,155.89,116.92,1.87,140.3,119
CPT,97542,HC PT WHEELCHAIR MGMT 15 MIN,157.29,117.97,1.89,141.56,119
CPT,97542,Wheelchair mngment training,,,29.71,83.6,63
CPT,97545,HC PT WORK HARDENING/CONDITIONING INIT 2 HRS,503.5,377.62,6.04,453.15,119
CPT,97546,HC PT WORK CONDITIONING/HARDENING EACH ADDL HR,238.9,179.18,2.87,215.01,119
CPT,97550,Caregiver traing 1st 30 min,,,44.46,142.81,27
CPT,97550,HC OT CAREGIVER TRAING 1ST 30 MIN,157.46,118.1,1.89,141.71,119
CPT,97550,HC PT CAREGIVER TRAING 1ST 30 MIN,157.47,118.1,1.89,141.72,119
CPT,97550,HC ST CAREGIVER TRAING 1ST 30 MIN,170.54,127.9,2.05,153.49,119
CPT,97551,Caregiver traing ea addl 15,,,23.88,70.38,27
CPT,97551,HC CAREGIVER TRAING EA ADDL 15,119.97,89.98,1.44,107.97,119
CPT,97551,HC OT CAREGIVER TRAING EA ADDL 15 MIN,91.59,68.69,1.1,82.43,119
CPT,97551,HC PT CAREGIVER TRAING EA ADDL 15 MIN,84.57,63.43,1.01,76.11,119
CPT,97551,HC ST CAREGIVER TRAING EA ADDL 15 MIN,91.59,68.69,1.1,82.43,119
CPT,97552,Group caregiver training,,,10.45,59.15,27
CPT,97552,HC GROUP CAREGIVER TRAINING,50.1,37.58,0.6,45.09,119
CPT,97552,HC OT GROUP CAREGIVER TRAINING IN HOME/COMM,40.08,30.06,0.48,36.07,119
CPT,97552,HC PT GROUP CAREGIVER TRAINING IN HOME/COMM,52.98,39.74,0.64,47.68,119
CPT,97552,HC ST GROUP CAREGIVER TRAINING IN HOME/COMM,53.61,40.21,0.64,48.25,119
CPT,97597,Dbrdmt opn wnd 1st 20 cm/<,,,34.76,258.6,63
CPT,97597,HC OT SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,545.64,409.23,6.55,491.08,119
CPT,97597,HC PT SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,624.53,468.4,7.49,562.08,119
CPT,97597,HC SELECT WOUND DEBRIDEMENT FIRST 2O SQ CM OR LESS,643.97,482.98,7.73,579.57,119
CPT,97598,Dbrdmt opn wnd addl 20cm/<,,,24.04,116.83,44
CPT,97598,HC OT SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,401.18,300.88,4.81,361.06,119
CPT,97598,HC PT SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,469.49,352.12,5.63,422.54,119
CPT,97598,HC SELECT WOUND DEBRIDEMENT EACH ADDL 20 SQ CM,616.095,462.07,7.07,578.94,238
CPT,97602,HC NON-SELECTIVE DEBRIDEMENT W/O ANESTH,377.37,283.03,4.53,339.63,119
CPT,97602,HC OT NON-SELECTIVE DEBRIDE W/O ANES,333.16,249.87,4.0,299.84,119
CPT,97602,HC PT NON-SELECTIVE DEBRIDE W/O ANES,431.93,323.95,5.18,388.74,119
CPT,97602,PBB RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,510.87,383.15,6.13,459.78,119
CPT,97602,Wound(s) care non-selective,,,190.49,221.16,19
CPT,97605,HC OT WOUND VAC <50 SQ CM,810.54,607.9,9.73,729.49,119
CPT,97605,HC PT WOUND THRP W/DME  <50 SQ CM,761.44,571.08,9.14,685.3,119
CPT,97605,HC WOUND THRP W/DME <50 SQ CM,900.6,675.45,10.81,810.54,119
CPT,97605,Neg prs wnd ther dme<50sqcm,,,24.27,221.16,63
CPT,97606,HC OT WOUND VAC >50 SQ CM,1037.73,778.3,12.45,933.96,119
CPT,97606,HC PT WOUND THRP W/DME >50 SQ CM,1055.81,791.86,12.67,950.23,119
CPT,97606,HC WOUND THRP W/DME >50 SQ CM,1270.5,952.88,15.25,1143.45,119
CPT,97606,Neg prs wnd ther dme>50 sqcm,,,26.27,444.68,63
CPT,97607,HC HH SN NEGATIVE PRESSURE WOUND THERAPY NON DME <50 SQ CM,801.78,601.34,9.62,721.6,119
CPT,97607,HC PT WOUND THRP W/O DME <50SQ CM,677.91,508.43,8.13,610.12,119
CPT,97607,HC WOUND THRP W/O DME <50 SQ CM,815.75,611.81,9.79,734.18,119
CPT,97607,Neg prs wnd thr ndme<50sqcm,,,21.28,850.87,63
CPT,97608,HC HH SN NEGATIVE PRESSURE WOUND THERAPY NON DME > 50 SQ CM,716.05,537.04,8.59,644.44,119
CPT,97608,HC PT WOUND THRP W/O DME >50SQ CM,1036.52,777.39,12.44,932.87,119
CPT,97608,HC WOUND THRP W/O DME >50 SQ CM,969.35,727.01,11.63,872.42,119
CPT,97608,Neg prs wnd ther ndme>50sqcm,,,24.48,887.7,63
CPT,97610,Low frequency non-thermal us,,,17.61,1045.32,63
CPT,97750,HC OT PHYS PERF TEST/MEAS/REP 15 MIN,154.65,115.99,1.86,139.18,119
CPT,97750,HC PT PHYS PERF TEST/MEAS/REP 15MIN,156.04,117.03,1.87,140.44,119
CPT,97750,Physical performance test,,,32.06,90.22,63
CPT,97755,Assistive technology assess,,,36.35,102.29,63
CPT,97755,HC OT ASSTV TECHN ASSMNT EA 15M,101.36,76.02,1.22,91.22,119
CPT,97755,HC PT ASSTV TECHN ASSMNT EA 15M,151.79,113.84,1.82,136.61,119
CPT,97760,HC OT INITIAL ORTHOTICS FIT/TRAIN PER 15 MIN,150.03,112.52,1.8,135.03,119
CPT,97760,HC PT INITIAL ORTHOTICS FIT/TRAIN PER 15 MIN,110.39,82.79,1.32,99.35,119
CPT,97760,Orthotic mgmt&traing 1st enc,,,43.94,123.65,63
CPT,97761,HC OT INITIAL PROSTHETIC TRAINING PER 15 MIN,136.98,102.74,1.64,123.28,119
CPT,97761,HC PT INITIAL PROSTHETIC TRAINING PER 15 MIN,131.23,98.42,1.57,118.11,119
CPT,97761,Prosthetic traing 1st enc,,,38.81,109.21,63
CPT,97763,HC OT SUBSEQ ORTH/PROSTHETIC TRAIN PER 15 MIN,142.84,107.13,1.71,128.56,119
CPT,97763,HC PT SUBSEQ ORTH/PROSTHETIC TRAIN PER 15 MIN,105.08,78.81,1.26,94.57,119
CPT,97763,Orthc/prostc mgmt sbsq enc,,,47.82,134.57,63
CPT,97799,HC OT IN CAR DRIVER EVALUATION,155.22,116.42,1.86,139.7,119
CPT,97799,HC OT WHEELCHAIR FITTING EVAL 97799,305.32,228.99,3.66,274.79,119
CPT,97799,HC PT APP PRESSURE OFFLOADING DVLPMNT 97799,106.2,79.65,1.27,95.58,119
CPT,97799,HC PT WHEELCHAIR FITTING EVAL 97799,413.35,310.01,4.96,372.02,119
CPT,97802,HC MED NUTRITION INDIV 1ST EA 15MIN,56.44,42.33,0.68,50.8,119
CPT,97802,HC VIDEO VISIT MEDICAL NUTRITION ASSMT INDIV EACH 15 MIN,63.27,47.45,0.76,56.94,119
CPT,97802,Medical nutrition indiv in,,,29.19,96.63,63
CPT,97803,HC MED NUTRTION INDIV RE-ASMT EA 15MIN,53.79,40.34,0.65,48.41,119
CPT,97803,Med nutrition indiv subseq,,,25.46,84.28,63
CPT,97804,HC MED NUTRITION GRP EA 30 MIN,40.02,30.02,0.48,36.02,119
CPT,97804,Medical nutrition group,,,13.54,44.82,63
CPT,97810,Acup 1/> wo estim 1st 15 min,,,23.48,120.92,62
CPT,97811,Acup 1/> w/o estim ea add 15,,,25.33,69.9,44
CPT,97813,Acup 1/> w/estim 1st 15 min,,,23.48,139.51,62
CPT,97814,Acup 1/> w/estim ea addl 15,,,27.66,78.46,44
CPT,98000,Synch audio-video new sf 15,,,114.36,136.45,8
CPT,98001,Synch audio-video new low 30,,,188.93,225.42,8
CPT,98002,Synch audio-video new mod 45,,,301.52,359.77,8
CPT,98003,Synch audio-video new hi 60,,,400.06,477.34,8
CPT,98004,Synch audio-video est sf 10,,,88.27,105.33,8
CPT,98005,Synch audio-video est low 20,,,154.66,184.54,8
CPT,98006,Synch audio-video est mod 30,,,228.29,272.39,8
CPT,98007,Synch audio-video est hi 40,,,302.94,361.46,8
CPT,98008,Synch audio-only new sf 15,,,108.51,129.48,8
CPT,98009,Synch audio-only new low 30,,,180.16,214.97,8
CPT,98010,Synch audio-only new mod 45,,,280.68,334.9,8
CPT,98011,Synch audio-only new high 60,,,365.08,435.6,8
CPT,98012,Synch audio-only est sf 10,,,80.89,96.52,8
CPT,98013,Synch audio-only est low 20,,,141.36,168.67,8
CPT,98014,Synch audio-only est mod 30,,,206.78,246.73,8
CPT,98015,Synch audio-only est high 40,,,300.79,358.9,8
CPT,98016,Brief comunicaj tech-bsd svc,,,36.41,43.45,8
CPT,98925,Osteopath manj 1-2 regions,,,21.86,82.61,63
CPT,98926,Osteopath manj 3-4 regions,,,21.86,119.82,63
CPT,98927,Osteopath manj 5-6 regions,,,21.86,156.15,63
CPT,98928,Osteopath manj 7-8 regions,,,21.86,189.95,63
CPT,98929,Osteopath manj 9-10 regions,,,21.86,223.74,63
CPT,98940,Chiropract manj 1-2 regions,,,21.53,72.43,62
CPT,98941,Chiropract manj 3-4 regions,,,21.86,105.39,62
CPT,98942,Chiropractic manj 5 regions,,,21.86,136.65,62
CPT,98943,Chiropract manj xtrspinl 1/>,,,57.15,68.19,8
CPT,98960,Edu&trn pt self-mgmt nqhp 1,,,66.91,79.83,8
CPT,98960,HC SELF-MGMT EDUC & TRAIN 1 PT,126.29,94.72,1.52,113.66,119
CPT,98961,Edu&trn pt slf-mgmt nqhp 2-4,,,32.02,38.21,8
CPT,98962,Edu&trn pt slf-mgmt nqhp 5-8,,,23.49,28.02,8
CPT,98966,HC NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN,38.08,28.56,0.46,34.27,119
CPT,98966,Ph1 assmt&mgmt nqhp 5-10,,,10.22,35.48,63
CPT,98967,HC NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN,70.7,53.02,0.85,63.63,119
CPT,98967,Ph1 assmt&mgmt nqhp 11-20,,,19.81,65.88,63
CPT,98968,HC NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN,105.09,78.82,1.26,94.58,119
CPT,98968,Ph1 assmt&mgmt nqhp 21-30,,,28.79,91.2,63
CPT,98970,Nqhp ol dig assmt&mgmt 5-10,,,10.22,31.24,62
CPT,98971,Nqhp ol dig assmt&mgmt 11-20,,,18.75,58.73,62
CPT,98972,Nqhp ol dig assmt&mgmt 21+,,,28.66,89.12,62
CPT,98975,Rtm 1st set-up&pt educaj eqp,,,17.84,143.43,62
CPT,98976,Rtm dev sply resp sys 16-30d,,,35.75,112.96,62
CPT,98977,Rtm dev sply mscskl 16-30 d,,,35.75,112.96,62
CPT,98978,Rtm dev sply cbt 16-30 d,,,35.75,41.5,18
CPT,98979,Rtm tx mgmt 1st 10 min,,,11.28,11.28,9
CPT,98980,Rtm tx mgmt 1st 20 min,,,25.38,135.41,62
CPT,98981,Rtm tx mgmt ea addl 20 min,,,25.04,106.48,62
CPT,98984,Rtm dev sply resp sys 2-15 d,,,37.79,37.79,9
CPT,98985,Rtm dev sply mscsk sys 2-15d,,,37.79,37.79,9
CPT,98986,Rtm dev sply cbt 2-15 d,,,37.79,37.79,9
CPT,99000,Specimen handling office-lab,,,8.37,8.37,3
CPT,99001,HC CLIENT CONVEYANCE AND HANDLING FEE,120.72,90.54,1.45,108.65,119
CPT,99001,HC CLIENT DRUG SCREEN COLLECTION,546.55,409.91,6.56,491.9,119
CPT,99001,Specimen handling pt-lab,,,9.95,9.95,3
CPT,99070,HC SPECIAL SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,99070,HC SPECIAL SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,99080,Special reports or forms,,,209.92,209.92,1
CPT,99091,Collj & interpj data ea 30 d,,,52.8,142.56,44
CPT,99151,HC MODERATE SEDATION SAME PHYS AS PERF INTITAL 15 MIN <5 YRS,819.76,614.82,9.84,737.78,119
CPT,99151,Mod sed same phys/qhp <5 yrs,,,23.76,155.05,44
CPT,99152,HC MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,819.76,614.82,9.84,737.78,119
CPT,99152,Mod sed same phys/qhp 5/>yrs,,,12.15,128.91,44
CPT,99153,HC MODERATE SEDATION UNDER PHYS SUPRVSN EA ADDTL 15 MIN,491.86,368.9,5.9,442.67,119
CPT,99153,Mod sed same phys/qhp ea,,,10.31,30.56,44
CPT,99155,HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,901.73,676.3,10.82,811.56,119
CPT,99155,Mod sed oth phys/qhp <5 yrs,,,80.92,220.45,44
CPT,99156,HC MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,901.73,676.3,10.82,811.56,119
CPT,99156,Mod sed oth phys/qhp 5/>yrs,,,74.06,196.84,44
CPT,99157,HC MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,541.03,405.77,6.49,486.93,119
CPT,99157,Mod sed other phys/qhp ea,,,60.33,152.8,44
CPT,99170,Anogenital exam child w imag,,,82.9,430.17,63
CPT,99172,Ocular function screen,,,80.93,80.93,1
CPT,99173,Visual acuity screen,,,3.11,8.49,9
CPT,99174,Ocular instrumnt screen bil,,,5.9,16.13,9
CPT,99175,Induction of vomiting,,,28.22,76.43,44
CPT,99177,Ocular instrumnt screen bil,,,4.65,12.75,9
CPT,99183,Hyperbaric oxygen therapy,,,103.29,281.15,44
CPT,99184,Hypothermia ill neonate,,,209.3,15039.8,63
CPT,99188,App topical fluoride varnish,,,25.94,30.95,8
CPT,99190,Special pump services,,,12954.18,15039.8,19
CPT,99191,Special pump services,,,12954.18,15039.8,19
CPT,99192,Special pump services,,,12954.18,15039.8,19
CPT,99195,HC PHLEBOTOMY THERAPEUTIC,364.29,273.22,4.2,340.63,238
CPT,99195,Phlebotomy,,,90.88,228.44,63
CPT,99202,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 2,298.38,223.78,3.58,268.54,119
CPT,99202,Office o/p new sf 15 min,,,46.73,189.11,44
CPT,99203,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 3,484.57,363.43,5.81,436.11,119
CPT,99203,Office o/p new low 30 min,,,80.54,295.92,44
CPT,99204,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 4,484.57,363.43,5.81,436.11,119
CPT,99204,Office o/p new mod 45 min,,,120.0,444.66,45
CPT,99205,HC OFFICE/OUTPATIENT VISIT NEW LEVEL 5,334.01,250.51,4.01,300.61,119
CPT,99205,Office o/p new hi 60 min,,,120.0,587.71,45
CPT,99211,HC OFFICE/OUTPATIENT VISIT EST LEVEL 1,253.64,190.23,3.04,228.28,119
CPT,99211,Off/op est may x req phy/qhp,,,8.59,60.53,44
CPT,99212,HC OFFICE/OUTPATIENT VISIT EST LEVEL 2,272.33,204.25,3.27,245.1,119
CPT,99212,Office o/p est sf 10 min,,,34.58,148.64,44
CPT,99213,HC OFFICE/OUTPATIENT VISIT EST LEVEL 3,380.37,285.28,4.56,342.33,119
CPT,99213,Office o/p est low 20 min,,,64.24,241.44,44
CPT,99214,HC OFFICE/OUTPATIENT VISIT EST LEVEL 4,449.6,337.2,5.4,404.64,119
CPT,99214,Office o/p est mod 30 min,,,94.9,340.33,45
CPT,99215,HC OFFICE/OUTPATIENT VISIT EST LEVEL 5,538.64,403.98,6.46,484.78,119
CPT,99215,Office o/p est hi 40 min,,,120.0,478.16,45
CPT,99217,Observation care discharge,,,162.84,194.3,8
CPT,99218,Initial observation care,,,223.2,266.32,8
CPT,99219,Initial observation care,,,302.49,360.93,8
CPT,99220,Initial observation care,,,408.85,487.83,8
CPT,99221,1st hosp ip/obs sf/low 40,,,80.91,218.82,44
CPT,99222,1st hosp ip/obs moderate 55,,,126.88,345.3,44
CPT,99223,1st hosp ip/obs high 75,,,169.22,460.31,44
CPT,99224,Subsequent observation care,,,89.1,106.31,8
CPT,99225,Subsequent observation care,,,161.97,193.26,8
CPT,99226,Subsequent observation care,,,231.05,275.69,8
CPT,99231,Sbsq hosp ip/obs sf/low 25,,,48.43,130.06,44
CPT,99232,Sbsq hosp ip/obs moderate 35,,,77.17,210.09,44
CPT,99233,Sbsq hosp ip/obs high 50,,,116.1,313.54,44
CPT,99234,Hosp ip/obs sm dt sf/low 45,,,96.27,258.44,44
CPT,99235,Hosp ip/obs same date mod 70,,,155.45,420.53,44
CPT,99236,Hosp ip/obs same date hi 85,,,203.77,550.11,44
CPT,99238,Hosp ip/obs dschrg mgmt 30/<,,,78.53,214.62,44
CPT,99239,Hosp ip/obs dschrg mgmt >30,,,111.42,303.51,44
CPT,99241,Office consultation,,,104.99,125.28,8
CPT,99242,Off/op consltj new/est sf 20,,,164.95,196.81,8
CPT,99243,Off/op cnsltj new/est low 30,,,249.75,298.0,8
CPT,99244,Off/op cnsltj new/est mod 40,,,356.07,424.86,8
CPT,99245,Off/op consltj new/est hi 55,,,465.38,555.28,8
CPT,99251,Inpatient consultation,,,111.48,133.01,8
CPT,99252,Ip/obs consltj new/est sf 35,,,157.12,12954.18,9
CPT,99253,Ip/obs cnsltj new/est low 45,,,221.58,12954.18,9
CPT,99254,Ip/obs cnsltj new/est mod 60,,,306.41,12954.18,9
CPT,99255,Ip/obs consltj new/est hi 80,,,412.55,12954.18,9
CPT,99281,Emr dpt vst mayx req phy/qhp,,,11.53,309.0,900
CPT,99281,HC EMERGENCY ROOM - LEVEL 1 W/MOD,1090.55,817.91,13.09,981.5,119
CPT,99281,HC EMERGENCY ROOM-LEVEL 1,1090.55,817.91,13.09,981.5,119
CPT,99282,Emergency dept visit sf mdm,,,41.04,767.0,900
CPT,99282,HC EMERGENCY ROOM - LEVEL 2 W/MOD,1635.16,1226.37,19.62,1471.64,119
CPT,99282,HC EMERGENCY ROOM-LEVEL 2,1635.16,1226.37,19.62,1471.64,119
CPT,99283,Emergency dept visit low mdm,,,70.48,1475.0,900
CPT,99283,HC EMERGENCY ROOM - LEVEL 3 W/MOD,2452.43,1839.32,29.43,2207.19,119
CPT,99283,HC EMERGENCY ROOM-LEVEL 3,2452.43,1839.32,29.43,2207.19,119
CPT,99284,Emergency dept visit mod mdm,,,118.65,3831.0,156
CPT,99284,HC EMERGENCY ROOM - LEVEL 4 W/MOD,3678.43,2758.82,44.14,3310.59,119
CPT,99285,Emergency dept visit hi mdm,,,172.65,5757.0,900
CPT,99285,HC EMERGENCY ROOM - LEVEL 5 W/MOD,5517.56,4138.17,66.21,4965.8,119
CPT,99291,Critical care first hour,,,208.42,9219.0,900
CPT,99291,HC ER CRITICAL CARE,8275.37,6206.53,99.3,7447.83,119
CPT,99291,HC ER CRITICAL CARE W/MOD,8275.37,6206.53,99.3,7447.83,119
CPT,99292,Critical care addl 30 min,,,104.66,9219.0,292
CPT,99292,HC ER CRITICAL CARE-'ADDL 30 MIN,3975.56,2981.67,47.71,3578.0,119
CPT,99304,1st nf care sf/low mdm 25,,,78.22,212.94,44
CPT,99305,1st nf care moderate mdm 35,,,129.53,352.34,44
CPT,99306,1st nf care high mdm 50,,,177.14,481.59,44
CPT,99307,Sbsq nf care sf mdm 10,,,38.39,105.33,44
CPT,99308,Sbsq nf care low mdm 20,,,72.09,196.44,44
CPT,99309,Sbsq nf care moderate mdm 30,,,103.41,285.14,44
CPT,99310,Sbsq nf care high mdm 45,,,148.78,406.82,44
CPT,99315,Nf dschrg mgmt 30 min/less,,,79.18,215.49,44
CPT,99316,Nf dschrg mgmt 30 min+,,,127.65,345.56,44
CPT,99318,N/A,,,216.5,258.32,8
CPT,99324,Domicil/r-home visit new pat,,,123.2,147.0,8
CPT,99325,Domicil/r-home visit new pat,,,180.18,214.99,8
CPT,99326,Domicil/r-home visit new pat,,,312.49,372.86,8
CPT,99327,Domicil/r-home visit new pat,,,419.94,501.06,8
CPT,99328,Domicil/r-home visit new pat,,,494.11,589.56,8
CPT,99334,Domicil/r-home visit est pat,,,137.63,164.22,8
CPT,99335,Domicil/r-home visit est pat,,,216.64,258.49,8
CPT,99336,Domicil/r-home visit est pat,,,306.66,365.9,8
CPT,99337,Domicil/r-home visit est pat,,,439.28,524.14,8
CPT,99339,N/A,,,173.79,207.36,8
CPT,99340,N/A,,,243.79,290.88,8
CPT,99341,Home/res vst new sf mdm 15,,,47.61,130.94,44
CPT,99342,Home/res vst new low mdm 30,,,76.15,208.77,44
CPT,99343,Home visit new patient,,,286.31,341.62,8
CPT,99344,Home/res vst new mod mdm 60,,,140.19,376.68,44
CPT,99345,Home/res vst new high mdm 75,,,196.86,532.3,44
CPT,99347,Home/res vst est sf mdm 20,,,43.6,120.13,44
CPT,99348,Home/res vst est low mdm 30,,,74.2,203.6,44
CPT,99349,Home/res vst est mod mdm 40,,,124.07,336.69,44
CPT,99350,Home/res vst est high mdm 60,,,181.1,488.99,44
CPT,99354,Prolng svc o/p 1st hour,,,291.99,348.4,8
CPT,99355,Prolng svc o/p ea addl 30,,,211.64,252.53,8
CPT,99356,Prolng svc i/p/obs 1st hour,,,205.98,245.77,8
CPT,99357,Prolng svc i/p/obs ea addl,,,206.74,246.68,8
CPT,99358,Prolong service w/o contact,,,199.21,237.7,8
CPT,99359,Prolong serv w/o contact add,,,84.24,100.52,8
CPT,99360,Physician standby services,,,129.24,154.2,8
CPT,99366,Team conf w/pat by hc prof,,,90.31,107.75,8
CPT,99367,Team conf w/o pat by phys,,,118.76,141.71,8
CPT,99368,Team conf w/o pat by hc pro,,,77.69,92.69,8
CPT,99374,Home health care supervision,,,52.14,179.93,9
CPT,99375,Home health care supervision,,,81.49,271.25,9
CPT,99377,Hospice care supervision,,,150.8,179.93,8
CPT,99378,Hospice care supervision,,,227.33,271.25,8
CPT,99379,Nursing fac care supervision,,,150.8,179.93,8
CPT,99380,Nursing fac care supervision,,,227.33,271.25,8
CPT,99381,Init pm e/m new pat infant,,,70.73,287.68,9
CPT,99382,Init pm e/m new pat 1-4 yrs,,,75.61,301.85,9
CPT,99383,Prev visit new age 5-11,,,80.18,313.51,9
CPT,99384,Prev visit new age 12-17,,,94.51,352.71,9
CPT,99385,Prev visit new age 18-39,,,90.61,342.89,9
CPT,99386,Prev visit new age 40-64,,,109.85,395.48,9
CPT,99387,Init pm e/m new pat 65+ yrs,,,117.99,429.64,9
CPT,99391,"HC PREVENTIVE VISIT,EST, INFANT < 1 YR",484.57,363.43,5.81,436.11,119
CPT,99391,Per pm reeval est pat infant,,,64.54,258.02,9
CPT,99392,Prev visit est age 1-4,,,70.73,274.93,9
CPT,99393,Prev visit est age 5-11,,,70.73,274.93,9
CPT,99394,Prev visit est age 12-17,,,80.18,300.79,9
CPT,99395,Prev visit est age 18-39,,,82.78,309.57,9
CPT,99396,Prev visit est age 40-64,,,89.94,329.19,9
CPT,99397,Per pm reeval est pat 65+ yr,,,94.51,354.4,9
CPT,99401,Prev med cnsl indiv apprx 15,,,22.81,100.57,9
CPT,99402,Prev med cnsl indiv apprx 30,,,46.28,164.76,9
CPT,99403,Prev med cnsl indiv apprx 45,,,69.09,226.31,9
CPT,99404,Prev med cnsl indiv apprx 60,,,92.23,292.12,9
CPT,99406,Behav chng smoking 3-10 min,,,11.54,37.99,63
CPT,99406,HC SMOKING CESSATION ASYMPTOMATIC >3 & UP TO 10 MIN,74.79,56.09,0.9,67.31,119
CPT,99407,Behav chng smoking > 10 min,,,24.39,72.68,63
CPT,99407,HC SMOKING CESSATION ASYMP >10MIN,82.78,62.08,0.99,74.5,119
CPT,99408,Audit/dast 15-30 min,,,75.92,90.58,8
CPT,99409,Audit/dast over 30 min,,,146.12,174.35,8
CPT,99411,Preventive counseling group,,,42.76,51.02,8
CPT,99412,Preventive counseling group,,,53.94,64.35,8
CPT,99415,Prolng clin staff svc 1st hr,,,17.55,52.65,44
CPT,99416,Prolng clin staff svc ea add,,,8.14,24.62,44
CPT,99417,Prolng op e/m each 15 min,,,29.0,81.83,9
CPT,99418,Prolng ip/obs e/m ea 15 min,,,87.4,15039.8,27
CPT,99421,Ol dig e/m svc 5-10 min,,,12.51,39.73,44
CPT,99422,Ol dig e/m svc 11-20 min,,,24.71,77.78,44
CPT,99423,Ol dig e/m svc 21+ min,,,39.22,122.91,44
CPT,99424,Prin care mgmt phys 1st 30,,,71.52,221.12,44
CPT,99425,Prin care mgmt phys ea addl,,,49.43,160.65,44
CPT,99426,Prin care mgmt staff 1st 30,,,47.84,168.27,62
CPT,99427,Prin care mgmt staff ea addl,,,33.98,136.78,44
CPT,99437,Chrnc care mgmt phys ea addl,,,49.12,157.25,44
CPT,99439,Chrnc care mgmt staf ea addl,,,33.99,124.86,44
CPT,99441,Phone e/m phys/qhp 5-10 min,,,33.99,152.07,44
CPT,99442,Phone e/m phys/qhp 11-20 min,,,64.24,245.86,44
CPT,99443,Phone e/m phys/qhp 21-30 min,,,94.31,348.48,44
CPT,99445,Rem mntr physiol param 2-15,,,37.79,37.79,9
CPT,99446,Ntrprof ph1/ntrnet/ehr 5-10,,,17.43,47.13,44
CPT,99447,Ntrprof ph1/ntrnet/ehr 11-20,,,34.58,95.11,44
CPT,99448,Ntrprof ph1/ntrnet/ehr 21-30,,,52.63,141.4,44
CPT,99449,Ntrprof ph1/ntrnet/ehr 31/>,,,69.81,191.1,44
CPT,99451,Ntrprof ph1/ntrnet/ehr 5/>,,,34.62,90.89,44
CPT,99452,Ntrprof ph1/ntrnet/ehr rfrl,,,32.42,92.58,44
CPT,99453,Rem mntr physiol param setup,,,17.84,143.43,63
CPT,99454,Rem mntr physiol param 16-30,,,35.75,112.96,63
CPT,99457,Rpm tx mgmt 1st 20 min,,,29.37,129.39,44
CPT,99458,Rpm tx mgmt ea addl 20 min,,,29.37,104.77,44
CPT,99459,Pelvic examination,,,45.54,54.34,8
CPT,99460,Init nb em per day hosp,,,90.55,244.37,63
CPT,99461,Init nb em per day non-fac,,,59.01,240.35,45
CPT,99462,Sbsq nb em per day hosp,,,39.95,15039.8,63
CPT,99463,Same day nb discharge,,,106.03,285.57,63
CPT,99464,Attendance at delivery,,,71.02,190.85,44
CPT,99465,HC DELIVERY BIRTHING ROOM RESUSCITATION,1267.89,950.92,15.21,1141.1,119
CPT,99465,Nb resuscitation,,,138.12,728.33,63
CPT,99466,Ped crit care transport,,,226.01,610.02,44
CPT,99467,Ped crit care transport addl,,,114.22,305.89,44
CPT,99468,Neonate crit care initial,,,872.46,15039.8,63
CPT,99469,Neonate crit care subsq,,,377.59,15039.8,63
CPT,99471,Ped critical care initial,,,754.9,15039.8,63
CPT,99472,Ped critical care subsq,,,382.48,15039.8,63
CPT,99473,Self-meas bp pt educaj/train,,,11.9,36.53,62
CPT,99474,Self-meas bp 2 readg bid 30d,,,8.59,44.4,44
CPT,99475,Ped crit care age 2-5 init,,,543.17,15039.8,63
CPT,99476,Ped crit care age 2-5 subsq,,,327.39,15039.8,63
CPT,99477,Init day hosp neonate care,,,330.71,15039.8,63
CPT,99478,Sbsq ic vlbw inf<1500 gm,,,130.14,15039.8,63
CPT,99479,Sbsq ic lbw inf 1500-2500,,,118.55,15039.8,63
CPT,99480,Sbsq ic inf pbw 2501-5000,,,114.22,15039.8,63
CPT,99483,Assmt & care pln pt cog imp,,,88.68,722.27,63
CPT,99484,Care mgmt svc bhvl hlth cond,,,28.56,144.92,63
CPT,99485,Suprv interfacilty transport,,,70.73,193.41,9
CPT,99486,Suprv interfac trnsport addl,,,61.28,167.57,9
CPT,99487,Cplx chrnc care 1st 60 min,,,88.39,356.64,63
CPT,99489,Cplx chrnc care ea addl 30,,,48.8,191.22,44
CPT,99490,Chrnc care mgmt staff 1st 20,,,49.12,164.9,62
CPT,99491,Chrnc care mgmt phys 1st 30,,,73.53,224.84,44
CPT,99492,1st psyc collab care mgmt,,,88.68,392.75,63
CPT,99493,Sbsq psyc collab care mgmt,,,88.68,363.21,63
CPT,99494,1st/sbsq psyc collab care,,,39.59,151.9,44
CPT,99495,Transj care mgmt mod f2f 14d,,,123.54,545.13,63
CPT,99496,Transj care mgmt high f2f 7d,,,123.54,738.96,63
CPT,99497,Advncd care plan 30 min,,,73.53,218.03,63
CPT,99498,Advncd care plan addl 30 min,,,69.51,189.41,44
CPT,99501,Home visit postnatal,,,179.44,179.44,1
CPT,99502,Home visit nb care,,,290.6,290.6,1
CPT,99503,Home visit resp therapy,,,270.71,270.71,1
CPT,99506,Home visit im injection,,,170.94,170.94,1
CPT,99601,Home nfs visit <2 hrs,,,416.52,416.52,1
CPT,99602,Home nfs visit each addl hr,,,242.16,242.16,1
CPT,99605,HC MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT,0.01,0.01,0.01,0.01,119
CPT,A0425,Ground mileage,,,8.97,10.41,19
CPT,A0426,Als 1,,,278.98,323.9,19
CPT,A0427,Als1-emergency,,,278.98,323.9,19
CPT,A0428,Bls,,,278.98,323.9,19
CPT,A0429,Bls-emergency,,,278.98,323.9,19
CPT,A0430,Fixed wing air transport,,,3785.9,4395.43,19
CPT,A0431,Rotary wing air transport,,,4401.68,5110.35,19
CPT,A0432,Pi volunteer ambulance co,,,278.98,323.9,19
CPT,A0433,Als 2,,,278.98,323.9,19
CPT,A0434,Specialty care transport,,,278.98,323.9,19
CPT,A0435,Fixed wing air mileage,,,10.75,12.48,19
CPT,A0436,Rotary wing air mileage,,,28.66,33.27,19
CPT,A2001,Innovamatrix ac per sq cm,,,126.0,126.0,9
CPT,A2002,Mirragen adv wnd mat per sq,,,126.0,126.0,9
CPT,A2005,Microlyte matrix per sq cm,,,126.0,126.0,9
CPT,A2006,Novosorb synpath per sq cm,,,126.0,126.0,9
CPT,A2007,Restrata per sq cm,,,126.0,126.0,9
CPT,A2008,Theragenesis per sq cm,,,126.0,126.0,9
CPT,A2009,Symphony per sq cm,,,126.0,126.0,9
CPT,A2010,Apis per square centimeter,,,126.0,126.0,9
CPT,A2011,Supra sdrm per sq cm,,,126.0,126.0,9
CPT,A2012,Suprathel per sq cm,,,126.0,126.0,9
CPT,A2013,Innovamatrix fs per sq cm,,,126.0,126.0,9
CPT,A2015,Phoenix wnd mtrx per sq cm,,,126.0,126.0,9
CPT,A2016,Permeaderm b per sq cm,,,126.0,126.0,9
CPT,A2018,Permeaderm c per sq cm,,,126.0,126.0,9
CPT,A2019,Kerecis marigen shld sq cm,,,126.0,126.0,9
CPT,A2021,Neomatrix per sq cm,,,126.0,126.0,9
CPT,A2022,Innovabrn/innovamatx xl sqcm,,,126.0,126.0,9
CPT,A2024,Resolve or xenopatch sq cm,,,126.0,126.0,9
CPT,A2025,Miro3d per cubic cm,,,126.0,126.0,9
CPT,A2027,Matriderm per sq cm,,,126.0,126.0,9
CPT,A2029,Mirotract matrix sheet,,,126.0,126.0,9
CPT,A2031,Mirodry per sq cm,,,126.0,126.0,9
CPT,A2036,Cohealyx col dml mx pr sq cm,,,126.0,126.0,9
CPT,A2038,Marigen pacto per sq cm,,,126.0,126.0,9
CPT,A2039,Innovamatrix fd per sq cm,,,126.0,126.0,9
CPT,A4216,Sterile water/saline 10 ml,,,1.5,1.8,8
CPT,A4217,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,30.0,22.5,0.36,27.0,119
CPT,A4217,Sterile water/saline 500 ml,,,9.0,10.74,8
CPT,A4217,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",72.0,54.0,0.86,64.8,119
CPT,A4217,"WATER FOR IRRIGATION, STERILE SOLUTION",26.25,19.689999999999998,0.29,25.65,238
CPT,A4221,Supp non-insulin inf cath/wk,,,64.29,76.71,8
CPT,A4222,Infusion supplies with pump,,,123.58,147.45,8
CPT,A4224,Supply insulin inf cath/wk,,,64.29,76.71,8
CPT,A4225,Sup/ext insulin inf pump syr,,,8.34,9.95,8
CPT,A4233,Alkalin batt for glucose mon,,,1.29,1.54,8
CPT,A4234,J-cell batt for glucose mon,,,6.0,7.16,8
CPT,A4235,Lithium batt for glucose mon,,,2.54,3.03,8
CPT,A4236,Silvr oxide batt glucose mon,,,2.95,3.52,8
CPT,A4238,Adju cgm supply allowance,,,666.2,794.89,8
CPT,A4239,Non-adju cgm supply allow,,,648.54,773.83,8
CPT,A4248,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,22.66,16.99,0.27,20.39,119
CPT,A4253,Blood glucose/reagent strips,,,21.16,25.24,8
CPT,A4255,Glucose monitor platforms,,,13.91,16.6,8
CPT,A4256,Calibrator solution/chips,,,8.6,10.26,8
CPT,A4257,Replace lensshield cartridge,,,43.16,51.49,8
CPT,A4258,Lancet device each,,,5.39,6.44,8
CPT,A4259,Lancets per box,,,3.61,4.31,8
CPT,A4265,Paraffin,,,11.52,13.74,8
CPT,A4271,Home lancing/test cartridges,,,33.43,38.81,19
CPT,A4280,Brst prsths adhsv attchmnt,,,18.11,21.61,8
CPT,A4310,Insert tray w/o bag/cath,,,22.2,26.49,8
CPT,A4311,Catheter w/o bag 2-way latex,,,50.1,59.78,8
CPT,A4312,Cath w/o bag 2-way silicone,,,61.01,72.8,8
CPT,A4313,Catheter w/bag 3-way,,,62.64,74.74,8
CPT,A4314,Cath w/drainage 2-way latex,,,85.5,102.02,8
CPT,A4315,Cath w/drainage 2-way silcne,,,89.21,106.45,8
CPT,A4316,Cath w/drainage 3-way,,,96.06,114.62,8
CPT,A4320,Irrigation tray,,,17.12,20.42,8
CPT,A4322,Irrigation syringe,,,9.03,10.77,8
CPT,A4326,Male external catheter,,,32.98,39.35,8
CPT,A4327,Fem urinary collect dev cup,,,150.86,180.0,8
CPT,A4328,Fem urinary collect pouch,,,35.3,42.12,8
CPT,A4330,Stool collection pouch,,,20.6,24.58,8
CPT,A4331,Extension drainage tubing,,,10.75,12.83,8
CPT,A4332,Lube sterile packet,,,0.38,0.45,8
CPT,A4333,Urinary cath anchor device,,,7.51,8.96,8
CPT,A4334,Urinary cath leg strap,,,16.63,19.85,8
CPT,A4336,Urethral insert,,,4.86,5.8,8
CPT,A4338,Indwelling catheter latex,,,41.5,49.52,8
CPT,A4340,Indwelling catheter special,,,91.27,108.91,8
CPT,A4341,Iduc valve pat inst repl,,,825.27,984.7,8
CPT,A4342,Iduc valve sply repl,,,2083.8,2486.35,8
CPT,A4344,Cath indw foley 2 way silicn,,,46.03,54.93,8
CPT,A4346,Cath indw foley 3 way,,,66.23,79.02,8
CPT,A4349,Disposable male external cat,,,6.79,8.11,8
CPT,A4351,Straight tip urine catheter,,,5.21,6.22,8
CPT,A4352,Coude tip urinary catheter,,,18.46,22.03,8
CPT,A4353,Intermittent urinary cath,,,23.7,28.28,8
CPT,A4354,Cath insertion tray w/bag,,,33.95,40.51,8
CPT,A4355,Bladder irrigation tubing,,,25.63,30.59,8
CPT,A4356,Ext ureth clmp or compr dvc,,,154.33,184.14,8
CPT,A4357,Bedside drainage bag,,,27.9,33.29,8
CPT,A4358,Urinary leg or abdomen bag,,,22.15,26.43,8
CPT,A4360,Disposable ext urethral dev,,,1.65,1.97,8
CPT,A4361,Ostomy face plate,,,62.1,74.1,8
CPT,A4362,Solid skin barrier,,,10.25,12.23,8
CPT,A4363,Ostomy clamp replacement,,,7.51,8.96,8
CPT,A4364,Adhesive liquid or equal,,,9.94,11.87,8
CPT,A4366,Ostomy vent,,,4.37,5.22,8
CPT,A4367,Ostomy belt,,,24.9,29.7,8
CPT,A4368,Ostomy filter,,,0.84,1.0,8
CPT,A4369,Skin barrier liquid per oz,,,7.0,8.35,8
CPT,A4371,Skin barrier powder per oz,,,12.15,14.5,8
CPT,A4372,Skin barrier solid 4x4 equiv,,,14.19,16.94,8
CPT,A4373,Skin barrier with flange,,,21.18,25.27,8
CPT,A4375,Drainable plastic pch w fcpl,,,58.09,69.31,8
CPT,A4376,Drainable rubber pch w fcplt,,,160.91,191.99,8
CPT,A4377,Drainable plstic pch w/o fp,,,14.49,17.29,8
CPT,A4378,Drainable rubber pch w/o fp,,,103.99,124.08,8
CPT,A4379,Urinary plastic pouch w fcpl,,,50.78,60.6,8
CPT,A4380,Urinary rubber pouch w fcplt,,,126.27,150.66,8
CPT,A4381,Urinary plastic pouch w/o fp,,,15.64,18.66,8
CPT,A4382,Urinary hvy plstc pch w/o fp,,,83.27,99.35,8
CPT,A4383,Urinary rubber pouch w/o fp,,,95.35,113.77,8
CPT,A4384,Ostomy faceplt/silicone ring,,,32.5,38.78,8
CPT,A4385,Ost skn barrier sld ext wear,,,17.22,20.55,8
CPT,A4387,Ost clsd pouch w att st barr,,,7.6,9.07,8
CPT,A4388,Drainable pch w ex wear barr,,,14.75,17.6,8
CPT,A4389,Drainable pch w st wear barr,,,21.01,25.06,8
CPT,A4390,Drainable pch ex wear convex,,,32.48,38.76,8
CPT,A4391,Urinary pouch w ex wear barr,,,23.91,28.53,8
CPT,A4392,Urinary pouch w st wear barr,,,27.64,32.98,8
CPT,A4393,Urine pch w ex wear bar conv,,,30.57,36.48,8
CPT,A4394,Ostomy pouch liq deodorant,,,8.77,10.47,8
CPT,A4395,Ostomy pouch solid deodorant,,,0.12,0.15,8
CPT,A4396,Peristomal hernia supprt blt,,,136.9,163.35,8
CPT,A4398,Ostomy irrigation bag,,,46.75,55.78,8
CPT,A4399,Ostomy irrig cone/cath w brs,,,35.27,42.08,8
CPT,A4400,Ostomy irrigation set,,,155.93,186.05,8
CPT,A4402,Lubricant per ounce,,,5.39,6.44,8
CPT,A4404,Ostomy ring each,,,5.67,6.76,8
CPT,A4405,Nonpectin based ostomy paste,,,11.55,13.78,8
CPT,A4406,Pectin based ostomy paste,,,19.35,23.09,8
CPT,A4407,Ext wear ost skn barr <4sq,,,29.63,35.35,8
CPT,A4408,Ext wear ost skn barr >4sq,,,33.4,39.85,8
CPT,A4409,Ost skn barr convex <4 sq i,,,21.01,25.06,8
CPT,A4410,Ost skn barr extnd >4 sq,,,30.57,36.48,8
CPT,A4411,Ost skn barr extnd 4sq,,,17.22,20.55,8
CPT,A4412,Ost pouch drain high output,,,9.15,10.92,8
CPT,A4413,2 pc drainable ost pouch,,,18.64,22.24,8
CPT,A4414,Ost sknbar w/o conv<4 sq in,,,16.63,19.85,8
CPT,A4415,Ost skn barr w/o conv >4 sqi,,,20.27,24.18,8
CPT,A4416,Ost pch clsd w barrier/filtr,,,9.31,11.11,8
CPT,A4417,Ost pch w bar/bltinconv/fltr,,,12.61,15.05,8
CPT,A4418,Ost pch clsd w/o bar w filtr,,,6.12,7.31,8
CPT,A4419,Ost pch for bar w flange/flt,,,5.83,6.95,8
CPT,A4422,Ost pouch absorbent material,,,0.38,0.45,8
CPT,A4423,Ost pch for bar w lk fl/fltr,,,6.28,7.5,8
CPT,A4424,Ost pch drain w bar & filter,,,16.1,19.2,8
CPT,A4425,Ost pch drain for barrier fl,,,12.11,14.45,8
CPT,A4426,Ost pch drain 2 piece system,,,9.23,11.01,8
CPT,A4427,Ost pch drain/barr lk flng/f,,,9.43,11.26,8
CPT,A4428,Urine ost pouch w faucet/tap,,,22.05,26.31,8
CPT,A4429,Urine ost pouch w bltinconv,,,27.9,33.29,8
CPT,A4430,Ost urine pch w b/bltin conv,,,28.81,34.38,8
CPT,A4431,Ost pch urine w barrier/tapv,,,21.01,25.06,8
CPT,A4432,Os pch urine w bar/fange/tap,,,12.14,14.48,8
CPT,A4433,Urine ost pch bar w lock fln,,,11.34,13.53,8
CPT,A4434,Ost pch urine w lock flng/ft,,,12.72,15.17,8
CPT,A4435,1pc ost pch drain hgh output,,,19.48,23.25,8
CPT,A4436,Irr supply sleev reus per mo,,,55.14,65.79,8
CPT,A4437,Irr supply sleev disp per mo,,,55.14,65.79,8
CPT,A4438,Adhesive clip ext ens contr,,,2.57,2.98,19
CPT,A4450,Non-waterproof tape,,,0.26,0.3,8
CPT,A4452,Waterproof tape,,,1.2,1.43,8
CPT,A4455,Adhesive remover per ounce,,,4.2,5.01,8
CPT,A4456,Adhesive remover wipes,,,0.81,0.97,8
CPT,A4461,Surgicl dress hold non-reuse,,,11.17,13.32,8
CPT,A4463,Surgical dress holder reuse,,,45.01,53.71,8
CPT,A4481,Tracheostoma filter,,,1.25,1.49,8
CPT,A4556,Electrodes pair,,,34.92,41.66,8
CPT,A4557,Lead wires pair,,,39.04,46.58,8
CPT,A4558,Conductive gel or paste,,,15.66,18.69,8
CPT,A4559,Coupling gel or paste,,,0.33,0.4,8
CPT,A4561,Pessary reusable rub anytype,,,69.89,83.39,8
CPT,A4562,Pessary reusable nonrubber,,,174.03,207.65,8
CPT,A4563,Vag inser rectal control sys,,,1668.99,4820.52,27
CPT,A4565,Slings,,,26.04,31.07,8
CPT,A4595,Tens suppl 2 lead per month,,,47.05,56.14,8
CPT,A4596,Ces system monthly supp,,,97.45,116.28,8
CPT,A4602,Replace lithium battery 1.5v,,,12.61,15.05,8
CPT,A4604,Tubing with heating element,,,137.44,163.99,8
CPT,A4605,Trach suction cath close sys,,,55.47,66.18,8
CPT,A4608,Transtracheal oxygen cath,,,169.56,202.31,8
CPT,A4614,Hand-held pefr meter,,,80.44,95.98,8
CPT,A4615,Cannula nasal,,,2.46,2.94,8
CPT,A4616,Tubing (oxygen) per foot,,,0.2,0.24,8
CPT,A4617,Mouth piece,,,10.48,12.51,8
CPT,A4618,Breathing circuits,,,3.48,4.16,8
CPT,A4619,Face tent,,,6.05,7.22,8
CPT,A4620,Variable concentration mask,,,2.16,2.58,8
CPT,A4623,Tracheostomy inner cannula,,,18.84,22.48,8
CPT,A4624,Tracheal suction tube,,,8.92,10.65,8
CPT,A4625,Trach care kit for new trach,,,23.43,27.95,8
CPT,A4626,Tracheostomy cleaning brush,,,10.78,12.86,8
CPT,A4628,Oropharyngeal suction cath,,,12.34,14.72,8
CPT,A4629,Tracheostomy care kit,,,15.64,18.66,8
CPT,A4630,Repl bat t.e.n.s. own by pt,,,21.08,25.16,8
CPT,A4633,Uvl replacement bulb,,,138.81,165.63,8
CPT,A4635,Underarm crutch pad,,,2.29,2.73,8
CPT,A4636,Handgrip for cane etc,,,1.02,1.22,8
CPT,A4637,Repl tip cane/crutch/walker,,,0.56,0.67,8
CPT,A4639,Infrared ht sys replcmnt pad,,,97.18,115.95,8
CPT,A4640,Alternating pressure pad,,,17.06,20.36,8
CPT,A4642,In111 satumomab,,,4311.13,5143.96,8
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 10,278.25,208.69,3.34,250.42,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 11,417.45,313.09,5.01,375.7,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 12,473.25,354.94,5.68,425.92,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 13,583.4,437.55,7.0,525.06,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 14,729.25,546.94,8.75,656.32,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,A4648,HC IMPLANTABLE TISSUE MARKER LVL 9,185.45,139.09,2.23,166.9,119
CPT,A4648,HC MARKER FIDUCIAL .75,759.55,569.66,9.11,683.6,119
CPT,A4648,HC NEEDLE DELIVERY SAVI SCOUT W REFLEC ALL,1976.25,1482.19,23.72,1778.62,119
CPT,A4649,HC SURGICAL SUPPLY IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 28,3281.4,2461.05,39.38,2953.26,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,A4649,HC SURGICAL SUPPLY NON IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,A5051,Pouch clsd w barr attached,,,6.97,8.32,8
CPT,A5052,Clsd ostomy pouch w/o barr,,,5.03,6.01,8
CPT,A5053,Clsd ostomy pouch faceplate,,,5.83,6.95,8
CPT,A5054,Clsd ostomy pouch w/flange,,,6.08,7.26,8
CPT,A5055,Stoma cap,,,4.4,5.25,8
CPT,A5056,1 pc ost pouch w filter,,,15.82,18.88,8
CPT,A5057,1 pc ost pou w built-in conv,,,32.48,38.76,8
CPT,A5061,Pouch drainable w barrier at,,,11.95,14.26,8
CPT,A5062,Drnble ostomy pouch w/o barr,,,7.55,9.01,8
CPT,A5063,Drain ostomy pouch w/flange,,,9.15,10.92,8
CPT,A5071,Urinary pouch w/barrier,,,20.32,24.24,8
CPT,A5072,Urinary pouch w/o barrier,,,10.35,12.35,8
CPT,A5073,Urinary pouch on barr w/flng,,,10.51,12.54,8
CPT,A5081,Stoma plug or seal any type,,,9.54,11.38,8
CPT,A5082,Continent stoma catheter,,,40.26,48.04,8
CPT,A5083,Stoma absorptive cover,,,2.19,2.61,8
CPT,A5093,Ostomy accessory convex inse,,,6.61,7.89,8
CPT,A5102,Bedside drain btl w/wo tube,,,76.32,91.07,8
CPT,A5105,Urinary suspensory,,,125.48,149.72,8
CPT,A5112,Urinary leg bag,,,114.82,137.0,8
CPT,A5113,Latex leg strap,,,13.55,16.17,8
CPT,A5114,Foam/fabric leg strap,,,25.74,30.71,8
CPT,A5120,Skin barrier wipe or swab,,,0.69,0.82,8
CPT,A5121,Solid skin barrier 6x6,,,21.85,26.07,8
CPT,A5122,Solid skin barrier 8x8,,,43.29,51.65,8
CPT,A5126,Disk/foam pad +or- adhesive,,,4.43,5.28,8
CPT,A5131,Appliance cleaner,,,53.61,63.97,8
CPT,A5200,Percutaneous catheter anchor,,,38.25,45.64,8
CPT,A5500,Diab shoe for density insert,,,215.08,256.63,8
CPT,A5501,Diabetic custom molded shoe,,,645.03,769.64,8
CPT,A5503,Diabetic shoe w/roller/rockr,,,109.51,130.66,8
CPT,A5504,Diabetic shoe with wedge,,,109.51,130.66,8
CPT,A5505,Diab shoe w/metatarsal bar,,,109.51,130.66,8
CPT,A5506,Diabetic shoe w/off set heel,,,109.51,130.66,8
CPT,A5507,Modification diabetic shoe,,,109.51,130.66,8
CPT,A5512,Multi den insert direct form,,,87.72,104.66,8
CPT,A5513,Multi den insert custom mold,,,130.9,156.19,8
CPT,A5514,Mult den insert dir carv/cam,,,130.9,156.19,8
CPT,A6010,Collagen based wound filler,,,104.76,124.99,8
CPT,A6011,Collagen gel/paste wound fil,,,7.74,9.23,8
CPT,A6021,Collagen dressing <16 sq in,,,71.1,84.84,8
CPT,A6022,Collagen drsg>16<48 sq in,,,71.1,84.84,8
CPT,A6023,Collagen dressing >48 sq in,,,643.66,768.0,8
CPT,A6024,Collagen dsg wound filler,,,20.93,24.97,8
CPT,A6154,Wound pouch each,,,48.58,57.96,8
CPT,A6196,Alginate dressing <16 sq in,,,24.9,29.7,8
CPT,A6197,Alginate drsg >16 <48 sq in,,,55.62,66.36,8
CPT,A6199,Alginate drsg wound filler,,,17.86,21.3,8
CPT,A6203,Composite drsg < 16 sq in,,,11.4,13.6,8
CPT,A6204,Composite drsg >16<48 sq in,,,21.03,25.1,8
CPT,A6207,Contact layer >16< 48 sq in,,,24.85,29.65,8
CPT,A6209,Foam drsg <16 sq in w/o bdr,,,25.28,30.17,8
CPT,A6210,Foam drg >16<48 sq in w/o b,,,67.4,80.42,8
CPT,A6211,Foam drg > 48 sq in w/o brdr,,,99.33,118.52,8
CPT,A6212,Foam drg <16 sq in w/border,,,32.83,39.18,8
CPT,A6214,Foam drg > 48 sq in w/border,,,34.81,41.54,8
CPT,A6216,Non-sterile gauze<16 sq in,,,0.12,0.15,8
CPT,A6219,Gauze < 16 sq in w/border,,,3.23,3.85,8
CPT,A6220,Gauze >16 <48 sq in w/bordr,,,8.77,10.47,8
CPT,A6222,Gauze <16 in no w/sal w/o b,,,7.22,8.62,8
CPT,A6223,Gauze >16<48 no w/sal w/o b,,,8.21,9.8,8
CPT,A6224,Gauze > 48 in no w/sal w/o b,,,12.18,14.53,8
CPT,A6229,Gauze >16<48 sq in watr/sal,,,12.18,14.53,8
CPT,A6231,Hydrogel dsg<16 sq in,,,15.87,18.93,8
CPT,A6232,Hydrogel dsg>16<48 sq in,,,23.22,27.71,8
CPT,A6233,Hydrogel dressing >48 sq in,,,64.86,77.39,8
CPT,A6234,Hydrocolld drg <16 w/o bdr,,,22.15,26.43,8
CPT,A6235,Hydrocolld drg >16<48 w/o b,,,56.89,67.88,8
CPT,A6236,Hydrocolld drg > 48 in w/o b,,,92.16,109.97,8
CPT,A6237,Hydrocolld drg <16 in w/bdr,,,26.75,31.92,8
CPT,A6238,Hydrocolld drg >16<48 w/bdr,,,77.11,92.0,8
CPT,A6240,Hydrocolld drg filler paste,,,41.43,49.43,8
CPT,A6241,Hydrocolloid drg filler dry,,,8.69,10.37,8
CPT,A6242,Hydrogel drg <16 in w/o bdr,,,20.47,24.42,8
CPT,A6243,Hydrogel drg >16<48 w/o bdr,,,41.69,49.74,8
CPT,A6244,Hydrogel drg >48 in w/o bdr,,,132.85,158.52,8
CPT,A6245,Hydrogel drg < 16 in w/bdr,,,24.6,29.35,8
CPT,A6246,Hydrogel drg >16<48 in w/b,,,33.6,40.09,8
CPT,A6247,Hydrogel drg > 48 sq in w/b,,,80.44,95.98,8
CPT,A6248,Hydrogel drsg gel filler,,,54.96,65.57,8
CPT,A6251,Absorpt drg <16 sq in w/o b,,,6.71,8.01,8
CPT,A6252,Absorpt drg >16 <48 w/o bdr,,,11.01,13.14,8
CPT,A6253,Absorpt drg > 48 sq in w/o b,,,21.41,25.55,8
CPT,A6254,Absorpt drg <16 sq in w/bdr,,,4.05,4.83,8
CPT,A6255,Absorpt drg >16<48 in w/bdr,,,10.28,12.26,8
CPT,A6257,Transparent film < 16 sq in,,,5.19,6.2,8
CPT,A6258,Transparent film >16<48 in,,,14.57,17.39,8
CPT,A6259,Transparent film > 48 sq in,,,36.98,44.12,8
CPT,A6266,Impreg gauze no h20/sal/yard,,,6.46,7.71,8
CPT,A6402,Sterile gauze < 16 sq in,,,0.38,0.45,8
CPT,A6403,Sterile gauze>16 < 48 sq in,,,1.4,1.67,8
CPT,A6407,Packing strips non-impreg,,,6.34,7.56,8
CPT,A6410,Sterile eye pad,,,1.28,1.52,8
CPT,A6441,Pad band w>3,,,2.31,2.76,8
CPT,A6442,Conform band n/s w<3,,,0.54,0.64,8
CPT,A6443,Conform band n/s w>3,,,0.94,1.12,8
CPT,A6444,Conform band n/s w>5,,,1.88,2.25,8
CPT,A6445,Conform band s w <3,,,1.06,1.27,8
CPT,A6446,Conform band s w>3,,,1.32,1.58,8
CPT,A6447,Conform band s w >5,,,2.31,2.76,8
CPT,A6448,Lt compres band <3,,,3.89,4.64,8
CPT,A6449,Lt compres band >3,,,5.92,7.07,8
CPT,A6450,Lt compres band >5,,,5.92,7.07,8
CPT,A6451,Mod compres band w>3,,,5.92,7.07,8
CPT,A6452,High compres band w>3,,,19.97,23.82,8
CPT,A6453,Self-adher band w <3,,,2.14,2.55,8
CPT,A6454,Self-adher band w>3,,,2.65,3.16,8
CPT,A6455,Self-adher band >5,,,4.71,5.62,8
CPT,A6456,Zinc paste band w >3,,,4.25,5.07,8
CPT,A6457,Tubular dressing,,,3.84,4.58,8
CPT,A6520,G com garmnt glove nghttime,,,123.13,142.95,19
CPT,A6521,G com garmnt glove nght cust,,,488.56,567.22,19
CPT,A6522,G com garment arm nighttime,,,299.18,347.35,19
CPT,A6523,G com garment arm nght custm,,,709.85,824.14,19
CPT,A6524,G com garmnt lwr leg/ft nght,,,373.26,433.35,19
CPT,A6525,G com garm lwrleg/ft ngt cus,,,753.55,874.87,19
CPT,A6526,G com garmt full leg/ft nght,,,674.84,783.49,19
CPT,A6527,G garmt full leg/ft nght cus,,,1240.94,1440.73,19
CPT,A6528,G com garment bra nighttime,,,648.9,753.37,19
CPT,A6529,G com garmt bra night custm,,,1025.36,1190.44,19
CPT,A6530,Compression stocking bk18-30,,,38.04,44.16,19
CPT,A6531,Compress stking bk30-40 surg,,,146.31,174.57,8
CPT,A6532,Compress stking bk40-50 surg,,,206.18,246.0,8
CPT,A6533,Gc stocking thighlngth 18-30,,,53.42,62.02,19
CPT,A6534,Gc stocking thighlngth 30-40,,,61.0,70.82,19
CPT,A6535,Gc stocking thighlngth 40+,,,70.23,81.54,19
CPT,A6536,Gc stocking full lngth 18-30,,,72.01,83.6,19
CPT,A6537,Gc stocking full lngth 30-40,,,85.37,99.11,19
CPT,A6538,Gc stocking full lngth 40+,,,99.95,116.04,19
CPT,A6539,Gc stocking waistlngth 18-30,,,95.29,110.63,19
CPT,A6540,Gc stocking waistlngth 30-40,,,113.61,131.9,19
CPT,A6541,Gc stocking waistlngth 40+,,,134.58,156.25,19
CPT,A6545,Grad com non-elastic bk surg,,,288.12,343.78,8
CPT,A6550,Neg pres wound ther drsg set,,,74.41,88.79,8
CPT,A6552,Grad com stocking bk 30-40,,,56.45,65.54,19
CPT,A6553,G com stcking bk 30-40 custm,,,220.43,255.92,19
CPT,A6554,Grad com stocking bk 40+,,,77.62,90.12,19
CPT,A6555,G com stcking bk 40+ custm,,,220.43,255.92,19
CPT,A6556,G com stcking thgh18-30 cust,,,302.09,350.73,19
CPT,A6557,G com stcking thgh30-40 cust,,,302.09,350.73,19
CPT,A6558,G com stcking thgh 40+ cust,,,311.75,361.94,19
CPT,A6562,G com stckng waist18-30 cust,,,988.68,1147.86,19
CPT,A6563,G com stckng waist30-40 cust,,,988.68,1147.86,19
CPT,A6564,G com stckng waist 40+ cust,,,1065.02,1236.49,19
CPT,A6565,Grad comp gauntlet custom,,,170.84,198.35,19
CPT,A6566,Grad com garment neck/head,,,248.05,287.99,19
CPT,A6567,G com garment neck/head cust,,,779.38,904.86,19
CPT,A6568,G com garment torso/shldr,,,161.89,187.95,19
CPT,A6569,G com garmnt torso/shdr cust,,,921.85,1070.27,19
CPT,A6570,Grad com garment genital,,,110.3,128.06,19
CPT,A6571,G com garment genital custm,,,662.94,769.67,19
CPT,A6572,Grad com garment toe caps,,,102.35,118.83,19
CPT,A6573,Grad com garmnt toe cap cust,,,242.87,281.97,19
CPT,A6574,Custom gradient sleev/glov,,,309.63,359.48,19
CPT,A6575,Gradient comp sleev/glov,,,100.34,116.49,19
CPT,A6576,Custom grad com sleeve med,,,190.03,220.62,19
CPT,A6577,Custom grad cm sleeve heavy,,,157.28,182.6,19
CPT,A6578,Gradient comp sleeve,,,77.46,89.93,19
CPT,A6579,Custom grad com glove med,,,305.02,354.13,19
CPT,A6580,Custom grad com glove heavy,,,302.78,351.53,19
CPT,A6581,Gradient comp glove,,,71.07,82.51,19
CPT,A6582,Gradient comp gauntlet,,,47.4,55.03,19
CPT,A6583,Grad com wrap w straps bk,,,155.92,181.02,19
CPT,A6585,Grad com wrap w straps ak,,,184.62,214.34,19
CPT,A6586,Grad com wrap w strap fu leg,,,543.9,631.47,19
CPT,A6587,Grad com wrap w straps foot,,,71.25,82.72,19
CPT,A6588,Grad com wrap w strap arm,,,237.46,275.69,19
CPT,A6589,Grad com wrap w straps bra,,,93.74,108.83,19
CPT,A6590,Urinary cath disp suc pump,,,1058.99,1263.57,8
CPT,A6591,Urinary cath suc pump,,,215.11,256.66,8
CPT,A6594,G comp bandge liner lwr extr,,,34.13,39.62,19
CPT,A6595,G comp bandge liner upr extr,,,33.57,38.97,19
CPT,A6596,G comp bandge conform gauze,,,0.18,0.21,19
CPT,A6597,G comp bandage long stretch,,,1.51,1.75,19
CPT,A6598,G comp bandage med stretch,,,0.73,0.85,19
CPT,A6599,G comp bandage short stretch,,,1.66,1.93,19
CPT,A6600,G com bandge hgh dn foam sht,,,2.99,3.47,19
CPT,A6601,G com bandge hgh dn foam pad,,,3.36,3.9,19
CPT,A6602,G com bandge hgh dn foamroll,,,4.9,5.69,19
CPT,A6603,G com bandge low dn foamchnl,,,2.3,2.67,19
CPT,A6604,G com bandge low dn foam flt,,,1.34,1.56,19
CPT,A6605,G com bandage padded foam,,,1.53,1.78,19
CPT,A6606,G com bandage padded textile,,,4.55,5.28,19
CPT,A6607,G com bandage tub protct lyr,,,1.22,1.42,19
CPT,A6608,G com bandage tub protct pad,,,5.07,5.89,19
CPT,A6610,G com stcking bk 18-30 custm,,,220.43,255.92,19
CPT,A7000,Disposable canister for pump,,,26.09,31.13,8
CPT,A7001,Nondisposable pump canister,,,111.87,133.49,8
CPT,A7002,Tubing used w suction pump,,,12.97,15.48,8
CPT,A7003,Nebulizer administration set,,,5.57,6.65,8
CPT,A7004,Disposable nebulizer sml vol,,,4.17,4.98,8
CPT,A7005,Nondisposable nebulizer set,,,54.63,65.18,8
CPT,A7006,Filtered nebulizer admin set,,,24.87,29.67,8
CPT,A7007,Lg vol nebulizer disposable,,,11.17,13.32,8
CPT,A7008,Disposable nebulizer prefill,,,37.18,44.36,8
CPT,A7009,Nebulizer reservoir bottle,,,142.24,169.72,8
CPT,A7010,Disposable corrugated tubing,,,54.78,65.36,8
CPT,A7012,Nebulizer water collec devic,,,9.51,11.35,8
CPT,A7013,Disposable compressor filter,,,1.88,2.25,8
CPT,A7014,Compressor nondispos filter,,,11.37,13.57,8
CPT,A7015,Aerosol mask used w nebulize,,,4.48,5.34,8
CPT,A7016,Nebulizer dome & mouthpiece,,,24.54,29.28,8
CPT,A7017,Nebulizer not used w oxygen,,,37.92,45.24,8
CPT,A7018,Water distilled w/nebulizer,,,0.99,1.19,8
CPT,A7020,Interface cough stim device,,,48.95,58.41,8
CPT,A7025,Replace chest compress vest,,,147.13,175.55,8
CPT,A7026,Replace chst cmprss sys hose,,,97.22,116.0,8
CPT,A7027,Combination oral/nasal mask,,,425.63,507.85,8
CPT,A7028,Repl oral cushion combo mask,,,114.98,137.19,8
CPT,A7029,Repl nasal pillow comb mask,,,49.95,59.6,8
CPT,A7030,Cpap full face mask,,,335.81,400.68,8
CPT,A7031,Replacement facemask interfa,,,126.37,150.78,8
CPT,A7032,Replacement nasal cushion,,,71.54,85.37,8
CPT,A7033,Replacement nasal pillows,,,55.21,65.88,8
CPT,A7034,Nasal application device,,,212.08,253.05,8
CPT,A7035,Pos airway press headgear,,,69.99,83.51,8
CPT,A7036,Pos airway press chinstrap,,,36.21,43.21,8
CPT,A7037,Pos airway pressure tubing,,,57.27,68.33,8
CPT,A7038,Pos airway pressure filter,,,8.62,10.29,8
CPT,A7039,Filter non disposable w pap,,,24.75,29.53,8
CPT,A7040,One way chest drain valve,,,138.61,165.39,8
CPT,A7041,Water seal drain container,,,260.37,310.67,8
CPT,A7044,Pap oral interface,,,267.83,319.57,8
CPT,A7045,Repl exhalation port for pap,,,3.89,4.64,8
CPT,A7046,Repl water chamber pap dev,,,43.84,52.31,8
CPT,A7047,Resp suction oral interface,,,408.92,487.91,8
CPT,A7048,Vacuum drain bottle/tube kit,,,144.91,172.9,8
CPT,A7501,Tracheostoma valve w diaphra,,,355.19,423.8,8
CPT,A7502,Replacement diaphragm/fplate,,,168.85,201.46,8
CPT,A7503,Hmes filter holder or cap,,,38.38,45.79,8
CPT,A7504,Tracheostoma hmes filter,,,2.31,2.76,8
CPT,A7505,Hmes or trach valve housing,,,15.87,18.93,8
CPT,A7506,Hmes/trachvalve adhesivedisk,,,1.09,1.3,8
CPT,A7507,Integrated filter & holder,,,8.44,10.07,8
CPT,A7508,Housing & integrated adhesiv,,,9.72,11.59,8
CPT,A7509,Heat & moisture exchange sys,,,4.75,5.67,8
CPT,A7520,Trach/laryn tube non-cuffed,,,160.57,191.59,8
CPT,A7521,Trach/laryn tube cuffed,,,159.1,189.84,8
CPT,A7522,Trach/laryn tube stainless,,,152.74,182.25,8
CPT,A7524,Tracheostoma stent/stud/bttn,,,261.83,312.41,8
CPT,A7525,Tracheostomy mask,,,6.97,8.32,8
CPT,A7526,Tracheostomy tube collar,,,11.47,13.68,8
CPT,A7527,Trach/laryn tube plug/stop,,,12.11,14.45,8
CPT,A8000,Soft protect helmet prefab,,,51.88,61.91,8
CPT,A8001,Hard protect helmet prefab,,,51.88,61.91,8
CPT,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 INTRAVENOUS SYRINGE,490.26,367.7,5.88,441.23,119
CPT,A9500,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.695,4.85,1223.42,1309
CPT,A9502,Tc99m tetrofosmin,,,247.23,294.99,8
CPT,A9503,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,180.0,135.0,2.16,162.0,357
CPT,A9503,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 25 MG IV SOLUTION,60.0,45.0,0.72,54.0,119
CPT,A9503,Tc99m medronate,,,37.69,44.97,8
CPT,A9505,Tl201 thallium,,,94.68,112.97,8
CPT,A9506,Tc-99m graphite crucible,,,328.6,381.5,19
CPT,A9507,In111 capromab,,,1730.29,2534.53,17
CPT,A9508,I131 iodobenguate dx,,,953.01,953.01,9
CPT,A9509,Iodine i-123 sod iodide mil,,,521.1,621.77,8
CPT,A9510,Tc99m disofenin,,,202.95,242.15,8
CPT,A9512,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,29374.004999999997,22030.5,0.15,77926.1,3094
CPT,A9512,Tc99m pertechnetate,,,4.52,5.4,8
CPT,A9513,LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION,191164.32,143373.24,2293.97,172047.89,238
CPT,A9513,Lutetium lu 177 dotatat ther,,,296.25,947.86,27
CPT,A9515,Choline c-11,,,2062.94,17296.65,27
CPT,A9516,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,2299.01,1724.26,27.59,2069.11,119
CPT,A9516,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE,829.83,622.38,2.16,3976.57,357
CPT,A9517,I131 iodide cap rx,,,23.13,123.5,27
CPT,A9517,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE (THERANOSTIC),99.0,74.25,1.19,89.1,119
CPT,A9520,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1804.8,1353.6,21.66,1624.32,238
CPT,A9520,Tc99 tilmanocept diag 0.5mci,,,1918.08,2288.62,8
CPT,A9521,KIT FOR PREPARATION OF TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS SOLUTION,5641.15,4230.87,67.69,5077.04,119
CPT,A9521,Tc99m exametazime,,,802.34,5489.99,27
CPT,A9524,I131 serum albumin dx,,,1501.58,1791.66,8
CPT,A9526,Nitrogen n-13 ammonia,,,1910.6,2279.7,8
CPT,A9527,Iodine i-125 sodium iodide,,,208.58,396.32,19
CPT,A9530,I131 iodide sol rx,,,20.77,24.24,19
CPT,A9530,SODIUM IODIDE-131 (I-131) 250 MCI/0.25 ML ORAL KIT (THERANOSTIC),435.75,326.81,5.23,392.18,119
CPT,A9532,I125 serum albumin dx,,,469.06,469.06,9
CPT,A9536,Tc99m depreotide,,,2059.05,2456.82,8
CPT,A9537,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,289.275,216.95999999999998,3.21,280.12,357
CPT,A9537,Tc99m mebrofenin,,,160.37,191.35,8
CPT,A9538,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,285.325,213.995,2.7,311.08,238
CPT,A9538,Tc99m pyrophosphate,,,185.71,221.58,8
CPT,A9539,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,714
CPT,A9539,Tc99m pentetate,,,90.84,108.39,8
CPT,A9540,KIT FOR PREPARATION OF TC 99M-ALBUMIN 2.5 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,119
CPT,A9540,Tc99m maa,,,86.98,103.78,8
CPT,A9541,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,1632.0,1224.0,19.58,1468.8,238
CPT,A9541,Tc99m sulfur colloid,,,775.17,924.91,8
CPT,A9542,In111 ibritumomab dx,,,798.02,12107.66,18
CPT,A9543,KIT FOR YTTRIUM-90-IBRITUMOMAB 3.2 MG/2 ML INTRAVENOUS,190068.69,142551.52,1003.68,208709.06,357
CPT,A9543,Y90 ibritumomab rx,,,56824.55,213684.06,27
CPT,A9546,Co57/58,,,3.28,3.92,8
CPT,A9547,In111 oxyquinoline,,,772.64,6185.71,27
CPT,A9548,In111 pentetate,,,715.29,2701.28,27
CPT,A9548,PENTETATE INDIUM DISODIUM IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4574.02,3430.52,54.89,4116.62,119
CPT,A9551,KIT FOR PREPARATION TC-99M-SUCCIMER 1 MG INTRAVENOUS SOLUTION,3918.385,2938.79,27.62,4981.5,357
CPT,A9551,Tc99m succimer,,,659.93,2073.56,17
CPT,A9552,F18 fdg,,,913.13,1089.53,8
CPT,A9552,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,1898.88,1424.16,10.23,2650.75,714
CPT,A9553,Cr51 chromate,,,1158.22,1917.96,17
CPT,A9554,I125 iothalamate dx,,,108.72,649.64,17
CPT,A9555,RUBIDIUM RB-82 CHLORIDE INTRAVENOUS SOLUTION,754.72,566.04,9.06,679.25,238
CPT,A9555,Rb82 rubidium,,,1324.37,1580.22,8
CPT,A9556,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,4384.42,3288.32,6.72,8878.13,595
CPT,A9556,Ga67 gallium,,,391.45,467.07,8
CPT,A9557,KIT FOR PREPARATION OF TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLUTION,13528.74,10146.56,162.34,12175.87,119
CPT,A9557,Tc99m bicisate,,,683.8,11296.9,27
CPT,A9558,XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) GAS FOR INHALATION,1148.165,861.12,11.76,1185.07,238
CPT,A9558,XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) GAS FOR INHALATION,2065.02,1548.7649999999999,23.94,1921.61,238
CPT,A9558,Xe133 xenon 10mci,,,670.84,800.44,8
CPT,A9559,Co57 cyano,,,226.27,269.98,8
CPT,A9560,KIT FOR TC 99M-LABELED RED BLOOD CELLS INTRAVENOUS SOLUTION,796.8,597.6,9.56,717.12,119
CPT,A9560,Tc99m labeled rbc,,,270.8,323.12,8
CPT,A9561,KIT FOR PREPARATION OF TC-99M-SODIUM OXIDRONATE 3.15 MG IV SOLUTION,198.0,148.5,2.38,178.2,238
CPT,A9561,Tc99m oxidronate,,,127.56,152.21,8
CPT,A9562,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,1186.97,890.225,4.3,1814.4,357
CPT,A9562,Tc99m mertiatide,,,2246.25,2680.19,8
CPT,A9563,P32 na phosphate,,,179.12,1054.67,27
CPT,A9564,P32 chromic phosphate,,,842.13,1004.82,8
CPT,A9568,Technetium tc99m arcitumomab,,,809.51,3747.61,18
CPT,A9569,Technetium tc-99m auto wbc,,,934.13,5489.99,27
CPT,A9570,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,13196.36,9897.27,158.36,11876.72,119
CPT,A9570,Indium in-111 auto wbc,,,1031.39,12371.45,27
CPT,A9571,Indium in-111 auto platelet,,,10368.45,12371.45,8
CPT,A9572,INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT,14169.6,10627.2,170.04,12752.64,238
CPT,A9572,Indium in-111 pentetreotide,,,1914.61,19635.16,27
CPT,A9573,Inj gadopiclenol 1 ml,,,4.88,4.88,8
CPT,A9575,Inj gadoterate meglumi 0.1ml,,,0.14,0.14,44
CPT,A9576,Inj prohance multipack,,,1.42,1.72,44
CPT,A9577,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,429.81,322.36,2.13,567.54,476
CPT,A9577,Inj multihance,,,1.84,2.12,44
CPT,A9578,Inj multihance multipack,,,1.8,2.1,44
CPT,A9579,Gad-base mr contrast nos1ml,,,1.58,1.75,44
CPT,A9581,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,464.92,348.69,5.58,418.43,119
CPT,A9581,Gadoxetate disodium inj,,,14.74,17.23,44
CPT,A9582,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN,3022.86,2267.15,36.27,2720.57,119
CPT,A9582,Iodine i-123 iobenguane,,,2074.81,15583.46,27
CPT,A9584,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3790.85,2843.14,45.49,3411.76,119
CPT,A9584,Iodine i-123 ioflupane,,,1387.74,8537.62,27
CPT,A9585,GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,2365.5,1774.125,17.93,2913.3,238
CPT,A9585,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,498.0,373.5,5.98,448.2,119
CPT,A9585,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,534.0,400.5,6.41,480.6,119
CPT,A9585,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,747.0,560.25,8.96,672.3,119
CPT,A9585,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,99.6,74.7,1.2,89.64,119
CPT,A9585,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,373.5,280.12,4.48,336.15,119
CPT,A9585,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,403.52,302.64,4.84,363.17,119
CPT,A9585,Gadobutrol injection,,,0.32,0.33,44
CPT,A9586,FLORBETAPIR F-18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,10543.81,7907.85,126.53,9489.43,119
CPT,A9586,Florbetapir f18,,,1825.64,9884.7,26
CPT,A9587,Gallium ga-68,,,49.63,192.2,27
CPT,A9587,KIT FOR THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN,11512.8,8634.6,138.15,10361.52,119
CPT,A9588,FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
CPT,A9588,Fluciclovine f-18,,,268.42,1660.48,27
CPT,A9589,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,2846.0,2134.5,34.15,2561.4,119
CPT,A9589,Insti hexaminolevulinate hcl,,,1230.84,1598.38,44
CPT,A9591,Fluoroestradiol f 18,,,460.42,2419.99,27
CPT,A9592,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
CPT,A9592,Copper cu 64 dotatate diag,,,594.28,3329.6,27
CPT,A9593,Gallium ga-68 psma-11 ucsf,,,534.91,621.03,19
CPT,A9594,Gallium ga-68 psma-11 ucla,,,363.5,432.09,19
CPT,A9595,PIFLUFOLASTAT F 18  296 MBQ TO 370 MBQ (8 MCI TO 10 MCI) IV SYRINGE,18931.48,14198.61,227.18,17038.33,119
CPT,A9595,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML (1-80 MCI/ML) IV SOLUTION",17483.22,13112.42,209.8,15734.9,119
CPT,A9595,Piflu f-18 dia 1 millicurie,,,332.44,1893.98,27
CPT,A9596,Gallium illuccix 1 millicure,,,478.52,3251.77,27
CPT,A9596,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,20562.3,15421.725,221.4,20407.14,357
CPT,A9597,Pet dx for tumor id noc,,,2319.4,2767.46,8
CPT,A9600,Sr89 strontium,,,4146.34,12972.49,27
CPT,A9601,Flortaucipir inj 1 millicuri,,,371.0,4307.31,19
CPT,A9602,Fluorodopa f-18 diag per mci,,,855.55,1756.09,26
CPT,A9604,Sm 153 lexidronam,,,3159.8,56327.88,27
CPT,A9606,"RADIUM RA 223 DICHLOR 1,100 KBQ/ML (30 MICROCURIE/ML) INTRAVENOUS SOLN",102892.62,77169.46,1234.71,92603.36,119
CPT,A9606,Radium ra223 dichloride ther,,,168.71,199.95,27
CPT,A9607,"LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",155669.85,116752.39,1868.04,140102.87,119
CPT,A9607,Lutetium lu 177 vipivotide,,,241.21,749.83,27
CPT,A9608,"FLOTUFOLASTAT F 18 GALLIUM 296-5,846 MBQ/ML (8-158 MCI/ML) IV SOLUTION",18450.0,13837.5,221.4,16605.0,119
CPT,A9608,Flotufolastat f18 diag 1 mci,,,651.67,779.29,19
CPT,A9609,FLUDEOXYGLUCOSE F-18 20 MCI TO 200 MCI/ML INTRAVENOUS SOLUTION,477.25,357.94,5.73,429.52,119
CPT,A9611,Flurpiridaz f18 diag 1 mci,,,530.0,615.33,18
CPT,A9612,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,1224.25,918.19,14.69,1101.82,238
CPT,A9615,Inj pegulicianine 1 mg,,,37.51,43.55,18
CPT,A9616,Gallium gozellix 1 millicuri,,,1171.3,1359.88,18
CPT,A9697,Inj magtrace per study dose,,,1137.96,1455.89,19
CPT,A9698,Non-rad contrast materialnoc,,,29.27,34.92,8
CPT,A9698,RADIOPAQUE PVC MARKERS-BARIUM SULFATE 24 MARKERS CAPSULE,83.7,62.78,1.0,75.33,119
CPT,A9800,Gallium locametz 1 millicuri,,,362.5,2850.49,27
CPT,A9800,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,15202.8,11402.1,182.43,13682.52,119
CPT,A9983,FLORBETABEN F-18 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,11439.0,8579.25,123.98,11291.4,238
CPT,ATP02,Automated Panel - 2 Tests,,,18.18,21.69,8
CPT,ATP03,Automated Panel - 3 Tests,,,23.2,27.68,8
CPT,ATP04,Automated Panel - 4 Tests,,,24.46,29.19,8
CPT,ATP05,Automated Panel - 5 Tests,,,27.29,32.56,8
CPT,ATP06,Automated Panel - 6 Tests,,,27.37,32.66,8
CPT,ATP07,Automated Panel - 7 Tests,,,28.51,34.02,8
CPT,ATP08,Automated Panel - 8 Tests,,,29.5,35.2,8
CPT,ATP09,Automated Panel - 9 Tests,,,30.29,36.14,8
CPT,ATP10,Automated Panel - 10 Tests,,,30.29,36.14,8
CPT,ATP11,Automated Panel - 11 Tests,,,30.83,36.78,8
CPT,ATP12,Automated Panel - 12 Tests,,,31.51,37.6,8
CPT,ATP16,Automated Panel - 16 Tests,,,36.85,43.97,8
CPT,ATP18,Automated Panel - 18 Tests,,,37.13,44.3,8
CPT,ATP19,Automated Panel - 19 Tests,,,38.61,46.06,8
CPT,ATP20,Automated Panel - 20 Tests,,,39.83,47.52,8
CPT,ATP21,Automated Panel - 21 Tests,,,41.1,49.04,8
CPT,ATP22,Automated Panel - 22 Tests,,,42.32,50.49,8
CPT,ATP23,Automated Panel - 23 Tests,,,42.32,50.49,8
CPT,B4034,Enter feed supkit syr by day,,,3.92,14.08,9
CPT,B4035,Enteral feed supp pump per d,,,6.95,25.77,9
CPT,B4036,Enteral feed sup kit grav by,,,5.25,18.72,9
CPT,B4081,Enteral ng tubing w/ stylet,,,19.14,61.2,9
CPT,B4082,Enteral ng tubing w/o stylet,,,13.59,44.12,9
CPT,B4083,Enteral stomach tube levine,,,2.13,6.86,9
CPT,B4087,Gastro/jejuno tube std,,,35.15,108.66,9
CPT,B4088,Gastro/jejuno tube low-pro,,,42.44,124.29,9
CPT,B4148,Enteral feed elastomer daily,,,7.37,7.37,1
CPT,B4149,Ef blenderized foods,,,1.27,4.19,9
CPT,B4150,Ef complet w/intact nutrient,,,0.47,1.64,9
CPT,B4152,Ef calorie dense>/1.5kcal,,,0.4,1.37,9
CPT,B4153,Ef hydrolyzed/amino acids,,,1.55,5.1,9
CPT,B4154,Ef spec metabolic noninherit,,,0.84,2.94,9
CPT,B4155,Ef incomplete/modular,,,0.98,2.97,9
CPT,B4164,Parenteral 50% dextrose solu,,,24.66,71.22,9
CPT,B4168,Parenteral sol amino acid 3.,,,35.96,103.87,9
CPT,B4176,Parenteral sol amino acid 7-,,,69.57,200.95,9
CPT,B4178,Parenteral sol amino acid >,,,83.49,241.12,9
CPT,B4180,Parenteral sol carb > 50%,,,35.4,102.23,9
CPT,B4185,Pn soln nos 10 grams lipids,,,16.29,47.06,9
CPT,B4187,Omegaven 10 grams lipids,,,16.29,47.06,9
CPT,B4189,Parenteral sol amino acid &,,,257.9,744.91,9
CPT,B4193,Parenteral sol 52-73 gm prot,,,333.24,962.48,9
CPT,B4197,Parenteral sol 74-100 gm pro,,,405.72,1171.83,9
CPT,B4199,Parenteral sol > 100gm prote,,,463.6,1339.0,9
CPT,B4216,Parenteral nutrition additiv,,,11.2,32.35,9
CPT,B4220,Parenteral supply kit premix,,,11.61,33.53,9
CPT,B4222,Parenteral supply kit homemi,,,14.33,41.39,9
CPT,B4224,Parenteral administration ki,,,36.27,104.75,9
CPT,B5000,Parenteral sol renal-amirosy,,,17.25,49.82,9
CPT,B5100,Parenteral solution hepatic,,,6.74,19.45,9
CPT,B9002,Enter nutr inf pump any type,,,229.78,274.17,8
CPT,B9004,Parenteral infus pump portab,,,1402.81,1673.81,8
CPT,B9006,Parenteral infus pump statio,,,1402.81,1673.81,8
CPT,C1052,HC CATHETER GI SUPPLY LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1600,Cath bladed vasc prep,,,,,0
CPT,C1601,Endo single pulmonary,,,,,0
CPT,C1602,Orth/matrx/bn fill drug-elut,,,,,0
CPT,C1603,HC RTRV/INSRT/LASER DEVICE FOR IVC FLTR LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1603,Ret dev laser ivc filter,,,,,0
CPT,C1604,Grft trnsmurl/trnsvens byps,,,,,0
CPT,C1605,Pmkr dual leadless,,,,,0
CPT,C1606,Adapter us to endoscope,,,,,0
CPT,C1607,Neurostim integ rechg,,,,,0
CPT,C1608,Prosthesis dual mob cmc1,,,,,0
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1713,HC ANCHOR/SCREW BONE/SOFT TISSUE-TO-BONE LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1714,HC CATHETER ATHERECTOMY DIRECTIONAL LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1714,HC CATHETER ATHERECTOMY DIRECTIONAL LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1716,Brachytx non-str gold-198,,,513.57,1008.13,19
CPT,C1717,Brachytx non-strhdr ir-192,,,342.39,397.51,19
CPT,C1717,HC BRACHYTHERAPY SOURCE HDR IR192,64501.4,48376.05,774.02,58051.26,119
CPT,C1719,Brachytx ns non-hdrir-192,,,564.5,908.7,19
CPT,C1721,HC ICD DUAL CHAMBER LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 53,64501.4,48376.05,774.02,58051.26,119
CPT,C1721,HC ICD DUAL CHAMBER LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 52,58637.6,43978.2,703.65,52773.84,119
CPT,C1722,HC ICD SINGLE CHAMBER LVL 56,74903.9,56177.92,898.85,67413.51,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1724,HC CATHETER ATHERECTOMY ROTATIONAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1725,HC CATHETER BLLN PTA LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1725,HC CATHETER BLLN PTA LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1725,HC CATHETER BLLN PTA LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1725,HC CATHETER BLLN PTA LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1725,HC CATHETER BLLN PTA LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1725,HC CATHETER BLLN PTA LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1725,HC CATHETER BLLN PTA LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1725,HC CATHETER BLLN PTA LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1725,HC CATHETER BLLN PTA LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1725,HC CATHETER BLLN PTA LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1725,HC CATHETER BLLN PTA LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1725,HC CATHETER BLLN PTA LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1725,HC CATHETER BLLN PTA LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1725,HC CATHETER BLLN PTA LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1725,HC CATHETER BLLN PTA LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1725,HC CATHETER BLLN PTA LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1725,HC CATHETER BLLN PTA LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1725,HC CATHETER BLLN PTA LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1725,HC CATHETER BLLN PTA LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1725,HC CATHETER BLLN PTA LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1725,HC CATHETER BLLN PTA LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1725,HC CATHETER BLLN PTA LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1725,HC CATHETER BLLN PTA LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1725,HC CATHETER BLLN PTA LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1725,HC CATHETER BLLN PTA LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1726,HC CATH BAL CERV RIPEN,341.45,256.09,4.1,307.3,119
CPT,C1726,HC CATH NASAL EPISTAT,516.5,387.38,6.2,464.85,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 12",473.25,354.94,5.68,425.92,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 17",1424.6,1068.45,17.1,1282.14,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 18",1780.8,1335.6,21.37,1602.72,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 19",2058.15,1543.61,24.7,1852.34,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 26",4315.0,3236.25,51.78,3883.5,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 28",5054.65,3790.99,60.66,4549.18,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 34",10247.6,7685.7,122.97,9222.84,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 36",12969.7,9727.28,155.64,11672.73,119
CPT,C1726,"HC CATHETER BLLN, DILATATION, NON-VASC LVL 37",14590.95,10943.21,175.09,13131.86,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 10",278.25,208.69,3.34,250.42,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 14",729.25,546.94,8.75,656.32,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 15",911.65,683.74,10.94,820.48,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 16",1139.65,854.74,13.68,1025.69,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 22",2853.35,2140.01,34.24,2568.02,119
CPT,C1726,"HC CATHETER BLLN, DILATION, NON-VASC LVL 9",185.45,139.09,2.23,166.9,119
CPT,C1728,HC CATHETER BRACHYTX SEED ADM LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1728,HC SAVI APPLICATOR 10-1,9230.0,6922.5,110.76,8307.0,119
CPT,C1728,HC SAVI APPLICATOR 6.1,9230.0,6922.5,110.76,8307.0,119
CPT,C1728,HC SAVI APPLICATOR 6.1-1 MINI,9230.0,6922.5,110.76,8307.0,119
CPT,C1728,HC SAVI APPLICATOR 8.1,9230.0,6922.5,110.76,8307.0,119
CPT,C1729,HC CATH ARGYLE UVC 3.5F- 5F 15IN SL,67.85,50.89,0.81,61.06,119
CPT,C1729,HC CATH ARGYLE UVC 3.5F-5FR DL/TL,219.45,164.59,2.63,197.5,119
CPT,C1729,HC CATH BACTISEAL EVD 1.9MM ID,2419.25,1814.44,29.03,2177.33,119
CPT,C1729,HC CATH CSF BACTISEAL EVD 1.5MM,2072.05,1554.04,24.86,1864.85,119
CPT,C1729,HC CATH DRAIN DAWSON MUELLER,336.15,252.11,4.03,302.53,119
CPT,C1729,HC CATH EDM LUMBAR 80CM,1035.35,776.51,12.42,931.82,119
CPT,C1729,HC CATH EDM VENTRICULAR 35CM,758.95,569.21,9.11,683.06,119
CPT,C1729,HC CATH HERMETIC LUMBAR CLOSED TIP DRAIN,759.85,569.89,9.12,683.86,119
CPT,C1729,HC CATH RESOLVE LOKG 10F 30CM PIG,310.5,232.88,3.73,279.45,119
CPT,C1729,HC CATH THORACIC ALL SIZE (ARGYLE/PLEUR),35.95,26.96,0.43,32.36,119
CPT,C1729,HC CATH VENTRICLEAR II EVD DRNG (G44130),1355.6,1016.7,16.27,1220.04,119
CPT,C1729,HC CATH VENTRICULAR TRAUMACATH SET,690.25,517.69,8.28,621.22,119
CPT,C1729,HC CATHETER DRAINAGE LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1729,HC CATHETER DRAINAGE LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1729,HC CATHETER DRAINAGE LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1729,HC CATHETER DRAINAGE LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1729,HC CATHETER DRAINAGE LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1729,HC CATHETER DRAINAGE LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1729,HC CATHETER DRAINAGE LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1729,HC CATHETER DRAINAGE LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1729,HC CATHETER DRAINAGE LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1729,HC CATHETER DRAINAGE LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1729,HC CATHETER DRAINAGE LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1729,HC CATHETER DRAINAGE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1729,HC CATHETER DRAINAGE LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1729,HC CATHETER DRAINAGE LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1729,HC CATHETER DRAINAGE LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1729,HC CATHETER DRAINAGE LVL 4,24.3,18.23,0.29,21.87,119
CPT,C1729,HC CATHETER DRAINAGE LVL 5,36.55,27.41,0.44,32.89,119
CPT,C1729,HC CATHETER DRAINAGE LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1729,HC CATHETER DRAINAGE LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1729,HC CATHETER DRAINAGE LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1729,HC CATHETER DRAINAGE LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1729,HC EDM LUMBAR DRAIN KIT 700ML,1302.95,977.21,15.64,1172.66,119
CPT,C1729,HC KIT EXT DRAIN MONITOR CSF BECKER,982.7,737.02,11.79,884.43,119
CPT,C1729,HC KIT FUHRMAN PLURAL PNEUMOPERIC,638.0,478.5,7.66,574.2,119
CPT,C1729,HC KIT PERCDTS P-TAIL LF CATH 8F,597.4,448.05,7.17,537.66,119
CPT,C1729,HC KIT PERICARDIOCENTESIS PC 100,474.85,356.14,5.7,427.36,119
CPT,C1729,HC KIT PNEUMOTHORAX,499.35,374.51,5.99,449.42,119
CPT,C1729,HC SET CATH WAYNE PNEUMOTHORAX,1233.95,925.46,14.81,1110.56,119
CPT,C1729,HC SYSTEM DRAIN LIMITORR VOL 20ML,1617.6,1213.2,19.41,1455.84,119
CPT,C1729,HC TRAY PERCARDIOCENTESIS LOCK 8.3F 40CM,866.2,649.65,10.39,779.58,119
CPT,C1729,HC TRAY PNEUMOTHORAX 9F -10.2,1110.3,832.72,13.32,999.27,119
CPT,C1729,HC TRAY THAL-QUICK CHEST TUBE ALL SIZES,1005.75,754.31,12.07,905.18,119
CPT,C1729,HC TRAY THORA 6F SFTY,414.0,310.5,4.97,372.6,119
CPT,C1729,HC TRAY THORA PARA 5FR DRAIN,267.9,200.92,3.21,241.11,119
CPT,C1729,HC TRAY THORACIC VENT PROCEDURE,1096.75,822.56,13.16,987.08,119
CPT,C1729,HC TRAY TURKEL PNEUMOTHORAX 8F,509.8,382.35,6.12,458.82,119
CPT,C1729,HC TUBE CHEST 8-12FR,83.6,62.7,1.0,75.24,119
CPT,C1730,HC CATH PACE TEMP 6F,900.75,675.56,10.81,810.68,119
CPT,C1730,HC CATH PACE VEN TEMP 5F 100CM,402.3,301.73,4.83,362.07,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1730,HC CATHETER EP 19-FEWER ELECTRODES LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1731,HC CATHETER EP 20+ ELECTRODES LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1731,HC CATHETER EP 20+ ELECTRODES LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1731,HC CATHETER EP 20+ ELECTRODES LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1731,HC CATHETER EP 20+ ELECTRODES LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1732,HC CATHETER EP DIAG/ABL/3D/MAP LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1733,HC CATHETER EP DIAG/ABL NON-3D/MAP/COOL-TIP LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1735,Cath renal denerv radiofreq,,,,,0
CPT,C1736,Cath renal denerv ultrasnd,,,,,0
CPT,C1737,Si&pelvis fusn&fixn dev,,,,,0
CPT,C1738,Power endo us-guid bx dev,,,,,0
CPT,C1739,Marker uniq detect w/prbe,,,,,0
CPT,C1740,Lt vent pacing syst sequen,,,,,0
CPT,C1741,Anchor/screw bone absorb,,,,,0
CPT,C1742,Pressure sens syst cont im,,,,,0
CPT,C1747,Endo single urinary tract,,,,,0
CPT,C1747,HC ENDOSCOPE INSERT SINGLE USE LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1748,HC ENDOSCOPE SINGLE USE LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1750,HC CATHETER HEMO/PERIT LONG-TERM IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1751,HC CATH CV HANDS-OFF TRPL-LUM 7F,185.55,139.16,2.23,167.0,119
CPT,C1751,HC CATH CV PICC 1.9FR DL 30CM,415.3,311.48,4.98,373.77,119
CPT,C1751,HC CATH CVC 1 LUMEN TELEFLEX,121.15,90.86,1.45,109.04,119
CPT,C1751,HC CATH CVC 2 LUMEN TELEFLEX,164.7,123.52,1.98,148.23,119
CPT,C1751,"HC CATH CVC 2L 4F,5F 12-15CM PED",886.75,665.06,10.64,798.08,119
CPT,C1751,HC CATH CVC 3 LUMEN TELEFLEX,262.2,196.65,3.15,235.98,119
CPT,C1751,"HC CATH CVC TRAY 1L  4F, 5F 5-12CM",513.35,385.01,6.16,462.02,119
CPT,C1751,HC CATH INFSN SLIC 1L 7F 6IN,45.45,34.09,0.55,40.9,119
CPT,C1751,HC CATH MIDLINE 3FR 20CM,699.75,524.81,8.4,629.78,119
CPT,C1751,HC CATH MIDLINE POWER 4FR SL 20CM,515.55,386.66,6.19,463.99,119
CPT,C1751,HC CATH NUTRILINE 2FR 30CM,304.65,228.49,3.66,274.18,119
CPT,C1751,HC CATH NUTRILINE PICC 2F 30CM,348.0,261.0,4.18,313.2,119
CPT,C1751,HC CATH NUTRILINE TWINFLO 2F 30CM,570.75,428.06,6.85,513.68,119
CPT,C1751,HC CATH PERCUT EMG CRICO 6MM KIT,1016.45,762.34,12.2,914.8,119
CPT,C1751,HC CATH PICC 1ST SL 1.9F 50CM,191.5,143.62,2.3,172.35,119
CPT,C1751,HC CATH PICC 2.6FR DL 50CM BASIC,630.05,472.54,7.56,567.04,119
CPT,C1751,HC CATH PICC 20G W/INTROSYTE-N,418.8,314.1,5.03,376.92,119
CPT,C1751,HC CATH PICC 3CG 4F 2-LUMEN,1118.9,839.18,13.43,1007.01,119
CPT,C1751,HC CATH PICC POWER 3FR SL BASIC,620.7,465.52,7.45,558.63,119
CPT,C1751,HC CATH PICC POWER 4FR DL 3CG FULL,1053.9,790.42,12.65,948.51,119
CPT,C1751,HC CATH PICC POWER 4FR SL NO TECH IR BASIC,378.65,283.99,4.54,340.78,119
CPT,C1751,HC CATH PICC POWER 5FR DL 3CG BASIC,816.75,612.56,9.8,735.08,119
CPT,C1751,HC CATH PICC POWER 5FR TL SHERLOCK BASIC HF,830.75,623.06,9.97,747.68,119
CPT,C1751,HC CATH PICC PROVENA 3F SL IR W/70CM GW,568.85,426.64,6.83,511.96,119
CPT,C1751,HC CATH PICC PROVENA 3FR SL 3CG,1202.75,902.06,14.43,1082.48,119
CPT,C1751,HC CATH PICC PROVENA 4FR DL IR W/135CM GW,612.75,459.56,7.35,551.48,119
CPT,C1751,HC CATH POWER MIDLINE 4FR,620.7,465.52,7.45,558.63,119
CPT,C1751,HC CATH POWERPICC PROVENA SOLO 5F,1206.25,904.69,14.48,1085.62,119
CPT,C1751,HC CATH PREMICATH 1.1F 20CM,278.05,208.54,3.34,250.24,119
CPT,C1751,HC CATH PREMICATH 1F W/STYLT,362.9,272.18,4.35,326.61,119
CPT,C1751,HC CATH SWAN 2L 7F 110CM,485.35,364.01,5.82,436.82,119
CPT,C1751,HC CATH SWAN SV02&EDV 110CM 8F,2672.7,2004.52,32.07,2405.43,119
CPT,C1751,HC CATH VASCULAR W/GW 20CM LEADERFLEX,215.75,161.81,2.59,194.18,119
CPT,C1751,HC CATHETER CV PICC 1.9FR SL 30CM,174.25,130.69,2.09,156.83,119
CPT,C1751,HC CATHETER DOUBLE LUMEN,578.7,434.02,6.94,520.83,119
CPT,C1751,HC CATHETER FILLIFORM SUPPLY LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1751,HC CATHETER INFUSION LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1751,HC CATHETER INFUSION LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1751,HC CATHETER INFUSION LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1751,HC CATHETER INFUSION LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1751,HC CATHETER INFUSION LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1751,HC CATHETER INFUSION LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1751,HC CATHETER INFUSION LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1751,HC CATHETER INFUSION LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1751,HC CATHETER INFUSION LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1751,HC CATHETER INFUSION LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1751,HC CATHETER INFUSION LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1751,HC CATHETER INFUSION LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1751,HC CATHETER INFUSION LVL 22272C175122,2853.35,2140.01,34.24,2568.02,119
CPT,C1751,HC CATHETER INFUSION LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1751,HC CATHETER INFUSION LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1751,HC CATHETER INFUSION LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1751,HC CATHETER INFUSION LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1751,HC CATHETER INFUSION LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1751,HC CATHETER INFUSION LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1751,HC CATHETER INFUSION LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1751,HC CATHETER INFUSION LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1751,HC CATHETER INFUSION LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1751,HC CATHETER SINGLE LUMEN,536.7,402.52,6.44,483.03,119
CPT,C1751,HC CATHETER TRIPLE LUMEN,723.4,542.55,8.68,651.06,119
CPT,C1751,HC CENTRAL LINE CATHETER (NURSING FLR),840.05,630.04,10.08,756.04,119
CPT,C1751,HC KIT ART CATHETERIZATION 18 GA X 16CM,551.3,413.48,6.62,496.17,119
CPT,C1751,HC KIT CATH CVC TEMP ANTIMIC 7FR TL 16CM FULL,519.9,389.92,6.24,467.91,119
CPT,C1751,HC KIT CATH PICC SINGLE LUMEN 4FR 55CM,652.0,489.0,7.82,586.8,119
CPT,C1751,HC KIT CVC 3 LUM PRES INJECT 7 FR X 20 CM AGB,519.9,389.92,6.24,467.91,119
CPT,C1751,HC KIT CVC PRES INJECT 7FR-8.5FR X 16/18/20CM AGB (CDC),595.5,446.62,7.15,535.95,119
CPT,C1751,HC KIT PI CVC 3-LUMEN 7F X 20CM,463.15,347.36,5.56,416.84,119
CPT,C1751,HC MAC KIT 2L 9FR DISTAL 11.5 CM AGB,845.65,634.24,10.15,761.08,119
CPT,C1751,HC TRAY CATH PICC PROVENA 4FR DL IR W/70CM GW,685.5,514.12,8.23,616.95,119
CPT,C1751,HC TRAY CATH POWERGLIDE,509.55,382.16,6.11,458.6,119
CPT,C1751,HC TRAY POWERPICC 5F 3L MAX TPS,1089.75,817.31,13.08,980.78,119
CPT,C1751,HC TRAY POWERPICC CATH 4F 1L 3CG BASIC,816.75,612.56,9.8,735.08,119
CPT,C1751,HC TRAY POWERPICC CATH 4F 1L MAX,910.05,682.54,10.92,819.04,119
CPT,C1751,HC TRAY POWERPICC SOLO 4F 1L MAX,1026.45,769.84,12.32,923.8,119
CPT,C1751,HC TRAY TRIALYSIS CATH STRAIGHT,977.8,733.35,11.73,880.02,119
CPT,C1751,HC TRAY TRIALYSIS POWER CATH CRV TEMP,1030.1,772.58,12.36,927.09,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1752,HC CATHETER HEMO/PERIT SHORT-TERM LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1752,HC KIT TRIALYSIS POWER CATH ST OR CRV,799.9,599.92,9.6,719.91,119
CPT,C1752,HC TRAY TRIALYSIS POWER ST OR CRV,1030.1,772.58,12.36,927.09,119
CPT,C1753,HC CATHETER IVUS LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1753,HC CATHETER IVUS LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1753,HC CATHETER IVUS LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1753,HC CATHETER IVUS LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1753,HC CATHETER IVUS LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1753,HC CATHETER IVUS LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1753,HC CATHETER IVUS LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1753,HC CATHETER IVUS LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1755,HC CATHETER INTRASPINAL LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1755,HC CATHETER INTRASPINAL LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1755,HC CATHETER INTRASPINAL LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1757,HC CATHETER THROMB/EMBOLECTOMY LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1759,HC CATHETER INTRACARD ECHO LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1760,HC CLOSURE DEVICE-VASCULAR NON IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1761,HC CATH TRANSLUM INTRAVASC LITHO/CORONARY LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1763,HC CONNECTIVE TISSUE NON-HUMAN LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1763,HC CONNECTIVE TISSUE NON-HUMAN LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1764,HC LOOP RECORDER IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1764,HC LOOP RECORDER IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1764,HC LOOP RECORDER IMPLANT LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1764,HC LOOP RECORDER IMPLANT LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1766,HC INTRO-SHEATH STEERABLE LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1767,HC GENERATOR NEURO NON-RECHARG IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1768,HC GRAFT VASCULAR IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1768,HC GRAFT VASCULAR IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1768,HC GRAFT VASCULAR IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1769,HC CATH MELKER UNIV 5MMX9CM SET,2613.15,1959.86,31.36,2351.84,119
CPT,C1769,HC GUIDEWIRE 3MM J .035INX150 STD,34.3,25.72,0.41,30.87,119
CPT,C1769,HC GUIDEWIRE BMW 190CM J-TIP,340.8,255.6,4.09,306.72,119
CPT,C1769,HC GUIDEWIRE COONS / ULTRA 145CM,130.15,97.61,1.56,117.14,119
CPT,C1769,HC GUIDEWIRE COPE / TORQ FLEX .018 X 60,120.65,90.49,1.45,108.58,119
CPT,C1769,HC GUIDEWIRE COPE MANDRIL ANGD,152.8,114.6,1.83,137.52,119
CPT,C1769,HC GUIDEWIRE GLIDE/STIFF ANG 150CM/180CM,293.45,220.09,3.52,264.1,119
CPT,C1769,HC GUIDEWIRE HI-TORQUE FLEX-T .018X145CM,378.65,283.99,4.54,340.78,119
CPT,C1769,HC GUIDEWIRE HYDROPHILIC ANGLED 035X150,141.35,106.01,1.7,127.22,119
CPT,C1769,HC GUIDEWIRE LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1769,HC GUIDEWIRE LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1769,HC GUIDEWIRE LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1769,HC GUIDEWIRE LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1769,HC GUIDEWIRE LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1769,HC GUIDEWIRE LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1769,HC GUIDEWIRE LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1769,HC GUIDEWIRE LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1769,HC GUIDEWIRE LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1769,HC GUIDEWIRE LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1769,HC GUIDEWIRE LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1769,HC GUIDEWIRE LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1769,HC GUIDEWIRE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1769,HC GUIDEWIRE LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1769,HC GUIDEWIRE LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1769,HC GUIDEWIRE LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1769,HC GUIDEWIRE LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1769,HC GUIDEWIRE LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1769,HC GUIDEWIRE LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1769,HC GUIDEWIRE LVL 5,36.55,27.41,0.44,32.89,119
CPT,C1769,HC GUIDEWIRE LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C1769,HC GUIDEWIRE LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1769,HC GUIDEWIRE LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1769,HC GUIDEWIRE LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1769,HC GUIDEWIRE LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1769,HC GUIDEWIRE ROADRUNNER UNIGLIDE 0.018X150CM HYDROPH STRAIGHT,114.8,86.1,1.38,103.32,119
CPT,C1769,HC GUIDEWIRE SPRING/DUOFLEX TELEFLEX,52.05,39.04,0.62,46.84,119
CPT,C1769,HC GUIDEWIRE STIFF .035INX80CM,278.6,208.95,3.34,250.74,119
CPT,C1769,HC GUIDEWIRE VAS 035/6/75 AMPLATZ SUPER STIFF,126.25,94.69,1.52,113.62,119
CPT,C1769,HC GUIDEWIRE VAS AUSTRALIAN TORQ-FLEX .018/40CM,116.45,87.34,1.4,104.8,119
CPT,C1769,HC GUIDEWIRE VAS FIXEDCORE CRV .038X80CMX3MM,47.55,35.66,0.57,42.8,119
CPT,C1769,HC GUIDEWIRE VASC FIXEDCORE STRAIGHT .038X80CM,101.75,76.31,1.22,91.58,119
CPT,C1769,HC GUIDEWIRE VASC NIT-VU,167.7,125.78,2.01,150.93,119
CPT,C1769,HC GUIDEWIRE VASC NITINOL MANDREL,172.6,129.45,2.07,155.34,119
CPT,C1769,HC GUIDEWIRE VASC NITINOL MANDREL 300CM,219.55,164.66,2.63,197.6,119
CPT,C1769,HC GUIDEWIRE ZIP ANG .035 150CM,136.0,102.0,1.63,122.4,119
CPT,C1769,HC SET INTRODUCER TRACH BLUE RHINO G2,1893.85,1420.39,22.73,1704.46,119
CPT,C1769,HC SET INTUB RETRO 11F 70-38J-110-01,899.8,674.85,10.8,809.82,119
CPT,C1769,HC SPRING WIRE GUIDE .032X 26 13/16 STRAIG,56.8,42.6,0.68,51.12,119
CPT,C1769,HC TRAY CIAGLIA RHINO G2 W/O TU,2207.55,1655.66,26.49,1986.8,119
CPT,C1769,HC WIRE RUNTHROUGH NS .014X180CM,641.7,481.28,7.7,577.53,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1773,HC RETRIEVAL DEVICE LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1777,HC LEAD ICD SINGLE COIL LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1778,HC LEAD SPNL CORD STIM KIT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1778,HC LEAD SPNL CORD STIM KIT LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1778,HC LEAD SPNL CORD STIM KIT LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1781,HC MESH IMPLANTABLE LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1785,HC PACEMAKER DUAL CHAMBER LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1786,HC PACEMAKER SINGLE CHAMBER LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1788,HC PORT INDWELLING IMPLANTABLE LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1788,HC PORT INDWELLING IMPLANTABLE LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1788,HC PORT INDWELLING IMPLANTABLE LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1788,HC PORT INDWELLING IMPLANTABLE LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1788,HC PORT INDWELLING IMPLANTABLE LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1817,HC IMPLANT-SEPTAL DEFECT LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1817,HC IMPLANT-SEPTAL DEFECT LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1817,HC IMPLANT-SEPTAL DEFECT LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1817,HC IMPLANT-SEPTAL DEFECT LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1817,HC SEPTAL DEFECT IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C1817,HC SEPTAL DEFECT IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C1817,HC SEPTAL DEFECT IMPLANT LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1817,HC SEPTAL DEFECT IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1819,HC TISSUE LOCALIZATION-EXCISION DEVICE LVL 08,123.6,92.7,1.48,111.24,119
CPT,C1820,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1820,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CPT,C1820,HC GENERATOR NEURO RECHG BATTERY SYSTEM IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CPT,C1823,HC NEUROSTIM GENERATOR/LEAD LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1823,HC NEUROSTIM GENERATOR/LEAD LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C1823,HC NEUROSTIM GENERATOR/LEAD LVL 61,95598.65,71698.99,1147.18,86038.78,119
CPT,C1823,HC NEUROSTIM GENERATOR/LEAD LVL 66,122011.0,91508.25,1464.13,109809.9,119
CPT,C1826,Gen neuro clo loop rechg,,,,,0
CPT,C1826,HC GEN NEURO RCHG W BAT & LDS & CMPNTS IMPLANT LVL 56,74903.9,56177.92,898.85,67413.51,119
CPT,C1827,Gen neuro imp led ex cntr,,,,,0
CPT,C1874,HC PK PAPYRUS COVERED CORONARY STENT H170004,10247.6,7685.7,122.97,9222.84,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 1,7.1,5.32,0.09,6.39,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 52,58637.6,43978.2,703.65,52773.84,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 53,64501.4,48376.05,774.02,58051.26,119
CPT,C1874,HC STENT COATED/COVERED IMPLANT LVL 62,100378.6,75283.95,1204.54,90340.74,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1876,HC STENT NON COATED/NON COVERED IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1876,HC STENT-NON COAT/NON-COV LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1876,HC STENT-NON COAT/NON-COV LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1877,HC STENT NON CTD/NON CVRD WO/DEL SYS IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1877,HC STENT NON CTD/NON CVRD WO/DEL SYS IMPLANT LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1880,HC IVC FILTER IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1881,HC DIALYSIS ACCESS SYS LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1882,HC ICD BIV/CRT-D LVL 46,33099.25,24824.44,397.19,29789.32,119
CPT,C1882,HC ICD BIV/CRT-D LVL 47,36409.2,27306.9,436.91,32768.28,119
CPT,C1882,HC ICD BIV/CRT-D LVL 48,40050.15,30037.61,480.6,36045.14,119
CPT,C1882,HC ICD BIV/CRT-D LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1882,HC ICD BIV/CRT-D LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1882,HC ICD BIV/CRT-D LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1882,HC ICD BIV/CRT-D LVL 52,58637.6,43978.2,703.65,52773.84,119
CPT,C1882,HC ICD BIV/CRT-D LVL 53,64501.4,48376.05,774.02,58051.26,119
CPT,C1882,HC ICD BIV/CRT-D LVL 54,67939.95,50954.96,815.28,61145.96,119
CPT,C1882,HC ICD BIV/CRT-D LVL 55,71337.0,53502.75,856.04,64203.3,119
CPT,C1882,HC ICD BIV/CRT-D LVL 56,74903.9,56177.92,898.85,67413.51,119
CPT,C1882,HC ICD BIV/CRT-D LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C1882,HC ICD BIV/CRT-D LVL 67,128111.55,96083.66,1537.34,115300.4,119
CPT,C1883,HC ADAPT/EXT PACING NEURO LEAD LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1883,HC ADAPT/EXT PACING NEURO LEAD LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1883,HC ADAPT/EXT PACING OR NEURO LEAD 08,123.6,92.7,1.48,111.24,119
CPT,C1883,HC ADAPT/EXT PACING OR NEURO LEAD 11,417.45,313.09,5.01,375.7,119
CPT,C1883,HC ADAPT/EXT PACING OR NEURO LEAD 14,729.25,546.94,8.75,656.32,119
CPT,C1883,HC ADAPT/EXT PACING OR NEURO LEAD 15,911.65,683.74,10.94,820.48,119
CPT,C1883,HC ADAPT/EXT PACING OR NEURO LEAD 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 36,12969.7,9727.28,155.64,11672.73,119
CPT,C1884,HC EMBOLIZATION PROTECTION DEVICE LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1885,HC CATH LASER LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1885,HC CATHETER LASER LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1885,HC CATHETER LASER LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1886,HC CATHETER EXTRAVASC TISSUE ABLAT LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1887,HC CATH-GUIDING LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1887,HC CATHETER GUIDING LVL 1,7.1,5.32,0.09,6.39,119
CPT,C1887,HC CATHETER GUIDING LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1887,HC CATHETER GUIDING LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1887,HC CATHETER GUIDING LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1887,HC CATHETER GUIDING LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1887,HC CATHETER GUIDING LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1887,HC CATHETER GUIDING LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1887,HC CATHETER GUIDING LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1887,HC CATHETER GUIDING LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1887,HC CATHETER GUIDING LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1887,HC CATHETER GUIDING LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1887,HC CATHETER GUIDING LVL 2,10.75,8.06,0.13,9.68,119
CPT,C1887,HC CATHETER GUIDING LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1887,HC CATHETER GUIDING LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1887,HC CATHETER GUIDING LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1887,HC CATHETER GUIDING LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1887,HC CATHETER GUIDING LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1887,HC CATHETER GUIDING LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1887,HC CATHETER GUIDING LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1887,HC CATHETER GUIDING LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1887,HC CATHETER GUIDING LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1887,HC CATHETER GUIDING LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1887,HC CATHETER GUIDING LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1887,HC CATHETER GUIDING LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1887,HC CATHETER GUIDING LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1887,HC CATHETER GUIDING LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1887,HC CATHETER GUIDING LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1887,HC CATHETER GUIDING LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1887,HC CATHETER GUIDING LVL 5,36.55,27.41,0.44,32.89,119
CPT,C1887,HC CATHETER GUIDING LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1887,HC CATHETER GUIDING LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1887,HC CATHETER GUIDING LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1887,HC CATHETER GUIDING LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1887,HC CATHETER GUIDING LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1887,HC KIT INTRO MICROPUNCTURE SET BEVEL 5FR,163.35,122.51,1.96,147.01,119
CPT,C1888,HC CATH-ABLAT NON-CARDIAC ENDOVASC LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1888,HC CATHETER ABLAT NON-CARDIAC ENDOVASC 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1889,HC HYDROGEL BARRIER SPACEOAR GEL,12969.7,9727.28,155.64,11672.73,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1889,HC IMPLANTABLE INSERTABLE DEVICE NOC LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 05,36.55,27.41,0.44,32.89,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 06,54.85,41.14,0.66,49.36,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 07,82.35,61.76,0.99,74.11,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 08,123.6,92.7,1.48,111.24,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 09,185.45,139.09,2.23,166.9,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 45,30090.2,22567.65,361.08,27081.18,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 50,48460.8,36345.6,581.53,43614.72,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 52,58637.6,43978.2,703.65,52773.84,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 53,64501.4,48376.05,774.02,58051.26,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 62,100378.6,75283.95,1204.54,90340.74,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 63,105397.55,79048.16,1264.77,94857.8,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC LVL 66,122011.0,91508.25,1464.13,109809.9,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C1889,HC IMPLANTABLE-INSERTABLE DEVICE NOC NON IMPLANT LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C1889,HC NTAP LIMFLOW SYSTEM,86710.75,65033.06,1040.53,78039.68,119
CPT,C1889,HC NTAP TRICLIP G4 VLV RPR SYSTM,148305.25,111228.94,1779.66,133474.72,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1892,HC INTRO-SHEATH PEEL-AWAY LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1893,HC INTRO-SHEATH EP LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1893,HC INTRO-SHEATH EP LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1893,HC INTRO-SHEATH EP LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1893,HC INTRO-SHEATH EP LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1893,HC INTRO-SHEATH EP LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1893,HC INTRO-SHEATH EP LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1893,HC INTRO-SHEATH EP LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1893,HC INTRO-SHEATH EP LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1893,HC INTRO-SHEATH EP LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1893,HC INTRO-SHEATH EP LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1893,HC INTRO-SHEATH EP LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1893,HC INTRO-SHEATH EP LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1893,HC INTRO-SHEATH EP LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1894,HC CATH REBOA CONVENIENCE KIT,1353.45,1015.09,16.24,1218.1,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 1,7.1,5.32,0.09,6.39,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 10,278.25,208.69,3.34,250.42,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 11,417.45,313.09,5.01,375.7,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 14,729.25,546.94,8.75,656.32,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 15,911.65,683.74,10.94,820.48,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 4,24.3,18.23,0.29,21.87,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 5,36.55,27.41,0.44,32.89,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 6,54.85,41.14,0.66,49.36,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 7,82.35,61.76,0.99,74.11,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 8,123.6,92.7,1.48,111.24,119
CPT,C1894,HC INTRO-SHEATH NON-SPECIAL LVL 9,185.45,139.09,2.23,166.9,119
CPT,C1894,HC INTRODUCER 5F-8F 11CM,34.8,26.1,0.42,31.32,119
CPT,C1894,HC INTRODUCER ET TU FLEX-GUIDE,509.65,382.24,6.12,458.68,119
CPT,C1894,HC INTRODUCER INTROFLEX W/5F SH,324.3,243.22,3.89,291.87,119
CPT,C1894,HC INTRODUCER INTROSYTE-N 1.9FR,447.25,335.44,5.37,402.52,119
CPT,C1894,HC INTRODUCER KIT PSI FOR TELEFLEX CATH,244.2,183.15,2.93,219.78,119
CPT,C1894,HC INTRODUCER MIC EZ 4.5F 5CM,154.6,115.95,1.86,139.14,119
CPT,C1894,HC INTRODUCER MIC-PUNC 4.5F 10,356.15,267.11,4.27,320.53,119
CPT,C1894,HC INTRODUCER MP 0.018IN,211.4,158.55,2.54,190.26,119
CPT,C1894,HC INTRODUCER MP 4F 10CM,132.1,99.08,1.59,118.89,119
CPT,C1894,HC INTRODUCER NIT 4F TUNG KIT,97.05,72.79,1.16,87.34,119
CPT,C1894,HC INTRODUCER PERCUT 8.5F 10CM,359.7,269.77,4.32,323.73,119
CPT,C1894,HC INTRODUCER PERCUT SHTH 7.5-8F,583.4,437.55,7.0,525.06,119
CPT,C1894,HC INTRODUCER SET MICRO-ACCESS,118.3,88.72,1.42,106.47,119
CPT,C1894,HC INTRODUCER SHEATH PINNACLE,52.05,39.04,0.62,46.84,119
CPT,C1894,HC KIT INTRODUCER CATH 6FR NDL 7CM BLUE MICROEZ,154.6,115.95,1.86,139.14,119
CPT,C1894,HC KIT INTRODUCER MIC 3.5F 5CM,255.95,191.96,3.07,230.36,119
CPT,C1894,HC KIT MICINTRD 5.0F 5CM MICRO-EZ,157.5,118.12,1.89,141.75,119
CPT,C1894,HC KIT MICROINTROD 4FR STIF 0.018X40CM NITINOL,95.6,71.7,1.15,86.04,119
CPT,C1894,HC MICROINTRODUCER BEVEL NDL MICROEZ BARD,258.4,193.8,3.1,232.56,119
CPT,C1894,HC SET INTRD W HEMO VLV 5FX7.5CM,111.25,83.44,1.34,100.12,119
CPT,C1894,HC SET INTRODUCER TEARAWAY 2FR 7CM T0.014IN GW,189.3,141.98,2.27,170.37,119
CPT,C1894,HC SHEATH BRIT TIP 7F 401-705M,60.0,45.0,0.72,54.0,119
CPT,C1894,HC SHEATH INTRODUCER PRELUDE,202.8,152.1,2.43,182.52,119
CPT,C1894,HC SHEATH SUP 4F 11CM .035IN GW,46.35,34.76,0.56,41.72,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 2,10.75,8.06,0.13,9.68,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C1895,HC LEAD ICD DUAL COIL LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1896,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1896,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1896,HC LEAD ICD SUBCUTAN NON SNG/DUAL LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C1897,HC LEAD NEUROSTIM TEST KIT LVL 12,473.25,354.94,5.68,425.92,119
CPT,C1897,HC LEAD NEUROSTIM TEST KIT LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1897,HC LEAD NEUROSTIM TEST KIT LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C1898,HC LEAD PACING LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C1898,HC LEAD PACING LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C1898,HC LEAD PACING LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C1898,HC LEAD PACING LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C1898,HC LEAD PACING LVL 22,2853.35,2140.01,34.24,2568.02,119
CPT,C1898,HC LEAD PACING LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1898,HC LEAD PACING LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1898,HC LEAD PACING LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1900,HC LEAD PACING CS/LV LVL 13,583.4,437.55,7.0,525.06,119
CPT,C1900,HC LEAD PACING CS/LV LVL 23,3281.4,2461.05,39.38,2953.26,119
CPT,C1900,HC LEAD PACING CS/LV LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C1900,HC LEAD PACING CS/LV LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C1900,HC LEAD PACING CS/LV LVL 26,4315.0,3236.25,51.78,3883.5,119
CPT,C1900,HC LEAD PACING CS/LV LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C1900,HC LEAD PACING CS/LV LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C1900,HC LEAD PACING CS/LV LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C1900,HC LEAD PACING CS/LV LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C1900,HC LEAD PACING CS/LV LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C1900,HC LEAD PACING CS/LV LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C1900,HC LEAD PACING CS/LV LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C1900,HC LEAD PACING CS/LV LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C1982,HC CATH PRESSURE VALVE OCCLU LVL 44,27354.7,20516.03,328.26,24619.23,119
CPT,C2616,Brachytx non-stryttrium-90,,,17485.1,20300.2,19
CPT,C2616,HC BRACHYTX NON-STR YTTRIUM-90,64501.4,48376.05,774.02,58051.26,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C2617,HC STENT NON CORONARY WO/DEL SYS TEMP IMPLANT LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C2618,HC NEEDLE/PROBE EP CRYO LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C2618,HC NEEDLE/PROBE EP CRYO LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C2618,HC NEEDLE/PROBE EP CRYO LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C2618,HC NEEDLE/PROBE EP CRYO LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C2618,HC NEEDLE/PROBE EP CRYO LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 38,16414.9,12311.18,196.98,14773.41,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 39,17749.95,13312.46,213.0,15974.96,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 43,24867.85,18650.89,298.41,22381.06,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 49,44055.2,33041.4,528.66,39649.68,119
CPT,C2621,HC PACEMAKER BIV CRT-P LVL 51,53306.9,39980.18,639.68,47976.21,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C2623,HC CATHETER BLLN PTA DRUG COATED LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C2624,HC WIRELESS PRESSURE SENSOR IMPLANT LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C2624,HC WIRELESS PRESSURE SENSOR LVL 59,86710.75,65033.06,1040.53,78039.68,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 10,278.25,208.69,3.34,250.42,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 11,417.45,313.09,5.01,375.7,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 12,473.25,354.94,5.68,425.92,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 13,583.4,437.55,7.0,525.06,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 14,729.25,546.94,8.75,656.32,119
CPT,C2625,HC STENT NON CORONARY W/DEL SYS TEMP IMPLANT LVL 15,911.65,683.74,10.94,820.48,119
CPT,C2628,HC CATH BLLN OCCULUSION LVL 18,1780.8,1335.6,21.37,1602.72,119
CPT,C2628,HC CATH HSG BAL 7F 30CM 3ML-SYR,189.5,142.12,2.27,170.55,119
CPT,C2628,HC CATH REBOA+ TRAUMA,15705.2,11778.9,188.46,14134.68,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 10,278.25,208.69,3.34,250.42,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 11,417.45,313.09,5.01,375.7,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 12,473.25,354.94,5.68,425.92,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 15,911.65,683.74,10.94,820.48,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 16,1139.65,854.74,13.68,1025.69,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 17,1424.6,1068.45,17.1,1282.14,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 19,2058.15,1543.61,24.7,1852.34,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 20,2157.45,1618.09,25.89,1941.7,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 21,2481.15,1860.86,29.77,2233.04,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 24,3773.65,2830.24,45.28,3396.29,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 25,4314.95,3236.21,51.78,3883.46,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 27,4493.0,3369.75,53.92,4043.7,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C2628,HC CATHETER BLLN OCCLUSION LVL 9,185.45,139.09,2.23,166.9,119
CPT,C2628,HC POSTPARTUM BALLOON BAKRI,1845.2,1383.9,22.14,1660.68,119
CPT,C2629,HC SHEATH LASER LVL 35,11528.6,8646.45,138.34,10375.74,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 28,5054.65,3790.99,60.66,4549.18,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 29,5686.55,4264.91,68.24,5117.9,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 30,6397.4,4798.05,76.77,5757.66,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 31,7197.15,5397.86,86.37,6477.44,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 32,8096.8,6072.6,97.16,7287.12,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 33,9108.95,6831.71,109.31,8198.06,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 34,10247.6,7685.7,122.97,9222.84,119
CPT,C2630,HC CATH EP DIAG/ABL NON 3D/MAP COOL-TIP LVL 37,14590.95,10943.21,175.09,13131.86,119
CPT,C2634,Brachytx non-str ha i-125,,,162.84,189.06,19
CPT,C2635,Brachytx non-str ha p-103,,,69.38,106.75,19
CPT,C2636,Brachy linear non-strp-103,,,52.91,89.4,19
CPT,C2637,Brachynon-strytterbium-169,,,,,0
CPT,C2638,Brachytx stranded i-125,,,35.26,43.0,19
CPT,C2638,HC BRACHYTHERAPY IBT I-125 SEED,164.6,123.45,1.98,148.14,119
CPT,C2639,Brachytx non-strandedi-125,,,35.11,40.76,19
CPT,C2639,HC BRACHY SEED NS IODINE 125,218.75,164.06,2.62,196.88,119
CPT,C2640,Brachytx stranded p-103,,,69.69,88.26,19
CPT,C2640,"HC BRACHYTX, STRANDED,P-103 LVL 10",278.25,208.69,3.34,250.42,119
CPT,C2641,Brachytx non-strandedp-103,,,64.48,92.61,19
CPT,C2641,"HC BRACHYTX, NON-STRANDED, P-103 LVL",278.25,208.69,3.34,250.42,119
CPT,C2642,Brachytx stranded c-131,,,107.86,125.23,19
CPT,C2643,Brachytx non-strandedc-131,,,96.56,112.11,19
CPT,C2644,Brachytx cesium-131 chloride,,,119.16,119.16,1
CPT,C2645,Brachytx planar p-103,,,4.69,5.45,19
CPT,C2698,Brachytx stranded nos,,,35.26,43.0,19
CPT,C2699,Brachytx non-stranded nos,,,35.11,40.76,19
CPT,C5271,Low cost skin substitute app,,,586.82,681.3,10
CPT,C5273,Low cost skin substitute app,,,1753.61,2035.94,10
CPT,C5275,Low cost skin substitute app,,,586.82,681.3,10
CPT,C5277,Low cost skin substitute app,,,586.82,681.3,10
CPT,C7900,Hopd mntl hlt 15-29 min,,,28.56,37.93,19
CPT,C7901,Hopd mntl hlt 30-60 min,,,88.68,102.96,19
CPT,C7903,Hopd mntl hlt grp,,,28.56,37.93,19
CPT,C8000,Suprt dev a-v fistula imp,,,,,0
CPT,C8001,3d anat seg imaging preop,,,84.41,174.14,19
CPT,C8002,Prep skin cell susp automtd,,,6950.77,8069.84,18
CPT,C8003,Imp extar knee shck absrb,,,17629.8,20468.2,19
CPT,C8004,HC SIM ANG W/PRS CATH RAD EMB,49059.9,36794.93,588.72,44153.91,119
CPT,C8004,Sim ang w/prs cath rad emb,,,10871.75,12622.1,18
CPT,C8005,Pef bronch ablt 3d nav ebus,,,16777.03,19478.14,18
CPT,C8006,Inst pleu-perit shnt w pump,,,5981.8,6944.87,18
CPT,C8900,Mra w/cont abd,,,342.37,397.49,19
CPT,C8901,Mra w/o cont abd,,,231.73,269.03,19
CPT,C8902,Mra w/o fol w/cont abd,,,342.37,397.49,19
CPT,C8903,Mri w/cont breast  uni,,,170.66,198.13,19
CPT,C8905,Mri w/o fol w/cont brst un,,,342.37,397.49,19
CPT,C8906,Mri w/cont breast  bi,,,342.37,397.49,19
CPT,C8908,Mri w/o fol w/cont breast,,,342.37,397.49,19
CPT,C8909,Mra w/cont chest,,,342.37,397.49,19
CPT,C8910,Mra w/o cont chest,,,231.73,269.03,19
CPT,C8911,Mra w/o fol w/cont chest,,,342.37,397.49,19
CPT,C8912,Mra w/cont lwr ext,,,342.37,397.49,19
CPT,C8913,Mra w/o cont lwr ext,,,231.73,269.03,19
CPT,C8914,Mra w/o fol w/cont lwr ext,,,342.37,397.49,19
CPT,C8918,Mra w/cont pelvis,,,342.37,397.49,19
CPT,C8919,Mra w/o cont pelvis,,,231.73,269.03,19
CPT,C8920,Mra w/o fol w/cont pelvis,,,342.37,397.49,19
CPT,C8921,Tte w or w/o fol w/cont com,,,757.39,879.33,19
CPT,C8922,Tte w or w/o fol w/cont f/u,,,757.39,879.33,19
CPT,C8923,2d tte w or w/o fol w/conco,,,757.39,879.33,19
CPT,C8924,2d tte w or w/o fol w/confu,,,342.37,397.49,19
CPT,C8925,2d tee w or w/o fol w/conin,,,757.39,879.33,19
CPT,C8926,Tee w or w/o fol w/contcong,,,757.39,879.33,19
CPT,C8927,HC US TEE OR OPEN NONVASC W/ CONTRAST,6421.76,4816.32,77.06,5779.58,119
CPT,C8927,Tee w or w/o fol w/cont mon,,,757.39,879.33,19
CPT,C8928,Tte w or w/o fol w/constres,,,757.39,879.33,19
CPT,C8929,Tte w or wo fol wcondoppler,,,757.39,879.33,19
CPT,C8930,Tte w or w/o contr cont ecg,,,757.39,879.33,19
CPT,C8931,Mra w/dye spinal canal,,,342.37,397.49,19
CPT,C8932,Mra w/o dye spinal canal,,,231.73,269.03,19
CPT,C8933,Mra w/o&w/dye spinal canal,,,342.37,397.49,19
CPT,C8934,Mra w/dye upper extremity,,,342.37,397.49,19
CPT,C8935,Mra w/o dye upper extr,,,231.73,269.03,19
CPT,C8936,Mra w/o&w/dye upper extr,,,342.37,397.49,19
CPT,C8937,HC MRI CAD BREAST,666.05,499.54,7.99,599.44,119
CPT,C8957,HC PROLONGED IV INF REQ PUMP>8 HRS NON-CHEMO,832.7,624.52,9.99,749.43,119
CPT,C8957,Prolonged iv inf req pump,,,215.37,369.17,19
CPT,C9046,COCAINE 4 % NASAL SOLUTION,1016.75,762.56,12.2,915.08,119
CPT,C9046,Cocaine hcl nasal (goprelto),,,1.66,1.66,8
CPT,C9047,Injection caplacizumab-yhdp,,,802.25,809.22,17
CPT,C9067,Gallium ga-68 dotatoc,,,3.61,4.7,19
CPT,C9088,Instill  bupivac and meloxic,,,0.77,0.79,9
CPT,C9089,Bupivacaine implant  1 mg,,,0.86,1.02,18
CPT,C9101,Inj oliceridine 0.1 mg,,,0.4,1.32,9
CPT,C9143,Cocaine hcl nasal (numbrino),,,2.42,2.42,8
CPT,C9144,Inj bupivacaine (posimir),,,0.5,0.59,18
CPT,C9145,Inj aponvie 1 mg,,,1.86,2.22,27
CPT,C9169,Inj- nogapendekin pmln 1 mcg,,,96.66,96.66,8
CPT,C9170,Inj- tarlatamab-dlle- 1 mg,,,1620.0,1620.0,8
CPT,C9171,Inj- pegulicianine- 1 mg,,,38.21,38.21,8
CPT,C9172,Inj- beqvez- per tx dose,,,3780000.0,3780000.0,8
CPT,C9173,Inj  nypozi  1 mcg,,,0.54,0.54,1
CPT,C9176,Dom nonHEU Tc99m add-on/dose,,,10.0,10.0,9
CPT,C9248,Inj  clevidipine butyrate,,,2.8,3.7,9
CPT,C9250,Artiss fibrin sealant,,,134.5,164.73,19
CPT,C9254,Injection lacosamide,,,0.35,0.35,8
CPT,C9254,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,393.12,294.84,4.72,353.81,238
CPT,C9257,Bevacizumab injection,,,1.83,2.15,27
CPT,C9285,Patch lidocaine/tetracaine,,,18.31,18.31,8
CPT,C9290,Inj- bupivacaine liposome,,,1.53,1.53,8
CPT,C9293,Injection glucarpidase,,,444.68,448.69,17
CPT,C9305,Inj  nipocalimab-aahu  3 mg,,,32.14,37.31,9
CPT,C9306,Telisotuzumab vedotin-tllv,,,143.99,167.17,9
CPT,C9307,Inj linvoseltamab-gcpt 1 mg,,,96.82,96.82,9
CPT,C9308,Inj carboplatin (avyxa),,,5.15,5.15,9
CPT,C9363,Integra meshed bil wound mat,,,126.0,126.0,9
CPT,C9399,ABIRATERONE 250 MG TABLET,11.25,8.44,0.14,10.12,119
CPT,C9399,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,4129.25,3096.94,49.55,3716.32,238
CPT,C9460,CANGRELOR 50 MG INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
CPT,C9460,Injection cangrelor,,,18.82,23.2,27
CPT,C9462,Injection delafloxacin,,,0.51,0.51,8
CPT,C9482,Sotalol hydrochloride iv,,,22.78,29.08,27
CPT,C9488,Conivaptan hcl,,,50.14,50.14,8
CPT,C9507,Covid-19 convalescent plasma,,,425.62,680.03,19
CPT,C9600,Perc drug-el cor stent sing,,,10871.75,12622.1,19
CPT,C9601,HCD REVASC DES W/ PTCA ADDTL ART/BRNCH,9547.58,7160.685,106.58,9192.32,238
CPT,C9602,Perc d-e cor stent ather s,,,17214.39,19985.91,19
CPT,C9604,Perc d-e cor revasc t cabg s,,,10871.75,12622.1,19
CPT,C9606,Perc d-e cor revasc w ami s,,,12954.18,15039.8,19
CPT,C9607,HC PERQ TRLUML REVSC CHRNC TOT OCCLS 1 C ART ANTGRD,37510.5,28132.88,450.13,33759.45,119
CPT,C9607,Perc d-e cor revasc chro sin,,,17214.39,19985.91,19
CPT,C9610,Cath coronary drug-delivery,,,,,0
CPT,C9610,HC CATH CORONARY DRUG-DELIVERY TPT LVL 40,22750.0,17062.5,273.0,20475.0,119
CPT,C9610,HC CATH CORONARY DRUG-DELIVERY TPT LVL 41,22750.0,17062.5,273.0,20475.0,119
CPT,C9610,HC CATH CORONARY DRUG-DELIVERY TPT LVL 42,22750.0,17062.5,273.0,20475.0,119
CPT,C9725,Place endorectal app,,,874.02,1014.74,19
CPT,C9727,Insert palate implants,,,1420.05,1648.68,19
CPT,C9728,HC PLACE DEVICE/MARKER NON PRO,2855.2,2141.4,34.26,2569.68,119
CPT,C9728,Place device/marker non pro,,,1311.7,1522.88,19
CPT,C9733,Non-ophthalmic fva,,,342.37,397.49,19
CPT,C9734,U/s trtmt not leiomyomata,,,12334.9,14320.82,18
CPT,C9739,Cystoscopy prostatic imp 1-3,,,4873.47,5658.09,19
CPT,C9740,Cysto impl 4 or more,,,8864.87,10292.11,19
CPT,C9751,"HCD BRONCHOSCOPY, MICROWAVE, 3D, EBUS",12236.6,9177.45,146.84,11012.94,119
CPT,C9751,Microwave bronch  3d  ebus,,,3595.46,4174.32,9
CPT,C9757,Spine device implant surgery,,,12334.9,14320.82,19
CPT,C9758,Blind interatrial shunt ide,,,16777.03,19478.14,18
CPT,C9760,Non-blind interatrial shunt,,,26363.63,30608.18,18
CPT,C9761,Cysto litho vacuum kidney,,,8864.87,10292.11,19
CPT,C9762,Cardiac mri seg dys strain,,,525.63,610.26,19
CPT,C9763,Cardiac mri seg dys stress,,,525.63,610.26,19
CPT,C9764,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY,26201.15,19650.86,314.41,23581.04,119
CPT,C9764,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY BILATERAL,26201.15,19650.86,314.41,23581.04,238
CPT,C9764,Revasc intravasc lithotripsy,,,10871.75,12622.1,19
CPT,C9765,HC OPEN OR PERC INTRAVASCULAR LITHOTRIPSY W/STENT,34717.25,26037.94,416.61,31245.52,119
CPT,C9765,Revasc intra lithotrip-stent,,,17214.39,19985.91,19
CPT,C9766,"HC OPEN/PERC INTRAVASCULAR LITHO W/ATHERECTOMY, LOWER EXTREM ARTERY",40464.52,30348.39,485.57,36418.07,119
CPT,C9766,Revasc intra lithotrip-ather,,,17214.39,19985.91,19
CPT,C9767,"HC OPEN/PERC INTRAVASCULAR LITHO W/ATHER & STENT, LOWER EXTREM ARTERY",49894.02,37420.52,598.73,44904.62,119
CPT,C9767,Revasc lithotrip-stent-ather,,,17214.39,19985.91,19
CPT,C9772,"HC OPEN/PERC INTRAVASCULAR LITHO, TIB/PERONEAL ARTERY",21039.19,15779.39,252.47,18935.27,119
CPT,C9772,Revasc lithotrip tibi/perone,,,10871.75,12622.1,18
CPT,C9773,HC OPEN/PERC INTRAVASCULAR LITHO W/STENT TIB/PERONEAL ARTERY,27877.51,20908.13,334.53,25089.76,119
CPT,C9773,Revasc lithotr-stent tib/per,,,17214.39,19985.91,18
CPT,C9774,HC OPEN/PERC INTRAVASCULAR LITHO W/ATHERECTOMY TIB/PERONEAL ARTERY,34846.89,26135.17,418.16,31362.2,119
CPT,C9774,Revasc lithotr-ather tib/per,,,17214.39,19985.91,18
CPT,C9775,HC OPEN/PERC INTRAVASCULAR LITHO W/ATHER & STENT TIB/PERONEAL ARTERY,49894.02,37420.52,598.73,44904.62,119
CPT,C9775,Revasc lith-sten-ath tib/per,,,17214.39,19985.91,18
CPT,C9777,Esophag muc integ w/eso egd,,,3647.25,4234.46,18
CPT,C9777,HC ESOPHAG MUC INTEG W/ESO EGD,20532.84,15399.63,246.39,18479.56,119
CPT,C9778,Colpopexy min/inv ex-perit,,,4732.38,5494.29,19
CPT,C9779,Esd endoscopy or colonoscopy,,,3647.25,4234.46,19
CPT,C9780,Insert cv cath inf & sup app,,,7909.43,9182.85,18
CPT,C9781,Arthro/shoul surg- w/spacer,,,12334.9,14320.82,19
CPT,C9782,Blind myocar trpl bon marrow,,,16777.03,19478.14,18
CPT,C9783,Blind cor sinus reducer impl,,,10871.75,12622.1,19
CPT,C9784,Endo sleeve gastro w/tube,,,9980.82,11587.73,9
CPT,C9785,Endo outlet restrict w/tube,,,9980.82,11587.73,18
CPT,C9789,Instill pharm renal pelvis,,,1239.32,2504.82,18
CPT,C9791,Mri hyperpolarized xenon129,,,1198.8,1391.81,18
CPT,C9792,Blind/nonblind trans atrial,,,9347.41,10852.34,18
CPT,C9793,Pre 3d mdl w/ccta and/or mri,,,869.49,1132.36,19
CPT,C9796,Rpr intst excl anrect fist,,,2629.02,3052.29,19
CPT,C9797,Vasc emb/occ w/prs cath,,,17214.39,19985.91,19
CPT,C9804,Pump elastomc non-opioid dev,,,,,0
CPT,C9806,Pump perist non-opioid dev,,,,,0
CPT,C9807,Nerve stim non-opioid dev,,,,,0
CPT,C9808,Cryo probe non-opioid dev,,,,,0
CPT,C9809,Cryo needle non-opioid dev,,,,,0
CPT,C9810,Cold therapy non-opioid dev,,,,,0
CPT,C9811,Elec amb pmp nonopioid dev,,,,,0
CPT,C9812,Echgnc nv ndls nonopioid dev,,,,,0
CPT,C9813,Prf infs cth nonopioid dev,,,,,0
CPT,C9814,Echognc cathr nonopioid dev,,,,,0
CPT,C9815,Peristlc pmp nonopioid dev,,,,,0
CPT,C9816,Pmp prs reusbl nonopioid dev,,,,,0
CPT,C9817,Crypnm cmprs nonopioid dev,,,,,0
CPT,C9901,Endo defect closure gi tract,,,9980.82,11587.73,19
CPT,D0120,Periodic oral evaluation,,,123.54,143.43,19
CPT,D0140,Limit oral eval problm focus,,,123.54,143.43,19
CPT,D0150,Comprehensve oral evaluation,,,123.54,143.43,19
CPT,D0160,Extensv oral eval prob focus,,,123.54,143.43,19
CPT,D0170,Re-evalest ptproblem focus,,,123.54,143.43,19
CPT,D0171,Re-eval post-op visit,,,123.54,143.43,19
CPT,D0180,Comp periodontal evaluation,,,123.54,143.43,19
CPT,D0191,Assessment of a patient,,,123.54,143.43,19
CPT,D0210,Intraor comprehensive series,,,231.73,269.03,19
CPT,D0220,Intraoral periapical first,,,84.41,98.0,19
CPT,D0240,Intraoral occlusal film,,,84.41,98.0,19
CPT,D0250,Extraoral 2d project image,,,84.41,98.0,19
CPT,D0251,Extraoral posterior image,,,84.41,98.0,18
CPT,D0270,Dental bitewing single image,,,84.41,98.0,19
CPT,D0272,Dental bitewings two images,,,84.41,98.0,19
CPT,D0273,Bitewings - three images,,,231.73,269.03,19
CPT,D0274,Bitewings four images,,,231.73,269.03,19
CPT,D0277,Vert bitewings 7 to 8 images,,,231.73,269.03,19
CPT,D0310,Dental saliography,,,231.73,269.03,19
CPT,D0320,Dental tmj arthrogram incl i,,,231.73,269.03,19
CPT,D0321,Other tmj images by report,,,84.41,98.0,19
CPT,D0322,Dental tomographic survey,,,101.95,118.36,19
CPT,D0330,Panoramic image,,,231.73,269.03,19
CPT,D0340,2d cephalometric image,,,84.41,98.0,19
CPT,D0350,Oral/facial photo images,,,84.41,98.0,19
CPT,D0364,Cone beam ct capt & interp,,,101.95,118.36,19
CPT,D0365,Cone beam ct interprete man,,,101.95,118.36,19
CPT,D0366,Cone beam ct interprete max,,,101.95,118.36,19
CPT,D0367,Cone beam ct interp both jaw,,,101.95,118.36,19
CPT,D0368,Cone beam ct interprete tmj,,,101.95,118.36,19
CPT,D0369,Max mri capture & interprete,,,101.95,118.36,19
CPT,D0370,Max ultrasound capt & interp,,,101.95,118.36,19
CPT,D0371,Sialoendoscopy capt & interp,,,84.41,98.0,19
CPT,D0380,Cone beam ct capture limited,,,101.95,118.36,19
CPT,D0381,Cone beam ct capt mandible,,,101.95,118.36,19
CPT,D0382,Cone beam ct capt maxilla,,,101.95,118.36,19
CPT,D0383,Cone beam ct both jaws,,,101.95,118.36,19
CPT,D0384,Cone beam ct capture tmj,,,101.95,118.36,19
CPT,D0385,Max mri image capture,,,101.95,118.36,19
CPT,D0386,Max ultrasound image capture,,,101.95,118.36,19
CPT,D0393,Trtmnt simulation 3d image,,,84.41,98.0,19
CPT,D0394,Digital sub 2 or more images,,,84.41,98.0,19
CPT,D0395,Fusion 2 or more 3d images,,,84.41,98.0,19
CPT,D0460,Pulp vitality test,,,654.59,1850.51,19
CPT,D0600,Non-ionizing diag proc,,,654.59,1850.51,19
CPT,D0701,Pano radio image,,,84.41,98.0,19
CPT,D0702,2d cephal radio image,,,84.41,98.0,19
CPT,D0703,2d oral/facial photo image,,,84.41,98.0,19
CPT,D0705,Extra oral post radio image,,,84.41,98.0,19
CPT,D0706,Intraoral occlus radio image,,,84.41,98.0,19
CPT,D0707,Intraoral periap radio image,,,84.41,98.0,19
CPT,D0708,Intraoral bite radio image,,,84.41,98.0,19
CPT,D0709,Intraoral comp image capture,,,84.41,98.0,19
CPT,D1110,Dental prophylaxis adult,,,123.54,143.43,19
CPT,D1510,Space maintainer fxd unilat,,,654.59,1850.51,19
CPT,D1516,Fixed bilat space maint max,,,654.59,1850.51,19
CPT,D1517,Fixed bilat space maint man,,,654.59,1850.51,19
CPT,D1520,Remove unilat space maintain,,,654.59,1850.51,19
CPT,D1526,Remove bilat space main max,,,654.59,1850.51,19
CPT,D1527,Remove bilat space main man,,,654.59,1850.51,19
CPT,D1551,Recement space maint - max,,,654.59,1850.51,19
CPT,D1552,Recement space maint - man,,,654.59,1850.51,19
CPT,D1553,Recement unilat space maint,,,654.59,1850.51,19
CPT,D1575,Dist space maint fixed unil,,,654.59,1850.51,19
CPT,D2140,Amalgam one surface permanen,,,654.59,1850.51,19
CPT,D2150,Amalgam two surfaces permane,,,654.59,1850.51,19
CPT,D2160,Amalgam three surfaces perma,,,654.59,1850.51,19
CPT,D2161,Amalgam 4 or > surfaces perm,,,654.59,1850.51,19
CPT,D2330,Resin one surface-anterior,,,654.59,1850.51,19
CPT,D2331,Resin two surfaces-anterior,,,654.59,1850.51,19
CPT,D2332,Resin three surfaces-anterio,,,654.59,1850.51,19
CPT,D2335,Resin 4/> surf or w incis an,,,654.59,1850.51,19
CPT,D2390,Ant resin-based cmpst crown,,,654.59,1850.51,19
CPT,D2391,Post 1 srfc resinbased cmpst,,,654.59,1850.51,19
CPT,D2392,Post 2 srfc resinbased cmpst,,,654.59,1850.51,19
CPT,D2393,Post 3 srfc resinbased cmpst,,,654.59,1850.51,19
CPT,D2394,Post >4srfc resinbase cmpst,,,654.59,1850.51,19
CPT,D2410,Dental gold foil one surface,,,654.59,1850.51,19
CPT,D2420,Dental gold foil two surface,,,654.59,1850.51,19
CPT,D2430,Dental gold foil three surfa,,,654.59,1850.51,19
CPT,D2510,Dental inlay metalic 1 surf,,,654.59,1850.51,19
CPT,D2520,Dental inlay metallic 2 surf,,,654.59,1850.51,19
CPT,D2530,Dental inlay metl 3/more sur,,,654.59,1850.51,19
CPT,D2542,Dental onlay metallic 2 surf,,,654.59,1850.51,19
CPT,D2543,Dental onlay metallic 3 surf,,,654.59,1850.51,19
CPT,D2544,Dental onlay metl 4/more sur,,,654.59,1850.51,19
CPT,D2610,Inlay porcelain/ceramic 1 su,,,654.59,1850.51,19
CPT,D2620,Inlay porcelain/ceramic 2 su,,,654.59,1850.51,19
CPT,D2630,Dental onlay porc 3/more sur,,,654.59,1850.51,19
CPT,D2642,Dental onlay porcelin 2 surf,,,654.59,1850.51,19
CPT,D2643,Dental onlay porcelin 3 surf,,,654.59,1850.51,19
CPT,D2644,Dental onlay porc 4/more sur,,,654.59,1850.51,19
CPT,D2650,Inlay composite/resin one su,,,654.59,1850.51,19
CPT,D2651,Inlay composite/resin two su,,,654.59,1850.51,19
CPT,D2652,Dental inlay resin 3/mre sur,,,654.59,1850.51,19
CPT,D2662,Dental onlay resin 2 surface,,,654.59,1850.51,19
CPT,D2663,Dental onlay resin 3 surface,,,654.59,1850.51,19
CPT,D2664,Dental onlay resin 4/mre sur,,,654.59,1850.51,19
CPT,D2710,Crown resin-based indirect,,,654.59,1850.51,19
CPT,D2712,Crown 3/4 resin-based compos,,,654.59,1850.51,19
CPT,D2720,Crown resin w/ high noble me,,,654.59,1850.51,19
CPT,D2721,Crown resin w/ base metal,,,654.59,1850.51,19
CPT,D2722,Crown resin w/ noble metal,,,654.59,1850.51,19
CPT,D2740,Crown porcelain/ceramic,,,654.59,1850.51,19
CPT,D2750,Crown porcelain w/ h noble m,,,654.59,1850.51,19
CPT,D2751,Crown porcelain fused base m,,,654.59,1850.51,19
CPT,D2752,Crown porcelain w/ noble met,,,654.59,1850.51,19
CPT,D2753,Crown porc fused to titanium,,,654.59,1850.51,19
CPT,D2780,Crown 3/4 cast hi noble met,,,654.59,1850.51,19
CPT,D2781,Crown 3/4 cast base metal,,,654.59,1850.51,19
CPT,D2782,Crown 3/4 cast noble metal,,,654.59,1850.51,19
CPT,D2783,Crown 3/4 porcelain/ceramic,,,654.59,1850.51,19
CPT,D2790,Crown full cast high noble m,,,654.59,1850.51,19
CPT,D2791,Crown full cast base metal,,,654.59,1850.51,19
CPT,D2792,Crown full cast noble metal,,,654.59,1850.51,19
CPT,D2794,Crown-titanium,,,654.59,1850.51,19
CPT,D2799,Interim crown,,,654.59,1850.51,19
CPT,D2910,Recement inlay onlay or part,,,654.59,1850.51,19
CPT,D2915,Recement cast or prefab post,,,654.59,1850.51,19
CPT,D2920,Re-cement or re-bond crown,,,654.59,1850.51,19
CPT,D2921,Reattach tooth fragment,,,654.59,1850.51,19
CPT,D2928,Prefab porc/cer crown perm,,,654.59,1850.51,19
CPT,D2929,Prefab porc/ceram crown pri,,,654.59,1850.51,19
CPT,D2930,Prefab stnlss steel crwn pri,,,654.59,1850.51,19
CPT,D2931,Prefab stnlss steel crown pe,,,654.59,1850.51,19
CPT,D2932,Prefabricated resin crown,,,654.59,1850.51,19
CPT,D2933,Prefab stainless steel crown,,,654.59,1850.51,19
CPT,D2934,Prefab steel crown primary,,,654.59,1850.51,19
CPT,D2940,Place direct restoration,,,654.59,1850.51,19
CPT,D2949,Restorative foundation,,,654.59,1850.51,19
CPT,D2950,Core build-up incl any pins,,,654.59,1850.51,19
CPT,D2951,Tooth pin retention,,,654.59,1850.51,19
CPT,D2952,Post and core cast + crown,,,654.59,1850.51,19
CPT,D2954,Prefab post/core + crown,,,654.59,1850.51,19
CPT,D2957,Each addtnl prefab post,,,654.59,1850.51,19
CPT,D2960,Labial veneer resin direct,,,654.59,1850.51,19
CPT,D2961,Labial veneer resin indirect,,,654.59,1850.51,19
CPT,D2962,Labial veneer porc indirect,,,654.59,1850.51,19
CPT,D2971,Add proc construct new crown,,,654.59,1850.51,19
CPT,D2975,Coping,,,654.59,1850.51,19
CPT,D2980,Crown repair,,,654.59,1850.51,19
CPT,D2981,Inlay repair,,,654.59,1850.51,19
CPT,D2982,Onlay repair,,,654.59,1850.51,19
CPT,D2983,Veneer repair,,,654.59,1850.51,19
CPT,D2990,Resin infiltration of lesion,,,654.59,1850.51,19
CPT,D2999,Dental unspec restorative pr,,,654.59,1850.51,19
CPT,D3110,Pulp cap direct,,,654.59,1850.51,19
CPT,D3120,Pulp cap indirect,,,654.59,1850.51,19
CPT,D3220,Therapeutic pulpotomy,,,654.59,1850.51,19
CPT,D3221,Gross pulpal debridement,,,654.59,1850.51,19
CPT,D3222,Part pulp for apexogenesis,,,654.59,1850.51,19
CPT,D3230,Pulpal therapy anterior prim,,,654.59,1850.51,19
CPT,D3240,Pulpal therapy posterior pri,,,654.59,1850.51,19
CPT,D3310,End thxpy anterior tooth,,,654.59,1850.51,19
CPT,D3320,End thxpy premolar tooth,,,654.59,1850.51,19
CPT,D3330,End thxpy molar tooth,,,654.59,1850.51,19
CPT,D3331,Non-surg tx root canal obs,,,654.59,1850.51,19
CPT,D3332,Incomplete endodontic tx,,,654.59,1850.51,19
CPT,D3333,Internal root repair,,,654.59,1850.51,19
CPT,D3346,Retreat root canal anterior,,,654.59,1850.51,19
CPT,D3347,Retreat root canal premolar,,,654.59,1850.51,19
CPT,D3348,Retreat root canal molar,,,654.59,1850.51,19
CPT,D3351,Apexification/recalc initial,,,654.59,1850.51,19
CPT,D3352,Apexification/recalc interim,,,654.59,1850.51,19
CPT,D3353,Apexification/recalc final,,,654.59,1850.51,19
CPT,D3355,Pulpal regeneration initial,,,654.59,1850.51,19
CPT,D3356,Pulpal regeneration interim,,,654.59,1850.51,19
CPT,D3357,Pulpal regeneration complete,,,654.59,1850.51,19
CPT,D3410,Apicoectomy - anterior,,,654.59,1850.51,19
CPT,D3421,Root surgery premolar,,,654.59,1850.51,19
CPT,D3425,Root surgery molar,,,654.59,1850.51,19
CPT,D3428,Bone graft peri per tooth,,,654.59,1850.51,19
CPT,D3430,Retrograde filling,,,654.59,1850.51,19
CPT,D3431,Biological materials,,,654.59,1850.51,19
CPT,D3432,Guided tissue regeneration,,,654.59,1850.51,19
CPT,D3450,Root amputation,,,654.59,1850.51,19
CPT,D3460,Endodontic endosseous implan,,,654.59,1850.51,19
CPT,D3470,Intentional replantation,,,654.59,1850.51,19
CPT,D3471,Surg rep root res anterior,,,654.59,1850.51,19
CPT,D3472,Surg rep root res premolar,,,654.59,1850.51,19
CPT,D3473,Surg rep root res molar,,,654.59,1850.51,19
CPT,D3501,Surg exp root surf anterior,,,654.59,1850.51,19
CPT,D3502,Surg exp root surf premolar,,,654.59,1850.51,19
CPT,D3503,Surg exp root surf molar,,,654.59,1850.51,19
CPT,D3910,Isolation- tooth w rubb dam,,,654.59,1850.51,19
CPT,D3911,Intraorifice barrier,,,654.59,1850.51,19
CPT,D3920,Tooth splitting,,,654.59,1850.51,19
CPT,D3921,Decor or submerg erupt tooth,,,654.59,1850.51,19
CPT,D3950,Canal prep/fitting of dowel,,,654.59,1850.51,19
CPT,D3999,Endodontic procedure,,,654.59,1850.51,19
CPT,D4210,Gingivectomy/plasty 4 or mor,,,3109.0,3609.55,19
CPT,D4211,Gingivectomy/plasty 1 to 3,,,3109.0,3609.55,19
CPT,D4212,Gingivectomy/plasty rest,,,3109.0,3609.55,19
CPT,D4230,Ana crown exp 4 or> per quad,,,3109.0,3609.55,19
CPT,D4231,Ana crown exp 1-3 per quad,,,1420.05,1648.68,19
CPT,D4240,Gingival flap proc w/ planin,,,3109.0,3609.55,19
CPT,D4241,Gngvl flap w rootplan 1-3 th,,,1420.05,1648.68,19
CPT,D4245,Apically positioned flap,,,1420.05,1648.68,19
CPT,D4249,Crown lengthen hard tissue,,,654.59,1850.51,19
CPT,D4260,Osseous surgery 4 or more,,,5671.11,6584.15,19
CPT,D4261,Osseous surg 1 to 3 teeth,,,3109.0,3609.55,19
CPT,D4263,Bone replce graft first site,,,654.59,1850.51,19
CPT,D4265,Bio mtrls to aid soft/os reg,,,654.59,1850.51,19
CPT,D4266,Guided tiss regen resorble,,,1420.05,1648.68,19
CPT,D4267,Guided tiss regen nonresorb,,,1420.05,1648.68,19
CPT,D4268,Surgical revision procedure,,,654.59,1850.51,19
CPT,D4270,Pedicle soft tissue graft pr,,,1420.05,1648.68,19
CPT,D4273,Auto tissue graft 1st tooth,,,1420.05,1648.68,19
CPT,D4274,Mesial/distal wedge proc,,,654.59,1850.51,19
CPT,D4275,Non-auto graft 1st tooth,,,1420.05,1648.68,19
CPT,D4276,Con tissue w pedicle graft,,,1420.05,1648.68,19
CPT,D4277,Soft tissue graft firsttooth,,,1420.05,1648.68,19
CPT,D4322,Splint intra-coronal,,,654.59,1850.51,19
CPT,D4323,Splint extra-coronal,,,654.59,1850.51,19
CPT,D4341,Periodontal scaling & root,,,654.59,1850.51,19
CPT,D4342,Periodontal scaling 1-3teeth,,,654.59,1850.51,19
CPT,D4346,Scaling gingiv inflammation,,,654.59,1850.51,19
CPT,D4355,Full mouth debridement,,,654.59,1850.51,19
CPT,D4381,Localized delivery antimicro,,,654.59,1850.51,19
CPT,D4910,Periodontal maint procedures,,,654.59,1850.51,19
CPT,D4920,Unscheduled dressing change,,,654.59,1850.51,19
CPT,D4921,Gingival irrigation per quad,,,123.54,143.43,19
CPT,D4999,Unspecified periodontal proc,,,222.62,258.46,19
CPT,D5911,Facial moulage sectional,,,654.59,1850.51,19
CPT,D5912,Facial moulage complete,,,654.59,1850.51,19
CPT,D5983,Radiation applicator,,,654.59,1850.51,19
CPT,D5984,Radiation shield,,,654.59,1850.51,19
CPT,D5985,Radiation cone locator,,,654.59,1850.51,19
CPT,D5987,Commissure splint,,,654.59,1850.51,19
CPT,D5988,Surgical splint,,,654.59,1850.51,19
CPT,D6920,Dental connector bar,,,654.59,1850.51,19
CPT,D7111,Extraction coronal remnants,,,654.59,1850.51,19
CPT,D7140,Extraction erupted tooth/exr,,,654.59,1850.51,19
CPT,D7210,Rem imp tooth w mucoper flp,,,1420.05,1648.68,19
CPT,D7220,Impact tooth remov soft tiss,,,654.59,1850.51,19
CPT,D7230,Impact tooth remov part bony,,,654.59,1850.51,19
CPT,D7240,Impact tooth remov comp bony,,,654.59,1850.51,19
CPT,D7241,Impact tooth rem bony w/comp,,,654.59,1850.51,19
CPT,D7250,Tooth root removal,,,654.59,1850.51,19
CPT,D7251,Coronectomy,,,1420.05,1648.68,19
CPT,D7260,Oral antral fistula closure,,,654.59,1850.51,19
CPT,D7261,Primary closure sinus perf,,,654.59,1850.51,19
CPT,D7270,Tooth reimplantation,,,654.59,1850.51,19
CPT,D7272,Tooth transplantation,,,654.59,1850.51,19
CPT,D7280,Exposure of unerupted tooth,,,654.59,1850.51,19
CPT,D7291,Transseptal fiberotomy,,,654.59,1850.51,19
CPT,D7310,Alveoplasty w/ extraction,,,1420.05,1648.68,19
CPT,D7311,Alveoloplasty w/extract 1-3,,,1420.05,1648.68,19
CPT,D7320,Alveoplasty w/o extraction,,,1420.05,1648.68,19
CPT,D7321,Alveoloplasty not w/extracts,,,1420.05,1648.68,19
CPT,D7340,Vestibuloplasty ridge extens,,,5671.11,6584.15,19
CPT,D7350,Vestibuloplasty exten graft,,,5671.11,6584.15,19
CPT,D7410,Rad exc lesion up to 1.25 cm,,,1420.05,1648.68,19
CPT,D7411,Excision benign lesion>1.25c,,,1420.05,1648.68,19
CPT,D7412,Excision benign lesion compl,,,1420.05,1648.68,19
CPT,D7413,Excision malig lesion<1.25c,,,1420.05,1648.68,19
CPT,D7414,Excision malig lesion>1.25cm,,,1420.05,1648.68,19
CPT,D7415,Excision malig les complicat,,,1420.05,1648.68,19
CPT,D7440,Malig tumor exc to 1.25 cm,,,3109.0,3609.55,19
CPT,D7441,Malig tumor > 1.25 cm,,,3109.0,3609.55,19
CPT,D7450,Rem odontogen cyst to 1.25cm,,,3109.0,3609.55,19
CPT,D7451,Rem odontogen cyst > 1.25 cm,,,3109.0,3609.55,19
CPT,D7460,Rem nonodonto cyst to 1.25cm,,,654.59,1850.51,19
CPT,D7461,Rem nonodonto cyst > 1.25 cm,,,654.59,1850.51,19
CPT,D7471,Rem exostosis any site,,,3109.0,3609.55,19
CPT,D7472,Removal of torus palatinus,,,654.59,1850.51,19
CPT,D7473,Remove torus mandibularis,,,654.59,1850.51,19
CPT,D7485,Surg reduct osseoustuberosit,,,5671.11,6584.15,19
CPT,D7510,I&d absc intraoral soft tiss,,,674.5,783.1,19
CPT,D7511,Incision/drain abscess intra,,,674.5,783.1,19
CPT,D7520,I&d abscess extraoral,,,674.5,783.1,19
CPT,D7521,Incision/drain abscess extra,,,674.5,783.1,19
CPT,D7530,Removal fb skin/areolar tiss,,,654.59,1850.51,19
CPT,D7540,Removal of fb reaction,,,654.59,1850.51,19
CPT,D7550,Removal of sloughed off bone,,,654.59,1850.51,19
CPT,D7670,Closd rductn splint alveolus,,,3109.0,3609.55,19
CPT,D7671,Alveolus open reduction,,,5671.11,6584.15,19
CPT,D7770,Open reduc compd alveolus fx,,,5671.11,6584.15,19
CPT,D7771,Alveolus clsd reduc stblz te,,,3109.0,3609.55,19
CPT,D7874,Tmj arthroscopy disc reposit,,,3110.48,3611.26,19
CPT,D7922,Place intra-socket bio dress,,,654.59,1850.51,19
CPT,D7940,Reshaping bone orthognathic,,,654.59,1850.51,19
CPT,D7950,Mandible graft,,,5671.11,6584.15,19
CPT,D9630,Drugs/meds disp for home use,,,1593.89,1593.89,1
CPT,D9930,Treatment of complications,,,654.59,1850.51,19
CPT,D9944,Occ guard hard full arch,,,654.59,1850.51,19
CPT,D9945,Occ guard soft full arch,,,654.59,1850.51,19
CPT,D9946,Occ guard hard part arch,,,654.59,1850.51,19
CPT,D9950,Occlusion analysis,,,654.59,1850.51,19
CPT,D9951,Limited occlusal adjustment,,,654.59,1850.51,19
CPT,D9952,Complete occlusal adjustment,,,654.59,1850.51,19
CPT,E0100,Cane adjust/fixed with tip,,,17.04,20.33,8
CPT,E0105,Cane adjust/fixed quad/3 pro,,,25.48,30.41,8
CPT,E0110,Crutch forearm pair,,,45.95,54.83,8
CPT,E0111,Crutch forearm each,,,28.51,34.02,8
CPT,E0112,Crutch underarm pair wood,,,33.62,40.12,8
CPT,E0113,Crutch underarm each wood,,,14.78,17.63,8
CPT,E0114,Crutch underarm pair no wood,,,24.62,29.38,8
CPT,E0116,Crutch underarm each no wood,,,15.57,18.57,8
CPT,E0117,Underarm springassist crutch,,,65.13,77.71,8
CPT,E0130,Walker rigid adjust/fixed ht,,,22.31,26.62,8
CPT,E0135,Walker folding adjust/fixed,,,22.63,27.01,8
CPT,E0140,Walker w trunk support,,,84.95,101.36,8
CPT,E0141,Rigid wheeled walker adj/fix,,,26.27,31.34,8
CPT,E0143,HC PT WALKER,480.65,360.49,5.77,432.58,119
CPT,E0143,Walker folding wheeled w/o s,,,25.81,30.8,8
CPT,E0144,Enclosed walker w rear seat,,,83.36,99.47,8
CPT,E0147,Walker variable wheel resist,,,131.1,156.43,8
CPT,E0148,Heavyduty walker no wheels,,,27.26,32.53,8
CPT,E0149,Heavy duty wheeled walker,,,41.18,49.13,8
CPT,E0153,Forearm crutch platform atta,,,26.55,31.68,8
CPT,E0154,Walker platform attachment,,,15.74,18.78,8
CPT,E0155,Walker wheel attachmentpair,,,7.37,8.8,8
CPT,E0156,Walker seat attachment,,,5.46,6.52,8
CPT,E0157,Walker crutch attachment,,,19.74,23.55,8
CPT,E0158,Walker leg extenders set of4,,,7.28,8.68,8
CPT,E0159,Brake for wheeled walker,,,4.51,5.38,8
CPT,E0160,Sitz type bath or equipment,,,9.89,11.8,8
CPT,E0161,Sitz bath/equipment w/faucet,,,7.58,9.04,8
CPT,E0162,Sitz bath chair,,,51.73,61.72,8
CPT,E0163,Commode chair with fixed arm,,,32.48,38.76,8
CPT,E0165,Commode chair with detacharm,,,43.67,52.1,8
CPT,E0167,Commode chair pail or pan,,,3.26,3.89,8
CPT,E0168,Heavyduty/wide commode chair,,,39.86,47.55,8
CPT,E0170,Commode chair electric,,,483.29,576.65,8
CPT,E0171,Commode chair non-electric,,,91.25,108.87,8
CPT,E0175,Commode chair foot rest,,,22.38,26.7,8
CPT,E0181,Press pad alternating w/ pum,,,58.37,69.65,8
CPT,E0182,Replace pump alt press pad,,,66.55,79.41,8
CPT,E0183,Press underlay alter w/pump,,,58.37,69.65,8
CPT,E0184,Dry pressure mattress,,,54.66,65.22,8
CPT,E0185,Gel pressure mattress pad,,,67.12,80.08,8
CPT,E0186,Air pressure mattress,,,54.15,64.61,8
CPT,E0187,Water pressure mattress,,,61.21,73.04,8
CPT,E0188,Synthetic sheepskin pad,,,7.45,8.89,8
CPT,E0189,Lambswool sheepskin pad,,,14.88,17.76,8
CPT,E0191,Protector heel or elbow,,,3.48,4.16,8
CPT,E0193,Powered air flotation bed,,,2238.55,2671.0,8
CPT,E0194,Air fluidized bed,,,11006.56,13132.83,8
CPT,E0196,Gel pressure mattress,,,95.98,114.52,8
CPT,E0197,Air pressure pad for mattres,,,66.15,78.93,8
CPT,E0198,Water pressure pad for mattr,,,74.95,89.43,8
CPT,E0199,Dry pressure pad for mattres,,,9.54,11.38,8
CPT,E0200,Heat lamp without stand,,,35.2,42.0,8
CPT,E0202,Phototherapy light w/ photom,,,194.32,231.86,8
CPT,E0205,Heat lamp with stand,,,65.64,78.32,8
CPT,E0210,Electric heat pad standard,,,10.4,12.41,8
CPT,E0215,Electric heat pad moist,,,21.31,25.43,8
CPT,E0217,Water circ heat pad w pump,,,158.9,189.6,8
CPT,E0225,Hydrocollator unit,,,110.15,131.43,8
CPT,E0235,Paraffin bath unit portable,,,49.6,59.18,8
CPT,E0236,Pump for water circulating p,,,127.19,151.76,8
CPT,E0239,Hydrocollator unit portable,,,152.16,181.56,8
CPT,E0249,Pad water circulating heat u,,,31.46,37.54,8
CPT,E0250,Hosp bed fixed ht w/ mattres,,,205.62,245.34,8
CPT,E0251,Hosp bed fixd ht w/o mattres,,,177.77,212.11,8
CPT,E0255,Hospital bed var ht w/ mattr,,,209.69,250.19,8
CPT,E0256,Hospital bed var ht w/o matt,,,195.14,232.84,8
CPT,E0260,Hosp bed semi-electr w/ matt,,,236.75,282.48,8
CPT,E0261,Hosp bed semi-electr w/o mat,,,234.18,279.42,8
CPT,E0265,Hosp bed total electr w/ mat,,,465.38,555.28,8
CPT,E0266,Hosp bed total elec w/o matt,,,409.71,488.86,8
CPT,E0271,Mattress innerspring,,,46.38,55.35,8
CPT,E0272,Mattress foam rubber,,,45.8,54.65,8
CPT,E0275,Bed pan standard,,,4.12,4.91,8
CPT,E0276,Bed pan fracture,,,3.71,4.43,8
CPT,E0277,Powered pres-redu air mattrs,,,950.27,1133.84,8
CPT,E0280,Bed cradle,,,9.92,11.83,8
CPT,E0290,Hosp bed fx ht w/o rails w/m,,,181.4,216.45,8
CPT,E0291,Hosp bed fx ht w/o rail w/o,,,136.75,163.17,8
CPT,E0292,Hosp bed var ht no sr w/matt,,,195.62,233.42,8
CPT,E0293,Hosp bed var ht no sr no mat,,,174.82,208.59,8
CPT,E0294,Hosp bed semi-elect w/ mattr,,,229.6,273.96,8
CPT,E0295,Hosp bed semi-elect w/o matt,,,227.18,271.07,8
CPT,E0296,Hosp bed total elect w/ matt,,,371.0,442.67,8
CPT,E0297,Hosp bed total elect w/o mat,,,324.31,386.96,8
CPT,E0300,Enclosed ped crib hosp grade,,,766.9,915.05,8
CPT,E0301,Hd hosp bed 350-600 lbs,,,550.99,657.43,8
CPT,E0302,Ex hd hosp bed > 600 lbs,,,1552.06,1851.9,8
CPT,E0303,Hosp bed hvy dty xtra wide,,,576.97,688.43,8
CPT,E0304,Hosp bed xtra hvy dty x wide,,,1603.08,1912.76,8
CPT,E0305,Rails bed side half length,,,35.15,41.94,8
CPT,E0310,Rails bed side full length,,,41.27,49.25,8
CPT,E0316,Bed safety enclosure,,,596.08,711.23,8
CPT,E0325,Urinal male jug-type,,,3.03,3.61,8
CPT,E0326,Urinal female jug-type,,,3.0,3.58,8
CPT,E0371,Nonpower mattress overlay,,,761.51,908.62,8
CPT,E0372,Powered air mattress overlay,,,830.63,991.1,8
CPT,E0373,Nonpowered pressure mattress,,,885.41,1056.46,8
CPT,E0424,Stationary compressed gas 02,,,322.63,384.96,8
CPT,E0431,Portable gaseous 02,,,63.23,75.44,8
CPT,E0433,Portable liquid oxygen sys,,,121.59,145.08,8
CPT,E0434,Portable liquid 02,,,121.59,145.08,8
CPT,E0439,Stationary liquid 02,,,322.63,384.96,8
CPT,E0441,Stationary o2 contents gas,,,172.3,205.59,8
CPT,E0442,Stationary o2 contents liq,,,172.3,205.59,8
CPT,E0443,Portable 02 contents gas,,,161.06,192.17,8
CPT,E0444,Portable 02 contents liquid,,,161.06,192.17,8
CPT,E0447,Port o2 cont liq over 4 lpm,,,243.21,290.19,8
CPT,E0462,Rocking bed w/ or w/o side r,,,985.59,1175.99,8
CPT,E0465,Home vent invasive interface,,,2964.68,3537.41,8
CPT,E0466,Home vent non-invasive inter,,,2964.68,3537.41,8
CPT,E0467,Home vent multi-function,,,3471.75,4142.43,8
CPT,E0470,Rad w/o backup non-inv intfc,,,420.65,501.91,8
CPT,E0471,Rad w/backup non inv intrfc,,,1007.56,1202.21,8
CPT,E0472,Rad w backup invasive intrfc,,,1244.66,1485.11,8
CPT,E0480,Percussor elect/pneum home m,,,126.35,150.76,8
CPT,E0482,Cough stimulating device,,,1454.43,1735.4,8
CPT,E0483,Hi freq chest wall oscil sys,,,3595.68,4290.3,8
CPT,E0484,Non-elec oscillatory pep dvc,,,12.49,14.9,8
CPT,E0490,Control unit nm hw remote,,,302.76,361.25,8
CPT,E0491,Oral dv nm mouthpc hw remote,,,250.04,298.35,8
CPT,E0500,Ippb all types,,,335.42,400.22,8
CPT,E0550,Humidif extens supple w ippb,,,162.41,193.79,8
CPT,E0560,Humidifier supplemental w/ i,,,49.8,59.42,8
CPT,E0561,Humidifier nonheated w pap,,,22.63,27.01,8
CPT,E0562,Humidifier heated used w pap,,,51.96,61.99,8
CPT,E0565,Compressor air power source,,,133.16,158.89,8
CPT,E0570,Nebulizer with compression,,,26.14,31.2,8
CPT,E0572,Aerosol compressor adjust pr,,,100.13,119.47,8
CPT,E0574,Ultrasonic generator w svneb,,,136.14,162.44,8
CPT,E0575,Nebulizer ultrasonic,,,337.41,402.59,8
CPT,E0580,Nebulizer for use w/ regulat,,,39.01,46.55,8
CPT,E0585,Nebulizer w/ compressor & he,,,87.72,104.66,8
CPT,E0600,Suction pump portab hom modl,,,154.85,184.77,8
CPT,E0601,Cont airway pressure device,,,170.85,203.86,8
CPT,E0602,Manual breast pump,,,10.07,12.01,8
CPT,E0605,Vaporizer room type,,,10.15,12.11,8
CPT,E0606,Drainage board postural,,,65.97,78.72,8
CPT,E0607,Blood glucose monitor home,,,22.58,26.94,8
CPT,E0610,Pacemaker monitr audible/vis,,,80.47,96.01,8
CPT,E0615,Pacemaker monitr digital/vis,,,197.86,236.08,8
CPT,E0617,Automatic ext defibrillator,,,1028.29,1226.94,8
CPT,E0618,Apnea monitor,,,805.99,961.7,8
CPT,E0620,Cap bld skin piercing laser,,,295.7,352.82,8
CPT,E0621,Patient lift sling or seat,,,24.69,29.46,8
CPT,E0627,Seat lift mech electric any,,,91.33,108.97,8
CPT,E0629,Seat lift mech non-electric,,,90.05,107.45,8
CPT,E0630,Patient lift hydraulic,,,213.4,254.63,8
CPT,E0635,Patient lift electric,,,348.57,415.91,8
CPT,E0636,Pt support & positioning sys,,,3100.77,3699.78,8
CPT,E0639,Moveable patient lift system,,,323.93,386.51,8
CPT,E0640,Fixed patient lift system,,,323.93,386.51,8
CPT,E0650,Pneuma compresor non-segment,,,300.61,358.68,8
CPT,E0651,Pneum compressor segmental,,,317.34,378.64,8
CPT,E0652,Pneum compres w/cal pressure,,,1506.21,1797.18,8
CPT,E0655,Pneumatic appliance half arm,,,38.71,46.19,8
CPT,E0656,Segmental pneumatic trunk,,,195.45,233.21,8
CPT,E0657,Segmental pneumatic chest,,,183.59,219.06,8
CPT,E0660,Pneumatic appliance full leg,,,47.78,57.02,8
CPT,E0665,Pneumatic appliance full arm,,,44.38,52.95,8
CPT,E0666,Pneumatic appliance half leg,,,48.09,57.38,8
CPT,E0667,Seg pneumatic appl full leg,,,105.47,125.84,8
CPT,E0668,Seg pneumatic appl full arm,,,147.48,175.97,8
CPT,E0669,Seg pneumatic appli half leg,,,62.0,73.98,8
CPT,E0670,Seg pneum int legs/trunk,,,417.44,498.08,8
CPT,E0671,Pressure pneum appl full leg,,,140.56,167.72,8
CPT,E0672,Pressure pneum appl full arm,,,109.23,130.34,8
CPT,E0673,Pressure pneum appl half leg,,,90.69,108.21,8
CPT,E0675,Pneumatic compression device,,,1300.57,1551.82,8
CPT,E0677,Non pneum seq comp trunk,,,195.45,233.21,8
CPT,E0691,Uvl pnl 2 sq ft or less,,,303.89,362.6,8
CPT,E0692,Uvl sys panel 4 ft,,,381.59,455.3,8
CPT,E0693,Uvl sys panel 6 ft,,,470.47,561.35,8
CPT,E0694,Uvl md cabinet sys 6 ft,,,1497.36,1786.63,8
CPT,E0705,Transfer device,,,15.15,18.08,8
CPT,E0720,Tens two lead,,,427.89,510.55,8
CPT,E0730,Tens four lead,,,433.29,516.99,8
CPT,E0731,Conductive garment for tens/,,,454.9,542.78,8
CPT,E0740,Non-implant pelv flr e-stim,,,176.85,211.02,8
CPT,E0744,Neuromuscular stim for scoli,,,309.71,369.54,8
CPT,E0745,Neuromuscular stim for shock,,,302.76,361.25,8
CPT,E0747,Elec osteogen stim not spine,,,1316.11,1570.36,8
CPT,E0748,Elec osteogen stim spinal,,,1315.8,1569.99,8
CPT,E0749,Elec osteogen stim implanted,,,961.76,1147.56,8
CPT,E0760,Osteogen ultrasound stimltor,,,1093.47,1304.71,8
CPT,E0762,Trans elec jt stim dev sys,,,371.89,443.73,8
CPT,E0764,Functional neuromuscularstim,,,3742.88,4465.93,8
CPT,E0765,Nerve stimulator for tx n&v,,,28.51,34.02,8
CPT,E0766,Elec stim cancer treatment,,,38884.1,46395.8,8
CPT,E0776,Iv pole,,,48.07,57.35,8
CPT,E0779,Amb infusion pump mechanical,,,56.03,66.85,8
CPT,E0780,Mech amb infusion pump <8hrs,,,35.07,41.84,8
CPT,E0781,External ambulatory infus pu,,,767.59,915.87,8
CPT,E0782,Non-programble infusion pump,,,1234.31,1472.76,8
CPT,E0783,Programmable infusion pump,,,2761.63,3295.13,8
CPT,E0784,Ext amb infusn pump insulin,,,1333.3,1590.87,8
CPT,E0785,Replacement impl pump cathet,,,1598.1,1906.82,8
CPT,E0786,Implantable pump replacement,,,2603.44,3106.38,8
CPT,E0791,Parenteral infusion pump sta,,,873.26,1041.96,8
CPT,E0840,Tract frame attach headboard,,,55.24,65.91,8
CPT,E0849,Cervical pneum trac equip,,,174.31,207.98,8
CPT,E0850,Traction stand free standing,,,41.48,49.5,8
CPT,E0855,Cervical traction equipment,,,169.99,202.83,8
CPT,E0856,Cervic collar w air bladders,,,52.06,62.12,8
CPT,E0860,Tract equip cervical tract,,,18.74,22.37,8
CPT,E0870,Tract frame attach footboard,,,38.55,46.0,8
CPT,E0880,Trac stand free stand extrem,,,56.66,67.61,8
CPT,E0890,Traction frame attach pelvic,,,111.04,132.49,8
CPT,E0900,Trac stand free stand pelvic,,,79.42,94.76,8
CPT,E0910,Trapeze bar attached to bed,,,38.5,45.94,8
CPT,E0911,Hd trapeze bar attach to bed,,,128.74,153.6,8
CPT,E0912,Hd trapeze bar free standing,,,259.46,309.58,8
CPT,E0920,Fracture frame attached to b,,,153.43,183.07,8
CPT,E0930,Fracture frame free standing,,,154.48,184.32,8
CPT,E0935,Cont pas motion exercise dev,,,65.38,78.02,8
CPT,E0940,Trapeze bar free standing,,,70.88,84.57,8
CPT,E0941,Gravity assisted traction de,,,141.86,169.26,8
CPT,E0942,Cervical head harness/halter,,,7.96,9.5,8
CPT,E0944,Pelvic belt/harness/boot,,,15.61,18.63,8
CPT,E0945,Belt/harness extremity,,,12.74,15.2,8
CPT,E0946,Fracture frame dual w cross,,,187.39,223.59,8
CPT,E0947,Fracture frame attachmnts pe,,,180.77,215.69,8
CPT,E0948,Fracture frame attachmnts ce,,,168.56,201.13,8
CPT,E0950,Tray,,,23.47,28.0,8
CPT,E0951,Loop heel,,,4.17,4.98,8
CPT,E0952,Toe loop/holder each,,,4.83,5.76,8
CPT,E0953,W/c lateral thigh/knee sup,,,23.4,27.92,8
CPT,E0954,Foot box any type each foot,,,15.95,19.03,8
CPT,E0955,Cushioned headrest,,,45.9,54.77,8
CPT,E0956,W/c lateral trunk/hip suppor,,,23.4,27.92,8
CPT,E0957,W/c medial thigh support,,,36.88,44.01,8
CPT,E0958,Whlchr att- conv 1 arm drive,,,125.18,149.36,8
CPT,E0959,Amputee adapter,,,13.75,16.41,8
CPT,E0960,W/c shoulder harness/straps,,,23.29,27.79,8
CPT,E0961,Wheelchair brake extension,,,7.02,8.38,8
CPT,E0966,Wheelchair head rest extensi,,,21.69,25.88,8
CPT,E0967,Man wc rim/projection rep ea,,,21.49,25.64,8
CPT,E0968,Wheelchair commode seat,,,51.52,61.48,8
CPT,E0969,Wheelchair narrowing device,,,51.6,61.57,8
CPT,E0971,Wheelchair anti-tipping devi,,,10.12,12.08,8
CPT,E0973,W/ch access det adj armrest,,,17.32,20.66,8
CPT,E0974,W/ch access anti-rollback,,,23.22,27.71,8
CPT,E0978,W/c accsaf belt pelv strap,,,8.57,10.23,8
CPT,E0980,Wheelchair safety vest,,,11.21,13.38,8
CPT,E0981,Seat upholstery replacement,,,12.59,15.03,8
CPT,E0982,Back upholstery replacement,,,13.83,16.51,8
CPT,E0983,Add pwr joystick,,,845.31,1008.61,8
CPT,E0984,Add pwr tiller,,,646.12,770.94,8
CPT,E0985,W/c seat lift mechanism,,,63.3,75.53,8
CPT,E0986,Man w/c powr assist syst,,,1645.2,1963.02,8
CPT,E0988,Lever-activated wheel drive,,,1012.45,1208.04,8
CPT,E0990,Wheelchair elevating leg res,,,22.4,26.73,8
CPT,E0992,Wheelchair solid seat insert,,,26.2,31.26,8
CPT,E0994,Wheelchair arm rest,,,6.03,7.19,8
CPT,E0995,Wc calf rest pad replacemnt,,,8.06,9.62,8
CPT,E1002,Pwr seat tilt,,,1106.67,1320.46,8
CPT,E1003,Pwr seat recline,,,1269.64,1514.91,8
CPT,E1004,Pwr seat recline mech,,,1398.58,1668.77,8
CPT,E1005,Pwr seat recline pwr,,,1525.87,1820.64,8
CPT,E1006,Pwr seat combo w/o shear,,,1878.25,2241.1,8
CPT,E1007,Pwr seat combo w/shear,,,2384.53,2845.17,8
CPT,E1008,Pwr seat combo pwr shear,,,2429.55,2898.89,8
CPT,E1010,Add pwr leg elevation,,,326.96,390.12,8
CPT,E1012,Ctr mount pwr elev leg rest,,,326.96,390.12,8
CPT,E1014,Reclining back add ped w/c,,,123.55,147.42,8
CPT,E1015,Shock absorber for man w/c,,,35.71,42.61,8
CPT,E1016,Shock absorber for power w/c,,,33.75,40.27,8
CPT,E1020,Residual limb support system,,,56.72,67.67,8
CPT,E1028,W/c manual swingaway,,,43.67,52.1,8
CPT,E1029,W/c vent tray fixed,,,107.68,128.48,8
CPT,E1030,W/c vent tray gimbaled,,,339.67,405.29,8
CPT,E1031,Rollabout chair with casters,,,129.6,154.63,8
CPT,E1035,Patient transfer system <300,,,1851.96,2209.73,8
CPT,E1036,Patient transfer system >300,,,2560.4,3055.02,8
CPT,E1037,Transport chair ped size,,,316.93,378.16,8
CPT,E1038,Transport chair pt wt<300lb,,,47.51,56.69,8
CPT,E1039,Transport chair pt wt >300lb,,,100.3,119.68,8
CPT,E1050,Whelchr fxd full length arms,,,292.8,349.37,8
CPT,E1060,Wheelchair detachable arms,,,410.04,489.25,8
CPT,E1070,Wheelchair detachable foot r,,,330.49,394.34,8
CPT,E1083,Hemi-wheelchair fixed arms,,,226.34,270.07,8
CPT,E1084,Hemi-wheelchair detachable a,,,305.13,364.08,8
CPT,E1087,Wheelchair lightwt fixed arm,,,427.94,510.62,8
CPT,E1088,Wheelchair lightweight det a,,,509.93,608.44,8
CPT,E1092,Wheelchair wide w/ leg rests,,,369.45,440.82,8
CPT,E1093,Wheelchair wide w/ foot rest,,,331.81,395.91,8
CPT,E1100,Whchr s-recl fxd arm leg res,,,298.39,356.03,8
CPT,E1110,Wheelchair semi-recl detach,,,321.92,384.11,8
CPT,E1150,Wheelchair standard w/ leg r,,,275.89,329.19,8
CPT,E1160,Wheelchair fixed arms,,,180.08,214.87,8
CPT,E1161,Manual adult wc w tiltinspac,,,800.22,954.81,8
CPT,E1170,Whlchr ampu fxd arm leg rest,,,256.78,306.39,8
CPT,E1171,Wheelchair amputee w/o leg r,,,230.41,274.92,8
CPT,E1172,Wheelchair amputee detach ar,,,281.69,336.11,8
CPT,E1180,Wheelchair amputee w/ foot r,,,291.32,347.6,8
CPT,E1190,Wheelchair amputee w/ leg re,,,350.58,418.31,8
CPT,E1195,Wheelchair amputee heavy dut,,,361.13,430.9,8
CPT,E1200,Wheelchair amputee fixed arm,,,250.12,298.44,8
CPT,E1221,Wheelchair spec size w foot,,,145.93,174.12,8
CPT,E1222,Wheelchair spec size w/ leg,,,194.83,232.47,8
CPT,E1223,Wheelchair spec size w foot,,,215.79,257.48,8
CPT,E1224,Wheelchair spec size w/ leg,,,233.29,278.36,8
CPT,E1225,Manual semi-reclining back,,,121.26,144.69,8
CPT,E1226,Manual fully reclining back,,,123.04,146.81,8
CPT,E1227,Wheelchair spec sz spec ht a,,,93.87,112.0,8
CPT,E1228,Wheelchair spec sz spec ht b,,,94.78,113.1,8
CPT,E1230,Power operated vehicle,,,752.38,897.73,8
CPT,E1232,Folding ped wc tilt-in-space,,,723.31,863.04,8
CPT,E1233,Rig ped wc tltnspc w/o seat,,,749.36,894.12,8
CPT,E1234,Fld ped wc tltnspc w/o seat,,,652.41,778.44,8
CPT,E1235,Rigid ped wc adjustable,,,628.25,749.62,8
CPT,E1236,Folding ped wc adjustable,,,554.24,661.31,8
CPT,E1237,Rgd ped wc adjstabl w/o seat,,,559.05,667.04,8
CPT,E1238,Fld ped wc adjstabl w/o seat,,,554.24,661.31,8
CPT,E1240,Whchr litwt det arm leg rest,,,348.47,415.79,8
CPT,E1270,Wheelchair lightweight leg r,,,250.78,299.23,8
CPT,E1280,Whchr h-duty det arm leg res,,,377.34,450.23,8
CPT,E1295,Wheelchair heavy duty fixed,,,349.18,416.64,8
CPT,E1296,Wheelchair special seat heig,,,168.97,201.61,8
CPT,E1297,Wheelchair special seat dept,,,38.98,46.52,8
CPT,E1298,Wheelchair spec seat depth/w,,,146.59,174.91,8
CPT,E1310,Whirlpool non-portable,,,621.15,741.14,8
CPT,E1353,Oxygen supplies regulator,,,95.78,114.28,8
CPT,E1355,Oxygen supplies stand/rack,,,72.18,86.12,8
CPT,E1372,Oxy suppl heater for nebuliz,,,48.22,57.53,8
CPT,E1390,Oxygen concentrator,,,322.63,384.96,8
CPT,E1391,Oxygen concentrator dual,,,322.63,384.96,8
CPT,E1392,Portable oxygen concentrator,,,121.59,145.08,8
CPT,E1405,O2/water vapor enrich w/heat,,,410.34,489.62,8
CPT,E1406,O2/water vapor enrich w/o he,,,348.77,416.15,8
CPT,E1700,Jaw motion rehab system,,,99.16,118.31,8
CPT,E1701,Repl cushions for jaw motion,,,30.47,36.35,8
CPT,E1702,Repl measr scales jaw motion,,,76.3,91.04,8
CPT,E1800,Adjust elbow ext & flex dev,,,414.31,494.35,8
CPT,E1801,Sps/pass elbow device,,,436.34,520.63,8
CPT,E1802,Adjst forearm pro/sup device,,,1105.32,1318.85,8
CPT,E1805,Adjust wrist ext & flex dev,,,427.34,509.89,8
CPT,E1806,Sps wrist device,,,358.28,427.5,8
CPT,E1810,Adjust knee ext & flex dev,,,421.38,502.78,8
CPT,E1811,Sps/pass knee device,,,453.58,541.2,8
CPT,E1812,Knee ext/flex w act res ctrl,,,290.84,347.03,8
CPT,E1815,Adjust ankle ext & flex dev,,,427.34,509.89,8
CPT,E1816,Sps/pass ankle device,,,460.8,549.82,8
CPT,E1818,Sps/pass forearm device,,,470.39,561.26,8
CPT,E1820,Soft interface material,,,27.39,32.69,8
CPT,E1821,Replacement interface spsd,,,35.5,42.36,8
CPT,E1825,Adjust finger ext & flex dev,,,427.34,509.89,8
CPT,E1830,Adjust toe ext & flex device,,,427.34,509.89,8
CPT,E1831,Static str toe dev ext/flex,,,223.45,266.62,8
CPT,E1840,Adj shoulder ext/flex device,,,1294.41,1544.47,8
CPT,E1841,Sps/pass shoulder device,,,1532.07,1828.04,8
CPT,E1905,Vr cbt therapy,,,1601.38,1910.74,8
CPT,E2000,Gastric suction pump hme mdl,,,175.3,209.17,8
CPT,E2100,Bld glucose monitor w voice,,,184.97,220.7,8
CPT,E2101,Bld glucose monitor w lance,,,63.78,76.1,8
CPT,E2102,Adju cgm receiver/monitor,,,56.76,67.73,8
CPT,E2103,Non-adju cgm receiver/mon,,,71.52,85.33,8
CPT,E2120,Pulse gen sys tx endolymp fl,,,958.91,1144.15,8
CPT,E2201,Man w/ch acc seat w>20,,,101.5,121.11,8
CPT,E2202,Seat width 24-27 in,,,145.16,173.21,8
CPT,E2203,Frame depth less than 22 in,,,130.39,155.58,8
CPT,E2204,Frame depth 22 to 25 in,,,226.57,270.34,8
CPT,E2205,Manual wc accessory handrim,,,10.02,11.96,8
CPT,E2206,Man wc whl lock comp repl ea,,,12.14,14.48,8
CPT,E2207,Crutch and cane holder,,,13.38,15.96,8
CPT,E2208,Cylinder tank carrier,,,25.2,30.07,8
CPT,E2209,Arm trough each,,,25.33,30.22,8
CPT,E2210,Wheelchair bearings,,,1.71,2.04,8
CPT,E2211,Pneumatic propulsion tire,,,10.15,12.11,8
CPT,E2212,Pneumatic prop tire tube,,,1.83,2.18,8
CPT,E2213,Pneumatic prop tire insert,,,8.85,10.56,8
CPT,E2214,Pneumatic caster tire each,,,10.48,12.51,8
CPT,E2215,Pneumatic caster tire tube,,,3.0,3.58,8
CPT,E2216,Foam filled propulsion tire,,,13.53,16.14,8
CPT,E2217,Foam filled caster tire each,,,11.98,14.29,8
CPT,E2218,Foam propulsion tire each,,,13.53,16.14,8
CPT,E2219,Foam caster tire any size ea,,,11.98,14.29,8
CPT,E2220,Solid propuls tire repl ea,,,8.54,10.2,8
CPT,E2221,Solid caster tire repl each,,,7.81,9.31,8
CPT,E2222,Solid caster integ whl repl,,,6.38,7.61,8
CPT,E2224,Propulsion whl excl tire rep,,,27.57,32.9,8
CPT,E2225,Caster wheel excludes tire,,,5.46,6.52,8
CPT,E2226,Caster fork replacement only,,,11.49,13.71,8
CPT,E2227,Gear reduction drive wheel,,,632.72,754.95,8
CPT,E2228,Mwc acc wheelchair brake,,,278.41,332.19,8
CPT,E2231,Solid seat support base,,,42.88,51.17,8
CPT,E2310,Electro connect btw control,,,322.84,385.2,8
CPT,E2311,Electro connect btw 2 sys,,,652.05,778.02,8
CPT,E2312,Mini-prop remote joystick,,,682.04,813.79,8
CPT,E2313,Pwc harness expand control,,,108.36,129.3,8
CPT,E2321,Hand interface joystick,,,438.6,523.33,8
CPT,E2322,Mult mech switches,,,407.72,486.49,8
CPT,E2323,Special joystick handle,,,19.91,23.76,8
CPT,E2324,Chin cup interface,,,12.72,15.17,8
CPT,E2325,Sip and puff interface,,,389.62,464.89,8
CPT,E2326,Breath tube kit,,,101.22,120.77,8
CPT,E2327,Head control interface mech,,,760.52,907.44,8
CPT,E2328,Head/extremity control inter,,,1437.24,1714.89,8
CPT,E2329,Head control nonproportional,,,514.82,614.27,8
CPT,E2330,Head control proximity switc,,,995.48,1187.79,8
CPT,E2340,W/c wdth 20-23 in seat frame,,,121.26,144.69,8
CPT,E2341,W/c wdth 24-27 in seat frame,,,181.79,216.91,8
CPT,E2342,W/c dpth 20-21 in seat frame,,,151.5,180.77,8
CPT,E2343,W/c dpth 22-25 in seat frame,,,242.4,289.22,8
CPT,E2351,Electronic sgd interface,,,203.74,243.1,8
CPT,E2359,Gr34 sealed leadacid battery,,,50.0,59.66,8
CPT,E2360,22nf nonsealed leadacid,,,35.4,42.24,8
CPT,E2361,22nf sealed leadacid battery,,,33.7,40.2,8
CPT,E2362,Gr24 nonsealed leadacid,,,31.08,37.09,8
CPT,E2363,Gr24 sealed leadacid battery,,,43.92,52.41,8
CPT,E2364,U1nonsealed leadacid battery,,,34.43,41.09,8
CPT,E2365,U1 sealed leadacid battery,,,24.52,29.25,8
CPT,E2366,Battery charger single mode,,,48.01,57.29,8
CPT,E2367,Battery charger dual mode,,,113.3,135.19,8
CPT,E2368,Pwr wc drivewheel motor repl,,,122.43,146.08,8
CPT,E2369,Pwr wc drivewheel gear repl,,,116.88,139.46,8
CPT,E2370,Pwr wc dr wh motor/gear comb,,,171.36,204.47,8
CPT,E2371,Gr27 sealed leadacid battery,,,40.8,48.68,8
CPT,E2373,Hand/chin ctrl spec joystick,,,232.5,277.41,8
CPT,E2374,Hand/chin ctrl std joystick,,,148.39,177.06,8
CPT,E2375,Non-expandable controller,,,204.65,244.19,8
CPT,E2376,Expandable controller repl,,,369.78,441.22,8
CPT,E2377,Expandable controller initl,,,136.14,162.44,8
CPT,E2378,Pw actuator replacement,,,166.81,199.04,8
CPT,E2381,Pneum drive wheel tire,,,18.74,22.37,8
CPT,E2382,Tube pneum wheel drive tire,,,5.49,6.55,8
CPT,E2383,Insert pneum wheel drive,,,39.42,47.04,8
CPT,E2384,Pneumatic caster tire,,,19.86,23.7,8
CPT,E2385,Tube pneumatic caster tire,,,13.2,15.75,8
CPT,E2386,Foam filled drive wheel tire,,,33.64,40.14,8
CPT,E2387,Foam filled caster tire,,,15.92,18.99,8
CPT,E2388,Foam drive wheel tire,,,14.09,16.81,8
CPT,E2389,Foam caster tire,,,7.83,9.35,8
CPT,E2390,Solid drive wheel tire,,,12.14,14.48,8
CPT,E2391,Solid caster tire,,,5.29,6.31,8
CPT,E2392,Solid caster tire integrate,,,12.77,15.24,8
CPT,E2394,Drive wheel excludes tire,,,17.8,21.24,8
CPT,E2395,Caster wheel excludes tire,,,13.55,16.17,8
CPT,E2396,Caster fork,,,16.51,19.7,8
CPT,E2397,Pwc acc lith-based battery,,,130.98,156.28,8
CPT,E2402,Neg press wound therapy pump,,,2568.94,3065.21,8
CPT,E2500,Sgd digitized pre-rec <8min,,,132.27,157.83,8
CPT,E2502,Sgd prerec msg >8min <20min,,,404.47,482.61,8
CPT,E2504,Sgd prerec msg>20min <40min,,,533.56,636.64,8
CPT,E2506,Sgd prerec msg > 40 min,,,782.24,933.36,8
CPT,E2508,Sgd spelling phys contact,,,1209.65,1443.33,8
CPT,E2510,Sgd w multi methods msg/accs,,,2289.11,2731.32,8
CPT,E2601,Gen w/c cushion wdth < 22 in,,,12.43,14.84,8
CPT,E2602,Gen w/c cushion wdth >22 in,,,27.29,32.56,8
CPT,E2603,Skin protect wc cus wd <22in,,,33.04,39.42,8
CPT,E2604,Skin protect wc cus wd>22in,,,47.15,56.26,8
CPT,E2605,Position wc cush wdth <22 in,,,65.33,77.95,8
CPT,E2606,Position wc cush wdth>22 in,,,104.55,124.75,8
CPT,E2607,Skin pro/pos wc cus wd <22in,,,66.18,78.96,8
CPT,E2608,Skin pro/pos wc cus wd>22in,,,79.86,95.29,8
CPT,E2611,Gen use back cush wdth <22in,,,55.34,66.03,8
CPT,E2612,Gen use back cush wdth>22in,,,96.95,115.68,8
CPT,E2613,Position back cush wd <22in,,,96.87,115.58,8
CPT,E2614,Position back cush wd>22in,,,136.62,163.01,8
CPT,E2615,Pos back post/lat wdth <22in,,,108.44,129.39,8
CPT,E2616,Pos back post/lat wdth>22in,,,148.85,177.61,8
CPT,E2619,Replace cover w/c seat cush,,,14.47,17.26,8
CPT,E2620,Wc planar back cush wd <22in,,,123.02,146.78,8
CPT,E2621,Wc planar back cush wd>22in,,,136.39,162.74,8
CPT,E2622,Adj skin pro w/c cus wd<22in,,,92.22,110.03,8
CPT,E2623,Adj skin pro wc cus wd>22in,,,116.81,139.38,8
CPT,E2624,Adj skin pro/pos cus<22in,,,93.52,111.58,8
CPT,E2625,Adj skin pro/pos wc cus>22,,,116.41,138.89,8
CPT,E2626,Seo mobile arm sup att to wc,,,192.49,229.68,8
CPT,E2627,Arm supp att to wc rancho ty,,,307.24,366.6,8
CPT,E2628,Mobile arm supports reclinin,,,235.09,280.51,8
CPT,E2629,Friction dampening arm supp,,,268.0,319.78,8
CPT,E2630,Monosuspension arm/hand supp,,,198.7,237.09,8
CPT,E2631,Elevat proximal arm support,,,81.87,97.68,8
CPT,E2632,Offset/lat rocker arm w/ela,,,51.43,61.36,8
CPT,E2633,Mobile arm support supinator,,,42.95,51.25,8
CPT,G0008,Admin influenza virus vac,,,44.23,90.83,27
CPT,G0009,Admin pneumococcal vaccine,,,44.23,90.83,27
CPT,G0010,Admin hepatitis b vaccine,,,44.23,90.83,27
CPT,G0011,Hiv prep counsel md 15-30m,,,60.66,72.38,8
CPT,G0012,Injection of hiv prep drug,,,31.46,79.22,26
CPT,G0013,Hiv prep counsel clin staff,,,28.56,60.53,26
CPT,G0017,Crisis psychotherapy 60m,,,183.76,574.68,9
CPT,G0018,Crisis psychotherapy add 30m,,,91.97,282.05,9
CPT,G0019,Comm hlth intg svs sdoh 60mn,,,88.68,210.75,26
CPT,G0022,Comm hlth intg svs add 30 m,,,110.33,131.64,8
CPT,G0023,Pin service 60m per month,,,88.68,210.75,26
CPT,G0024,Pin srv add 30 min pr m,,,110.33,131.64,8
CPT,G0027,Semen analysis,,,5.79,9.75,58
CPT,G0071,Comm svcs by rhc/fqhc 5 min,,,16.64,40.97,9
CPT,G0076,Care manag h vst new pt 20 m,,,47.95,142.17,44
CPT,G0077,Care manag h vst new pt 30 m,,,71.74,212.35,44
CPT,G0078,Care manag h vst new pt 45 m,,,119.06,347.2,44
CPT,G0079,Care manag h vst new pt 60 m,,,157.47,456.27,44
CPT,G0080,Care manag h vst new pt 75 m,,,203.98,594.62,44
CPT,G0081,Care man h v ext pt 20 mi,,,46.98,139.35,44
CPT,G0082,Care man h v ext pt 30 m,,,76.23,225.44,44
CPT,G0083,Care man h v ext pt 45 m,,,120.34,352.28,44
CPT,G0084,Care man h v ext pt 60 m,,,170.25,495.86,44
CPT,G0085,Care man h v ext pt 75 m,,,203.98,594.62,44
CPT,G0086,Care man home care plan 30 m,,,72.59,211.5,44
CPT,G0087,Care man home care plan 60 m,,,101.5,296.59,44
CPT,G0101,Ca screen-pelvic/breast exam,,,26.71,110.09,63
CPT,G0102,Prostate ca screening- dre,,,8.59,65.27,44
CPT,G0103,HC PROSTATE SPECIFIC ANTIGEN SCREEN,128.14,96.1,1.54,115.33,119
CPT,G0103,Psa screening,,,17.21,28.97,58
CPT,G0104,Ca screen-flexi sigmoidscope,,,53.66,1014.74,63
CPT,G0105,Colorectal scrn- hi risk ind,,,163.38,1014.74,63
CPT,G0105,HC SCREENING COLONOSCOPY HIGH RIS,2920.16,2190.12,35.04,2628.14,119
CPT,G0106,Colon ca screen-barium enema,,,58.87,627.69,80
CPT,G0108,Diab manage trn  per indiv,,,51.44,156.09,63
CPT,G0108,HC DIABETES INITIAL/FOLLOWUP INDIVIDUAL 30 MIN,146.35,109.76,1.76,131.72,119
CPT,G0109,Diab manage trn ind/group,,,14.73,44.7,63
CPT,G0117,Glaucoma scrn hgh risk direc,,,23.47,176.03,63
CPT,G0118,Glaucoma scrn hgh risk direc,,,37.63,114.67,63
CPT,G0120,Colon ca scrn- barium enema,,,58.87,627.69,80
CPT,G0121,Colon ca scrn not hi rsk ind,,,163.67,1014.74,63
CPT,G0121,HC SCREENING COLONOSCOPY LOW RISK,3670.28,2752.71,44.04,3303.25,119
CPT,G0122,Colon ca scrn- barium enema,,,768.61,917.09,8
CPT,G0123,HC THIN PREP PAP SCREEN CRYOPATH,395.23,296.42,4.74,355.71,119
CPT,G0123,Screen cerv/vag thin layer,,,18.05,30.39,58
CPT,G0124,Screen c/v thin layer by md,,,21.97,70.4,47
CPT,G0127,HC TRIMMING DYSTROPHIC NAILS; ANY NUMBER,144.05,108.04,1.73,129.65,119
CPT,G0127,Trim nail(s),,,7.31,67.06,63
CPT,G0128,Corf skilled nursing service,,,8.45,26.55,44
CPT,G0129,Php/iop ot service,,,106.64,316.52,18
CPT,G0130,Single energy x-ray study,,,10.57,118.36,99
CPT,G0136,Adm of soc dtr assess 5-15 m,,,28.56,49.5,26
CPT,G0138,Iv cipaglucosidase alfa-atga,,,379.73,724.01,26
CPT,G0140,Nav srv peer sup 60 min pr m,,,88.68,210.75,26
CPT,G0141,Scr c/v cytoautosys and md,,,21.97,70.4,47
CPT,G0143,Scr c/v cytothinlayerrescr,,,24.1,40.58,58
CPT,G0144,Scr c/v cytothinlayerrescr,,,39.18,145.9,66
CPT,G0145,Scr c/v cytothinlayerrescr,,,23.6,39.74,58
CPT,G0146,Nav srv peer sup add 30 pr m,,,110.33,131.64,8
CPT,G0147,Scr c/v cyto automated sys,,,15.82,22.73,58
CPT,G0148,Scr c/v cyto autosys rescr,,,28.46,47.91,58
CPT,G0166,Extrnl counterpulse per tx,,,97.82,274.71,63
CPT,G0168,HC WOUND CLOSURE UTILIZ TISSUE ADHESIVE(S) ONLY,54.15,40.61,0.65,48.74,119
CPT,G0168,Wound closure by adhesive,,,14.46,273.11,44
CPT,G0175,Opps servicesched team conf,,,408.21,473.94,19
CPT,G0176,Opps/php/iop- activity thrpy,,,106.64,316.52,18
CPT,G0179,Md recertification hha pt,,,39.64,119.26,44
CPT,G0180,Md certification hha patient,,,50.24,151.85,44
CPT,G0181,Home health care supervision,,,100.76,300.72,44
CPT,G0182,Hospice care supervision,,,101.39,297.08,44
CPT,G0183,Software meas of cardiac vol,,,84.41,98.0,18
CPT,G0186,Dstry eye lesnfdr vssl tech,,,525.92,610.6,19
CPT,G0235,HC PET CERVICAL NON CMS,154.77,116.08,1.86,139.29,119
CPT,G0235,Pet not otherwise specified,,,385.22,447.24,19
CPT,G0237,HC RESPIRATORY MUSCLE THERAPY EA 15 MIN,149.51,112.13,1.79,134.56,119
CPT,G0237,Therapeutic procd strg endur,,,10.02,32.05,63
CPT,G0238,HC RESP FUNCTION 1:1 PER 15 MIN,79.99,59.99,0.96,71.99,119
CPT,G0238,Oth resp proc indiv,,,9.71,29.28,63
CPT,G0239,HC RESP MUSCLE/FUNCTION GROUP,183.08,137.31,2.2,164.77,119
CPT,G0239,Oth resp proc group,,,11.9,43.69,63
CPT,G0245,Initial foot exam pt lops,,,38.84,181.62,63
CPT,G0246,Followup eval of foot pt lop,,,19.6,143.43,63
CPT,G0247,Routine footcare pt w lops,,,21.3,231.32,63
CPT,G0248,Demonstrate use home inr mon,,,91.23,273.8,62
CPT,G0249,Provide inr test mater/equip,,,63.05,172.18,63
CPT,G0250,Md inr test revie inter mgmt,,,8.47,25.0,45
CPT,G0252,Pet imaging initial dx,,,,,0
CPT,G0257,HC NON-ROUTINE ESRD DIALYSIS OP,2811.94,2108.96,33.74,2530.75,119
CPT,G0257,HC OUTPT UNSCHD EMERGENT HEMODIAL,2811.94,2108.96,33.74,2530.75,119
CPT,G0257,Unsched dialysis esrd pt hos,,,670.79,778.79,19
CPT,G0260,Inj for sacroiliac jt anesth,,,663.89,770.78,19
CPT,G0260,PBB INJEC SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,2146.78,1610.08,25.76,1932.1,119
CPT,G0268,Removal of impacted wax md,,,32.7,146.84,44
CPT,G0269,HC PLACE VENOUS/ART DEVICE,1186.26,889.7,14.24,1067.63,119
CPT,G0270,Mnt subs tx for change dx,,,25.46,90.89,62
CPT,G0271,Group mnt 2 or more 30 mins,,,13.54,48.34,62
CPT,G0276,Pild/placebo control clin tr,,,57.56,7951.0,63
CPT,G0277,HC HYPERBARIC OXYGEN FULL BODY CHAMBER PER 30 MIN,671.11,503.33,8.05,604.0,119
CPT,G0277,Hbot full body chamber 30m,,,132.2,481.7,63
CPT,G0278,HC ILIAC ANGIOGRAM,1307.25,980.44,15.69,1176.53,119
CPT,G0278,Iliac art angiocardiac cath,,,13.05,37.36,44
CPT,G0279,Tomosynthesis mammo,,,11.93,124.81,100
CPT,G0281,Elec stim unattend for press,,,10.95,33.23,63
CPT,G0281,HC OT ELEC STIM UNATTEND FOR PRESS,143.23,107.42,1.72,128.91,119
CPT,G0282,Elect stim wound care not pd,,,33.72,33.72,1
CPT,G0282,HC PT E-STIM UNATTENDED NON-WND ULCER G0282,132.42,99.32,1.59,119.18,119
CPT,G0283,Elec stim other than wound,,,11.27,35.99,63
CPT,G0283,HC OT ELEC STIM OTHER THAN WOUND,109.39,82.04,1.31,98.45,119
CPT,G0288,Recon cta for surg plan,,,37.45,128.17,44
CPT,G0289,Arthro loose body + chondro,,,123.75,242.25,44
CPT,G0293,Non-cov surg procclin trial,,,37.63,43.69,18
CPT,G0294,Non-cov proc clinical trial,,,37.63,43.69,18
CPT,G0296,Visit to determ ldct elig,,,25.07,102.96,62
CPT,G0302,Pre-op service lvrs complete,,,377.83,590.56,19
CPT,G0303,Pre-op service lvrs 10-15dos,,,218.63,346.59,19
CPT,G0304,Pre-op service lvrs 1-9 dos,,,377.83,590.56,19
CPT,G0305,Post op service lvrs min 6,,,377.83,590.56,19
CPT,G0306,Cbc/diffwbc w/o platelet,,,6.92,11.66,58
CPT,G0307,Cbc without platelet,,,5.76,9.71,58
CPT,G0316,Prolong inpt eval add15 m,,,29.69,91.0,44
CPT,G0317,Prolong nursin fac eval 15m,,,29.69,90.09,44
CPT,G0318,Prolong home eval add 15m,,,29.06,89.16,44
CPT,G0323,Care manage beh svs 20mins,,,28.43,158.13,63
CPT,G0327,Colon ca scrn-bld-bsd biomrk,,,0.5,0.5,3
CPT,G0328,Fecal blood scrn immunoassay,,,16.08,27.08,58
CPT,G0329,Electromagntic tx for ulcers,,,9.79,29.7,63
CPT,G0330,Facility svs dental rehab,,,3109.0,3609.55,19
CPT,G0333,Dispense fee initial 30 day,,,144.96,172.97,8
CPT,G0337,Hospice evaluation preelecti,,,165.92,197.97,8
CPT,G0339,Robot lin-radsurg com first,,,2743.55,3273.55,8
CPT,G0340,Robt lin-radsurg fractx 2-5,,,3489.6,4163.73,8
CPT,G0341,Percutaneous islet celltrans,,,301.97,15039.8,62
CPT,G0342,Laparoscopy islet cell trans,,,117.06,15039.8,98
CPT,G0343,Laparotomy islet cell transp,,,191.83,15039.8,98
CPT,G0372,Md service required for pmd,,,8.45,24.92,45
CPT,G0378,HC OBSERVATION/HR,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR CARDIOLOGY CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR DIALYSIS CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR ECHO CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR GI CARVEOUT`,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR INFUSION INJECTION CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR PT OT SLP CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR RADIOLOGY CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR RC 361 CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0378,HC OBSERVATION/HR RESPIRATORY CARVEOUT,173.99,130.49,2.09,156.59,119
CPT,G0379,Direct refer hospital observ,,,587.75,682.38,19
CPT,G0379,HC OBSERVATION DIRECT ADMIT,970.68,728.01,11.65,873.61,119
CPT,G0380,Lev 1 hosp type b ed visit,,,75.26,309.0,864
CPT,G0381,Lev 2 hosp type b ed visit,,,94.05,767.0,864
CPT,G0382,Lev 3 hosp type b ed visit,,,174.04,1475.0,864
CPT,G0383,Lev 4 hosp type b ed visit,,,267.62,3831.0,864
CPT,G0384,Lev 5 hosp type b ed visit,,,387.19,5757.0,864
CPT,G0390,HC FULL TRAUMA ACTIVATION,20839.79,15629.84,250.08,18755.81,119
CPT,G0390,HC LIMITED TRAUMA ACTIVATION,15861.61,11896.21,190.34,14275.45,119
CPT,G0390,Trauma respons w/hosp criti,,,1268.47,1472.69,19
CPT,G0396,Alcohol/subs interv 15-30mn,,,28.56,99.5,63
CPT,G0397,Alcohol/subs interv >30 min,,,63.57,186.2,63
CPT,G0398,Home sleep test/type 2 porta,,,149.99,357.59,27
CPT,G0399,Home sleep test/type 3 porta,,,113.02,218.63,27
CPT,G0400,Home sleep test/type 4 porta,,,115.56,346.59,26
CPT,G0402,Initial preventive exam,,,123.54,472.2,62
CPT,G0403,Ekg for initial prevent exam,,,13.88,40.48,44
CPT,G0404,Ekg tracing for initial prev,,,5.94,29.28,63
CPT,G0405,Ekg interpret & report preve,,,7.94,23.09,44
CPT,G0406,Inpt/tele follow up 15,,,40.3,116.71,44
CPT,G0407,Inpt/tele follow up 25,,,70.39,206.92,44
CPT,G0408,Inpt/tele follow up 35,,,102.55,298.84,44
CPT,G0409,Corf related serv 15 mins ea,,,21.32,65.94,44
CPT,G0410,Grp psych php/iop 45-50,,,106.64,316.52,18
CPT,G0411,Interactive grp psyc php/iop,,,106.64,316.52,18
CPT,G0412,Open tx iliac spine uni/bil,,,112.65,15039.8,135
CPT,G0413,Pelvic ring fracture uni/bil,,,165.33,7951.0,135
CPT,G0414,Pelvic ring fx treat int fix,,,155.88,15039.8,135
CPT,G0415,Open tx post pelvic fxcture,,,212.87,15039.8,135
CPT,G0416,"HC PROSTATE BIOPSY, ANY METHOD",3369.85,2527.39,40.44,3032.86,119
CPT,G0416,Prostate biopsy any mthd,,,170.82,1027.36,102
CPT,G0420,Ed svc ckd ind per session,,,102.36,310.61,63
CPT,G0421,Ed svc ckd grp per session,,,24.62,74.71,63
CPT,G0422,Intens cardiac rehab w/exerc,,,115.79,370.21,63
CPT,G0423,Intens cardiac rehab no exer,,,115.79,370.21,63
CPT,G0425,Inpt/ed teleconsult30,,,90.74,264.42,44
CPT,G0426,Inpt/ed teleconsult50,,,127.22,373.34,44
CPT,G0427,Inpt/ed teleconsult70,,,181.42,531.73,44
CPT,G0429,Dermal filler injection(s),,,65.81,2089.12,62
CPT,G0432,Eia hiv-1/hiv-2 screen,,,17.44,29.36,58
CPT,G0432,HC INFECTIOUS AG AB (EIA) HIV-1/HIV-2 CONVENTIONAL SCREENING,165.13,123.85,1.98,148.62,119
CPT,G0433,Elisa hiv-1/hiv-2 screen,,,16.3,27.44,58
CPT,G0435,Oral hiv-1/hiv-2 screen,,,10.67,17.97,58
CPT,G0438,Ppps initial visit,,,155.31,471.29,63
CPT,G0439,Ppps subseq visit,,,122.15,370.66,63
CPT,G0442,Annual alcohol screen 15 min,,,8.9,49.71,63
CPT,G0443,Brief alcohol misuse counsel,,,22.38,102.96,62
CPT,G0444,Depression screen annual,,,8.9,49.71,62
CPT,G0445,High inten beh couns std 30m,,,22.07,102.96,63
CPT,G0446,Intens behave ther cardio dx,,,22.38,93.67,62
CPT,G0447,Behavior counsel obesity 15m,,,22.38,102.96,63
CPT,G0451,Devlopment test interpt&rep,,,10.02,102.96,63
CPT,G0452,Molecular pathology interpr,,,2.8,139.83,83
CPT,G0453,Cont intraop neuro monitor,,,30.92,90.01,44
CPT,G0454,Md document visit by npp,,,8.59,25.0,44
CPT,G0455,Fecal microbiota prep instil,,,69.22,1014.74,63
CPT,G0455,HC FECAL MICROBIOTA PREP WITH INSTILL ANY METHOD,4420.16,3315.12,53.04,3978.14,119
CPT,G0459,Telehealth inpt pharm mgmt,,,40.9,125.3,44
CPT,G0460,Autolog prp not diab ulcer,,,1753.61,2089.12,18
CPT,G0463,HC E&M TECHNICAL VISIT,364.3,273.23,4.37,327.87,119
CPT,G0463,HC URGENT CARE,1192.3,894.22,14.31,1073.07,119
CPT,G0463,Hospital outpt clinic visit,,,123.54,143.43,19
CPT,G0463,PBB ESTABLISHED/NEW VISIT,334.01,250.51,4.01,300.61,119
CPT,G0465,Autolog prp diab wound ulcer,,,1753.61,2532.26,27
CPT,G0471,Ven blood coll snf/hha,,,10.57,12.88,55
CPT,G0472,Hep c screen high risk/other,,,41.3,69.53,58
CPT,G0473,Group behave couns 2-10,,,11.23,37.93,63
CPT,G0475,Hiv combination assay,,,21.46,36.12,58
CPT,G0476,Hpv combo assay ca screen,,,31.27,52.64,58
CPT,G0480,Drug test def 1-7 classes,,,101.96,171.65,58
CPT,G0480,"HC DRUG DEFINITIVE, EA PROCEDURE 1-7 DRUG CLASSES",133.93,100.45,1.61,120.54,119
CPT,G0481,Drug test def 8-14 classes,,,139.52,519.56,66
CPT,G0481,"HC DRUG DEFINITIVE, EA PROCEDURE 8-14 DRUG CLASSES",521.37,391.03,6.26,469.23,119
CPT,G0482,Drug test def 15-21 classes,,,177.08,659.42,66
CPT,G0482,"HC DRUG DEFINITIVE, EA PROCEDURE 15-21 DRUG CLASSES",267.07,200.3,3.2,240.36,119
CPT,G0483,Drug test def 22+ classes,,,220.01,819.28,66
CPT,G0483,"HC DRUG TESTS, DEFINITIVE 22 OR MORE DRUG CLASSES",323.82,242.86,3.89,291.44,119
CPT,G0491,HC DIALYSIS ACU KIDNEY NO ESRD,2030.75,1523.06,24.37,1827.68,238
CPT,G0498,Chemo extend iv infus w/pump,,,317.98,543.78,27
CPT,G0499,Hepb screen high risk indiv,,,25.19,42.41,58
CPT,G0500,Mod sedat endo service >5yrs,,,5.23,156.33,44
CPT,G0506,Comp asses care plan ccm svc,,,42.85,177.88,44
CPT,G0508,Crit care telehea consult 60,,,200.43,590.33,44
CPT,G0509,Crit care telehea consult 50,,,184.47,541.81,44
CPT,G0511,Ccm/bhi by rhc/fqhc 20min mo,,,134.67,160.68,8
CPT,G0512,Cocm by rhc/fqhc 60 min mo,,,341.62,407.62,8
CPT,G0513,Prolong prev svcs first 30m,,,57.68,179.85,44
CPT,G0514,Prolong prev svcs addl 30m,,,58.0,179.85,44
CPT,G0516,Insert drug del implant >4,,,94.08,485.39,63
CPT,G0517,Remove drug implant,,,107.0,547.67,63
CPT,G0518,Remove w insert drug implant,,,176.06,871.3,63
CPT,G0537,Risk ascvd tst once pr 12 mo,,,28.56,49.5,27
CPT,G0538,Ascvd rsk mng clin stf pr mo,,,34.36,102.96,27
CPT,G0539,Initial care training 30 m,,,39.35,142.81,26
CPT,G0540,Train for caregiver add 15,,,20.86,70.38,26
CPT,G0541,No pt prsnt train initial 30,,,29.28,142.81,26
CPT,G0542,No pt prsnt train add 15,,,23.5,70.38,17
CPT,G0543,Group train w/o patient,,,10.15,59.15,26
CPT,G0544,Post d/c phone follow up,,,88.68,168.27,27
CPT,G0545,Inherent visit to inpt,,,99.19,118.36,8
CPT,G0546,Phone/internet ehr assess,,,39.5,47.13,8
CPT,G0547,Phone/internet svs 11-20 m,,,79.71,95.11,8
CPT,G0548,Phone/inter svs 21-30 m,,,120.66,143.97,8
CPT,G0549,Phone/inter for treat>31m,,,161.58,192.79,8
CPT,G0550,Phone/inter for dx/treat >5m,,,74.74,89.18,8
CPT,G0551,Phn/intr svs fr dx treat 30m,,,78.3,93.43,8
CPT,G0552,Supply of digital device,,,123.54,143.43,19
CPT,G0553,Monthly tx for dmht 20mins,,,117.05,143.43,27
CPT,G0554,Add 20 m of monthly tx,,,90.66,108.17,8
CPT,G0555,Replacment pt electronic sys,,,869.49,1132.36,19
CPT,G0556,Adv prim care mgmt lvl 1,,,28.56,41.42,26
CPT,G0557,Adv prim care mgmt lvl 2,,,28.56,132.93,26
CPT,G0558,Adv prim care mgmt lvl 3,,,88.68,291.25,26
CPT,G0559,Unrelat prac follow up visit,,,20.02,23.89,8
CPT,G0560,Safety plan interven,,,39.22,115.34,26
CPT,G0562,Complex simulation w/pet-ct,,,1869.87,2170.92,18
CPT,G0563,Sbrt w/positron emission del,,,3221.44,4174.32,18
CPT,G0566,3d bn img algor drvd fr mri,,,130.29,174.14,18
CPT,G0567,Screening hep c detect,,,0.5,35.09,12
CPT,G0568,Int psych care mng 1 cal mo,,,102.86,102.86,9
CPT,G0569,Subs psych care mng subs mo,,,102.86,102.86,9
CPT,G0570,Care manage serv pr cal mo,,,37.93,37.93,9
CPT,G0659,Drug test def simple all cl,,,62.14,206.18,65
CPT,G1028,Take home supply 8mg per 0.1,,,324.46,387.15,8
CPT,G2000,Blinded conv. tx mdd clin tr,,,377.83,590.56,18
CPT,G2001,Post d/c h vst new pt 20 m,,,47.95,142.17,44
CPT,G2002,Post-d/c h vst new pt 30 m,,,71.74,212.35,44
CPT,G2003,Post-d/c h vst new pt 45 m,,,119.06,347.2,44
CPT,G2004,Post-d/c h vst new pt 60 m,,,157.47,456.27,44
CPT,G2005,Post-d/c h vst new pt 75 m,,,203.98,594.62,44
CPT,G2006,Post-d/c h vst ext pt 20 m,,,46.98,139.35,44
CPT,G2007,Post-d/c h vst ext pt 30 m,,,76.23,225.44,44
CPT,G2008,Post-d/c h vst ext pt 45 m,,,120.34,352.28,44
CPT,G2009,Post-d/c h vst ext pt 60 m,,,170.25,495.86,44
CPT,G2010,Remot image submit by pt,,,8.9,35.08,44
CPT,G2011,Alcohol/sub misuse assess,,,16.16,47.94,63
CPT,G2012,Brief check in by md/qhp,,,12.2,41.27,44
CPT,G2013,Post-d/c h vst ext pt 75 m,,,203.98,594.62,44
CPT,G2014,Post-d/c care plan overs 30m,,,72.59,211.5,44
CPT,G2015,Post-d/c care plan overs 60m,,,101.5,296.59,44
CPT,G2023,Specimen collect covid-19,,,23.46,23.46,36
CPT,G2024,Spec coll snf/lab covid-19,,,25.46,25.46,36
CPT,G2025,Dis site tele svcs rhc/fqhc,,,93.58,276.83,9
CPT,G2066,Inter devc remote 30d,,,193.13,230.44,8
CPT,G2067,Med assist tx meth wk,,,611.85,730.04,8
CPT,G2068,Med assist tx bupre oral,,,716.72,855.18,8
CPT,G2069,Med assist tx inject,,,4948.66,5904.65,8
CPT,G2070,Med assist tx implant,,,13719.68,16370.07,8
CPT,G2071,Med tx remove implant,,,1181.95,1410.29,8
CPT,G2072,Med tx insert/remove imp,,,14295.15,17056.71,8
CPT,G2073,Med tx naltrexone,,,3938.35,4699.17,8
CPT,G2074,Med assist tx no drug,,,484.33,577.89,8
CPT,G2076,Intake act w/med exam,,,471.33,562.38,8
CPT,G2077,Periodic assessment,,,289.64,345.6,8
CPT,G2078,Take-home meth,,,77.9,119.23,9
CPT,G2079,Take-hom buprenorphine,,,204.8,244.37,8
CPT,G2080,Add 30 mins counsel,,,81.26,96.96,8
CPT,G2082,Visit esketamine 56m or less,,,34.25,2342.6,62
CPT,G2083,Visit esketamine > 56m,,,34.25,3320.66,62
CPT,G2086,Off base opioid tx 70min,,,154.03,1341.49,63
CPT,G2087,Off base opioid tx 60 m,,,154.03,1217.69,63
CPT,G2088,Off base opioid tx add30,,,34.61,161.98,44
CPT,G2211,Complex e/m visit add on,,,35.85,42.78,8
CPT,G2212,Prolong outpt/office vis,,,30.32,91.92,44
CPT,G2213,Initiat med assist tx in er,,,61.23,177.0,44
CPT,G2214,Init/sub psych care m 1st 30,,,36.99,158.92,63
CPT,G2215,Home supply nasal naloxone,,,199.69,238.27,8
CPT,G2250,Remot img sub by pt non e/m,,,7.88,35.08,63
CPT,G2251,Brief chkin 5-10 non-e/m,,,10.53,41.02,63
CPT,G2252,Brief chkin by md/qhp 11-20,,,21.98,75.62,63
CPT,G3002,Chronic pain mgmt 30 mins,,,71.52,236.6,44
CPT,G3003,Chronic pain mgmt addl 15m,,,24.71,86.6,44
CPT,G6001,Echo guidance radiotherapy,,,30.91,490.1,80
CPT,G6002,Stereoscopic x-ray guidance,,,20.08,210.44,80
CPT,G6003,Radiation treatment delivery,,,143.38,415.76,44
CPT,G6004,Radiation treatment delivery,,,121.1,337.01,44
CPT,G6005,Radiation treatment delivery,,,121.42,337.01,44
CPT,G6006,Radiation treatment delivery,,,120.79,335.19,44
CPT,G6007,Radiation treatment delivery,,,223.4,598.01,44
CPT,G6008,Radiation treatment delivery,,,167.21,464.31,44
CPT,G6009,Radiation treatment delivery,,,166.58,467.95,44
CPT,G6010,Radiation treatment delivery,,,165.64,460.64,44
CPT,G6011,Radiation treatment delivery,,,223.07,611.75,44
CPT,G6012,Radiation treatment delivery,,,220.56,612.66,44
CPT,G6013,Radiation treatment delivery,,,221.18,615.39,44
CPT,G6014,Radiation treatment delivery,,,219.93,611.75,44
CPT,G6015,Radiation tx delivery imrt,,,337.88,955.17,44
CPT,G6016,Delivery comp imrt,,,337.0,951.5,44
CPT,G6017,Intrafraction track motion,,,289.44,345.36,8
CPT,G9037,Intrpro req fr rec phys/qhcp,,,91.15,108.76,8
CPT,G9038,Co-management services,,,113.93,135.94,8
CPT,G9143,Warfarin respon genetic test,,,120.72,181.08,39
CPT,G9157,Transesoph doppl cardiac mon,,,92.38,269.01,44
CPT,G9187,Bpci home visit,,,43.04,132.12,44
CPT,G9481,Remote e/m new pt 10mins,,,18.02,51.68,44
CPT,G9482,Remote e/m new pt 20mins,,,33.86,97.68,44
CPT,G9483,Remote e/m new pt 30mins,,,53.1,154.0,44
CPT,G9484,Remote e/m new pt 45mins,,,89.09,260.42,44
CPT,G9485,Remote e/m new pt 60mins,,,116.51,342.21,44
CPT,G9486,Remote e/m est. pt 10mins,,,18.02,51.68,44
CPT,G9487,Remote e/m est. pt 15mins,,,35.8,104.33,44
CPT,G9488,Remote e/m est. pt 25mins,,,54.93,160.92,44
CPT,G9489,Remote e/m est. pt 40mins,,,77.36,226.29,44
CPT,G9490,Cmmi mod home visit,,,42.75,132.12,44
CPT,G9685,Acute nursing facility care,,,182.3,532.64,44
CPT,G9868,Cmmi asyntelehealth <10min,,,27.11,78.53,44
CPT,G9869,Cmmi asyntelehealth 10-20min,,,36.26,105.02,44
CPT,G9870,Cmmi asyntelehealth >20min,,,45.41,131.51,44
CPT,G9873,1 em core session,,,96.64,115.31,8
CPT,G9873,HC FIRST MDPP SESSION,26.0,19.5,0.31,23.4,238
CPT,G9874,4 em core sessions,,,292.47,348.97,8
CPT,G9874,HC MDPP 4 CORE SESSION 1-6M,52.0,39.0,0.62,46.8,238
CPT,G9875,9 em core sessions,,,485.75,579.59,8
CPT,G9875,HC MDPP 9 CORE SESSION 1-6M,94.0,70.5,1.13,84.6,238
CPT,G9876,2 em core ms mo 7-9 no wl,,,193.28,230.62,8
CPT,G9876,HC MDPP SESSION 2CM 7-9M 5% WL NOT ACH,15.0,11.25,0.18,13.5,238
CPT,G9877,2 em core ms mo 10-12 no wl,,,193.28,230.62,8
CPT,G9877,HC MDPP SESSION 2CM 10-12 NO WL,15.0,11.25,0.18,13.5,238
CPT,G9878,2 em core ms mo 7-9 wl,,,256.86,306.48,8
CPT,G9878,HC MDPP SESSION 2CM 7-9M 5% WL ACH,63.0,47.25,0.76,56.7,238
CPT,G9879,2 em core ms mo 10-12 wl,,,256.86,306.48,8
CPT,G9879,HC MDPP SESSION 2CM 10-12M 5% WL ACH,66.15,49.61,0.79,59.54,119
CPT,G9880,Em 5 percent wl,,,467.95,558.35,8
CPT,G9880,HC MDPP SESSION 5% LOSS 1-12M,168.0,126.0,2.02,151.2,238
CPT,G9881,Em 9 percent wl,,,96.64,115.31,8
CPT,G9881,HC MDPP SESSION 5% LOSS 1-24M,26.0,19.5,0.31,23.4,238
CPT,G9882,2 em ongoing ms mo 13-15 wl,,,144.96,172.97,8
CPT,G9883,2 em ongoing ms mo 16-18 wl,,,144.96,172.97,8
CPT,G9884,2 em ongoing ms mo 19-21 wl,,,147.51,176.0,8
CPT,G9885,2 em ongoing ms mo 22-24 wl,,,147.51,176.0,8
CPT,G9890,Em bridge payment,,,96.64,115.31,8
CPT,G9978,Remote e/m new pt 10mins,,,27.12,138.67,44
CPT,G9979,Remote e/m new pt 20mins,,,46.73,203.92,44
CPT,G9980,Remote e/m new pt 30 mins,,,74.44,301.41,44
CPT,G9981,Remote e/m new pt 45mins,,,123.92,462.82,44
CPT,G9982,Remote e/m new pt 60mins,,,164.83,601.35,44
CPT,G9983,Remote e/m est. pt 10mins,,,27.12,138.67,44
CPT,G9984,Remote e/m est. pt  15mins,,,53.06,227.99,44
CPT,G9985,Remote e/m est. pt 25mins,,,80.67,325.75,44
CPT,G9986,Remote e/m est. pt 40mins,,,115.96,447.89,44
CPT,G9987,Bpci advanced in home visit,,,43.04,132.12,44
CPT,H0015,Alcohol and/or drug services,,,206.56,206.56,1
CPT,H0015,HC ADULT GROUP CDIOP,275.86,206.9,3.31,248.27,119
CPT,H0020,Alcohol and/or drug services,,,143.62,143.62,1
CPT,H0047,Alcohol/drug abuse svc nos,,,290.6,290.6,1
CPT,H2019,Ther behav svc - per 15 min,,,47.07,47.07,1
CPT,J0120,Tetracyclin injection,,,,,0
CPT,J0121,Inj. omadacycline 1 mg,,,3.68,4.67,63
CPT,J0122,Inj. eravacycline 1 mg,,,1.05,1.41,53
CPT,J0129,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,4160.32,3120.24,49.92,3744.29,119
CPT,J0129,Abatacept injection,,,43.49,51.21,63
CPT,J0130,Abciximab injection,,,,,0
CPT,J0131,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION (REPACKAGED)",61.2,45.9,0.68,58.86,357
CPT,J0131,Inj acetaminophen (nos),,,0.05,0.1,44
CPT,J0132,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,599.94,449.96,7.2,539.95,119
CPT,J0132,Acetylcysteine injection,,,0.67,0.98,44
CPT,J0133,ACYCLOVIR IN NS (5 MG/ML) IV SOLUTION NEO/PED,1050.0,787.5,12.6,945.0,119
CPT,J0133,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,142.44,106.83,0.81,189.0,714
CPT,J0133,Acyclovir injection,,,0.03,0.05,44
CPT,J0134,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",61.2,45.9,0.68,58.86,238
CPT,J0134,Inj acetaminophen -fresenius,,,0.05,0.13,44
CPT,J0135,Adalimumab injection,,,1869.11,1869.11,8
CPT,J0136,Inj acetaminophen (b braun),,,0.04,0.06,44
CPT,J0137,Inj acetaminophen (hikma),,,0.06,0.06,8
CPT,J0138,Inj acetaminoph 10mg/ibu 3mg,,,0.04,0.25,26
CPT,J0139,Inj adalimumab 1 mg,,,91.72,106.5,10
CPT,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,238
CPT,J0153,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,155.4,116.55,1.86,139.86,119
CPT,J0153,Adenosine inj 1mg,,,0.47,0.51,44
CPT,J0166,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
CPT,J0168,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,75.0,56.25,0.9,67.5,119
CPT,J0169,EPINEPHRINE 1 MG/ML (1 ML) ANAPHYLAXIS KIT,60.59,45.44,0.73,54.53,119
CPT,J0169,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,67.32,50.49,0.81,60.59,238
CPT,J0169,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,1503.36,1127.52,18.04,1353.02,238
CPT,J0169,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
CPT,J0171,Adrenalin epinephrine inject,,,0.72,0.96,44
CPT,J0172,Inj  aducanumab-avwa  2 mg,,,5.97,6.99,53
CPT,J0173,Inj  epinephrine (belcher),,,2.35,2.35,8
CPT,J0174,LECANEMAB-IRMB 100 MG/ML INTRAVENOUS SOLUTION,1951.04,1463.28,23.41,1755.94,119
CPT,J0174,Lecanemab-irmb for iv inj,,,1.32,1.56,26
CPT,J0175,Inj donanemab-azbt 2 mg,,,4.09,4.79,27
CPT,J0177,Inj aflibercept hd 1 mg,,,306.99,390.36,27
CPT,J0178,AFLIBERCEPT 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,4182.85,3137.14,50.19,3764.57,119
CPT,J0178,Aflibercept injection,,,763.9,961.56,63
CPT,J0179,Inj brolucizumab-dbll 1 mg,,,313.47,401.83,63
CPT,J0180,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,20140.08,15105.06,241.68,18126.07,119
CPT,J0180,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,3072.88,2304.66,36.87,2765.59,119
CPT,J0180,Agalsidase beta injection,,,208.32,267.2,63
CPT,J0184,Inj amisulpride 1 mg,,,9.08,11.16,27
CPT,J0185,Inj. aprepitant 1 mg,,,1.64,2.06,63
CPT,J0190,Inj biperiden lactate/5 mg,,,,,0
CPT,J0200,Alatrofloxacin mesylate,,,,,0
CPT,J0202,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,66585.86,49939.4,799.03,59927.27,119
CPT,J0202,Injection alemtuzumab,,,2244.91,2821.1,63
CPT,J0205,Alglucerase injection,,,52.54,52.54,1
CPT,J0206,Inj allopurinol sodium 1 mg,,,4.4,5.85,27
CPT,J0207,Amifostine,,,1157.12,1157.12,8
CPT,J0208,Inj pedmark 100 mg,,,95.11,110.42,27
CPT,J0208,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,486.0,364.5,5.83,437.4,119
CPT,J0209,Inj sod thiosulfate (hope),,,0.84,0.88,17
CPT,J0210,Methyldopate hcl injection,,,,,0
CPT,J0211,Inj nithiodote 3mg / 125mg,,,1.57,2.59,27
CPT,J0211,SODIUM NITRITE-SODIUM THIOSULFATE 300 MG/10 ML-12.5 GRAM/50 ML IV SOLN,671.42,503.56,8.06,604.28,119
CPT,J0215,Alefacept,,,,,0
CPT,J0216,Inj alfentanil hcl 500mcg,,,,,0
CPT,J0217,Inj velmanase alfa-tycv 1 mg,,,440.81,540.13,27
CPT,J0218,Inj olipudase alfa-rpcp 1mg,,,381.58,457.04,27
CPT,J0219,Inj aval alfa-nqpt 4mg,,,72.5,93.94,63
CPT,J0220,Alglucosidase alfa injection,,,,,0
CPT,J0221,Lumizyme injection,,,188.44,239.85,63
CPT,J0222,Inj. patisiran 0.1 mg,,,98.83,116.07,63
CPT,J0223,Inj givosiran 0.5 mg,,,109.81,136.25,63
CPT,J0224,Inj. lumasiran 0.5 mg,,,310.89,382.03,63
CPT,J0225,Inj vutrisiran 1 mg,,,4917.75,5809.23,27
CPT,J0248,Inj remdesivir 1 mg,,,5.5,7.81,63
CPT,J0248,REMDESIVIR 1.25 MG/ML IN NS IVPB (NEO/PED) CMPD,2698.24,2023.68,32.38,2428.42,119
CPT,J0248,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,1706.12,1279.59,20.47,1535.51,119
CPT,J0256,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION",1508.38,1131.29,18.1,1357.54,119
CPT,J0256,Alpha 1 proteinase inhibitor,,,4.59,6.34,63
CPT,J0257,Glassia injection,,,5.09,6.55,63
CPT,J0270,ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,669.31,501.98,8.03,602.38,119
CPT,J0270,Alprostadil for injection,,,7.09,7.09,8
CPT,J0275,Alprostadil urethral suppos,,,,,0
CPT,J0278,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,39.05,29.285,0.4,40.5,476
CPT,J0278,Amikacin sulfate injection,,,0.85,0.9,44
CPT,J0280,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,109.08,81.81,1.31,98.17,119
CPT,J0280,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.2,52.65,0.84,63.18,238
CPT,J0280,Aminophyllin 250 mg inj,,,7.58,13.09,44
CPT,J0281,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,44.88,33.66,0.4,50.87,476
CPT,J0282,AMIODARONE 150 MG/3 ML INTRAVENOUS SYRINGE,77.99,58.5,0.94,70.19,119
CPT,J0282,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,17.5,13.12,0.14,20.69,476
CPT,J0282,Amiodarone hcl,,,0.5,0.5,8
CPT,J0283,AMIODARONE 1.8 MG/ML IN D5W FOR BOLUS DOSE CMPD,28.8,21.6,0.35,25.92,119
CPT,J0283,"AMIODARONE 150 MG/100 ML (1.5 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",208.2,156.15,2.5,187.38,119
CPT,J0283,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",277.2,207.9,3.33,249.48,119
CPT,J0283,Inj amiodarone (nexterone),,,2.98,2.98,8
CPT,J0285,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,157.2,117.9,1.89,141.48,119
CPT,J0285,Amphotericin b,,,41.81,57.27,44
CPT,J0287,Amphotericin b lipid complex,,,10.29,11.96,54
CPT,J0288,Ampho b cholesteryl sulfate,,,,,0
CPT,J0289,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,725.02,543.76,8.7,652.52,238
CPT,J0289,Amphotericin b liposome inj,,,20.72,27.29,63
CPT,J0290,AMPICILLIN 1 GRAM/10 ML SOLUTION FOR INJECTION,41.45,31.09,0.5,37.31,119
CPT,J0290,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.62,31.96,0.17,54.28,595
CPT,J0290,AMPICILLIN 250 MG SOLUTION FOR INJECTION,10.47,7.8549999999999995,0.11,10.24,476
CPT,J0290,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),11.38,8.54,0.1,12.81,1071
CPT,J0290,AMPICILLIN 500 MG SOLUTION FOR IM INJECTION (UW),16.91,12.69,0.2,15.22,119
CPT,J0290,AMPICILLIN 500 MG/5 ML SOLUTION FOR INJECTION,16.91,12.69,0.2,15.22,119
CPT,J0290,Ampicillin 500 mg inj,,,0.72,0.92,44
CPT,J0291,Inj. plazomicin 5 mg,,,3.43,4.2,63
CPT,J0295,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,14.715,11.04,0.14,16.07,357
CPT,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,31.8,23.85,0.38,28.62,238
CPT,J0295,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (2 GM AMP NEO/PED)(UW),31.8,23.85,0.38,28.62,238
CPT,J0295,Ampicillin sulbactam 1.5 gm,,,2.28,2.36,44
CPT,J0300,Amobarbital 125 mg inj,,,197.93,197.93,8
CPT,J0330,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,57.0,42.75,0.68,51.3,238
CPT,J0330,Succinycholine chloride inj,,,0.87,0.87,8
CPT,J0348,Anidulafungin injection,,,0.51,0.54,44
CPT,J0349,Inj rezafungin 1 mg,,,10.42,12.34,27
CPT,J0350,Injection anistreplase 30 u,,,,,0
CPT,J0360,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,42.72,32.04,0.25,58.0,357
CPT,J0360,Hydralazine hcl injection,,,4.73,6.75,44
CPT,J0364,Apomorphine hydrochloride,,,42.23,42.23,8
CPT,J0365,Aprotonin  10 000 kiu,,,,,0
CPT,J0380,Inj metaraminol bitartrate,,,,,0
CPT,J0390,Chloroquine injection,,,,,0
CPT,J0391,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,13838.88,10379.16,166.07,12454.99,119
CPT,J0391,Inj artesunate 1mg,,,48.9,60.17,27
CPT,J0395,Arbutamine hcl injection,,,,,0
CPT,J0400,Aripiprazole injection,,,,,0
CPT,J0401,"ARIPIPRAZOLE ER 400 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",7982.85,5987.14,95.79,7184.56,119
CPT,J0401,"ARIPIPRAZOLE ER 400 MG SUSPENSION, EXTENDED REL.INTRAMUSCULAR SYRINGE",7982.85,5987.14,95.79,7184.56,119
CPT,J0401,Inj abilify maintena 1 mg,,,6.41,8.45,63
CPT,J0402,Inj abilify asimtufii 1 mg,,,5.92,7.0,27
CPT,J0456,AZITHROMYCIN 500 MG IN NS 250 ML IVPB BATCH,57.0,42.75,0.68,51.3,119
CPT,J0456,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,16.21,12.155000000000001,0.15,17.98,238
CPT,J0456,AZITHROMYCIN IN NS (2 MG/ML) PEDS/NEO,33.0,24.75,0.4,29.7,119
CPT,J0456,Azithromycin,,,2.41,2.56,44
CPT,J0457,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,89.44,67.08,1.07,80.5,238
CPT,J0457,Injection aztreonam 100 mg,,,2.31,2.31,8
CPT,J0458,Aztreonam/avibactam 10 mg,,,1.68,1.95,18
CPT,J0461,ATROPINE 0.1 MG/ML INJECTION SYRINGE,68.7,51.53,0.82,61.83,119
CPT,J0461,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CPT,J0461,Atropine sulfate injection,,,0.06,0.13,44
CPT,J0470,Dimecaprol injection,,,57.76,57.76,8
CPT,J0475,Baclofen 10 mg injection,,,173.84,210.4,63
CPT,J0476,Baclofen intrathecal trial,,,45.52,59.69,44
CPT,J0480,BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,12285.16,9213.87,147.42,11056.64,119
CPT,J0480,Basiliximab,,,4238.68,5441.43,63
CPT,J0485,BELATACEPT 250 MG INTRAVENOUS SOLUTION,2760.28,2070.21,33.12,2484.25,119
CPT,J0485,Belatacept injection,,,3.78,4.52,63
CPT,J0490,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,1806.5,1354.87,21.68,1625.85,119
CPT,J0490,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,5815.0,4361.25,69.78,5233.5,119
CPT,J0490,Belimumab injection,,,50.19,65.1,63
CPT,J0491,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,14660.39,10995.29,175.92,13194.35,119
CPT,J0491,Inj anifrolumab-fnia 1mg,,,16.31,20.99,63
CPT,J0500,Dicyclomine injection,,,18.57,24.18,44
CPT,J0515,BENZTROPINE 1 MG/ML INJECTION SOLUTION,270.0,202.5,3.24,243.0,238
CPT,J0515,Inj benztropine mesylate,,,17.46,19.38,44
CPT,J0517,BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRINGE,15044.46,11283.34,180.53,13540.01,119
CPT,J0517,Inj. benralizumab 1 mg,,,163.97,195.71,63
CPT,J0520,Bethanechol chloride inject,,,,,0
CPT,J0558,Peng benzathine/procaine inj,,,13.88,22.84,63
CPT,J0561,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1392.28,1044.21,16.71,1253.05,238
CPT,J0561,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE (UW)",1392.28,1044.21,16.71,1253.05,238
CPT,J0561,Penicillin g benzathine inj,,,18.11,34.84,63
CPT,J0565,Inj bezlotoxumab 10 mg,,,39.83,46.63,63
CPT,J0567,Inj. cerliponase alfa 1 mg,,,102.66,139.74,27
CPT,J0570,Buprenorphine implant 74.2mg,,,,,0
CPT,J0571,Buprenorphine oral 1mg,,,1.94,1.94,8
CPT,J0572,Bupren/nal up to 3mg bupreno,,,5.24,5.24,8
CPT,J0573,Bupren/nal 3.1 to 6mg bupren,,,7.92,7.92,8
CPT,J0574,Bupren/nal 6.1 to 10mg bupre,,,9.27,9.27,8
CPT,J0575,Bupren/nal over 10mg bupreno,,,16.22,16.22,8
CPT,J0577,Inj brixadi 7 days or less,,,420.05,502.03,27
CPT,J0578,Inj brixadi more than 7 day,,,1680.21,2008.13,27
CPT,J0583,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,311.73,233.8,3.49,299.66,357
CPT,J0583,Bivalirudin,,,0.2,0.26,44
CPT,J0584,Injection burosumab-twza 1m,,,411.01,562.09,63
CPT,J0585,Injectiononabotulinumtoxina,,,6.31,7.55,63
CPT,J0585,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,1838.52,1378.89,22.06,1654.67,119
CPT,J0586,Abobotulinumtoxina,,,8.53,10.16,63
CPT,J0587,Inj rimabotulinumtoxinb,,,12.47,15.43,63
CPT,J0588,Incobotulinumtoxin a,,,5.13,6.47,63
CPT,J0589,Inj daxibotulinumtoxina-lanm,,,3.11,4.54,27
CPT,J0591,Inj deoxycholic acid 1 mg,,,,,0
CPT,J0592,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,61.29,45.97,0.74,55.16,238
CPT,J0592,Buprenorphine hydrochloride,,,4.03,4.71,44
CPT,J0593,Inj. lanadelumab-flyo 1 mg,,,87.19,101.33,26
CPT,J0594,Busulfan injection,,,0.88,1.49,63
CPT,J0595,Butorphanol tartrate 1 mg,,,3.53,4.75,44
CPT,J0596,Injection ruconest,,,31.7,42.69,63
CPT,J0597,C-1 esterase berinert,,,60.77,88.07,63
CPT,J0597,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,11740.52,8805.39,140.89,10566.47,119
CPT,J0598,C-1 esterase cinryze,,,60.7,76.2,63
CPT,J0599,Inj. haegarda 10 units,,,11.73,13.62,17
CPT,J0600,Edetate calcium disodium inj,,,5708.59,7440.13,63
CPT,J0601,HC SEVELAMER CARBONATE ORAL 20MG,0.18,0.14,0.01,0.16,119
CPT,J0602,HC SEVELAMER CARBONATE ORAL POWDER 20 MG,0.22,0.16,0.01,0.2,119
CPT,J0603,HC SEVELAMER HYDROCHLORIDE ORAL 20 MG,0.29,0.22,0.01,0.26,119
CPT,J0604,Cinacalcet esrd on dialysis,,,0.93,0.93,8
CPT,J0605,HC SUCROFERRIC OXYHYDROXIDE ORAL 5MG,0.43,0.32,0.01,0.39,119
CPT,J0606,Inj etelcalcetide 0.1 mg,,,2.3,4.25,17
CPT,J0607,"HC LANTHANUM CARBONATE, ORAL 5 MG",0.12,0.09,0.01,0.11,119
CPT,J0608,"HC LANTHANUM CARBONATE, ORAL POWDER 5 MG",0.17,0.13,0.01,0.15,119
CPT,J0609,HC FERRIC CITRATE ORAL 3 MG FERRIC IRON,0.27,0.2,0.01,0.24,119
CPT,J0610,Calcium glucon (fresenius),,,5.16,5.16,36
CPT,J0611,Calcium glucon (wg critical),,,1.68,1.68,36
CPT,J0612,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,162.0,121.5,0.72,291.6,714
CPT,J0612,Inj calcium gluconate nos,,,0.05,0.05,8
CPT,J0613,Calcium glucon (wg critical),,,0.1,0.1,8
CPT,J0614,Inj treosulfan 50 mg,,,31.21,37.54,18
CPT,J0615,"HC CALCIUM ACETATE, ORAL, 23MG",0.04,0.03,0.01,0.04,119
CPT,J0616,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,7.77,5.83,0.06,7.02,595
CPT,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,85.94,64.45,1.03,77.35,238
CPT,J0618,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,44.62,33.47,0.54,40.16,119
CPT,J0620,Calcium glycer & lact/10 ml,,,,,0
CPT,J0630,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,11555.42,8666.565,138.64,10401.71,238
CPT,J0630,Calcitonin salmon injection,,,484.97,1937.88,54
CPT,J0636,Inj calcitriol per 0.1 mcg,,,0.68,1.07,44
CPT,J0637,Caspofungin acetate,,,5.61,7.39,44
CPT,J0638,Canakinumab injection,,,119.55,164.4,63
CPT,J0640,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,58.95,44.209999999999994,0.63,58.95,357
CPT,J0640,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,77.06,57.795,0.91,70.74,238
CPT,J0640,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,213.32,159.99,2.56,191.99,119
CPT,J0640,Leucovorin calcium injection,,,3.6,4.76,44
CPT,J0641,Inj levoleucovorin nos 0.5mg,,,0.24,0.26,44
CPT,J0642,Injection khapzory 0.5 mg,,,1.47,1.61,44
CPT,J0650,Inj levothyroxine nos 10mcg,,,9.92,9.92,8
CPT,J0650,LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,924.36,693.27,11.09,831.92,119
CPT,J0651,Inj levothyroxine freskabi,,,3.82,8.09,27
CPT,J0651,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,399.1,299.33,4.79,359.19,119
CPT,J0652,Inj levothyroxine hikma,,,5.14,8.09,18
CPT,J0654,Inj liothyronine 1 mcg,,,39.53,39.53,9
CPT,J0665,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,13.89,10.415,0.16,12.64,238
CPT,J0665,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,15.629999999999999,11.725,0.18,28.3,476
CPT,J0665,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,17.1,12.82,0.21,15.39,238
CPT,J0665,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,16.14,12.1,0.19,25.11,476
CPT,J0665,Inj bupivacaine nos 0.5mg,,,0.01,0.01,8
CPT,J0666,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1439.9299999999998,1079.945,13.03,1614.65,476
CPT,J0666,Inj bupivacaine liposome,,,1.44,1.71,19
CPT,J0668,Instill bupivac and meloxic,,,0.81,0.94,18
CPT,J0670,Inj mepivacaine hcl/10 ml,,,2.84,4.08,44
CPT,J0675,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1224.92,918.69,14.7,1102.43,119
CPT,J0675,Inj carboprost 0.1 mg,,,13.7,59.27,18
CPT,J0681,Inj ceftobipole medocarl 3mg,,,1.09,1.27,18
CPT,J0687,Inj cefazolin (wg crit care),,,0.95,1.21,18
CPT,J0688,Inj cefazolin sodium hikma,,,0.93,1.15,18
CPT,J0689,Inj cefazolin sodium baxter,,,1.16,1.47,44
CPT,J0690,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.02,5.26,0.08,7.39,595
CPT,J0690,CEFAZOLIN 2 GRAM/20 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,35.16,26.37,0.42,31.64,119
CPT,J0690,CEFAZOLIN 3 GRAM/30 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,19.98,14.98,0.24,17.98,119
CPT,J0690,Cefazolin sodium injection,,,0.73,0.94,44
CPT,J0691,Inj lefamulin 1 mg,,,0.72,0.74,44
CPT,J0692,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.450000000000003,16.09,0.26,19.31,238
CPT,J0692,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,38.25,28.69,0.27,41.65,476
CPT,J0692,Cefepime hcl for injection,,,1.28,1.42,44
CPT,J0694,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,59.7,44.78,0.72,53.73,119
CPT,J0694,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
CPT,J0694,Cefoxitin sodium injection,,,4.87,5.28,44
CPT,J0695,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,658.4,493.8,7.9,592.56,119
CPT,J0695,Inj ceftolozane tazobactam,,,6.55,10.53,63
CPT,J0696,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,8.32,6.234999999999999,0.09,8.23,357
CPT,J0696,CEFTRIAXONE 1000 MG IN SWFI 10 ML IV PUSH,91.38,68.54,1.1,82.24,119
CPT,J0696,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,17.36,13.02,0.21,15.62,238
CPT,J0696,CEFTRIAXONE 2000 MG IN SWFI 20 ML (100 MG/ML) NEO/PEDS IVPB,42.24,31.68,0.51,38.02,119
CPT,J0696,CEFTRIAXONE 2000 MG IN SWFI 20 ML IV PUSH,42.24,31.68,0.51,38.02,119
CPT,J0696,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,4.57,3.43,0.05,4.11,119
CPT,J0696,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,5.79,4.34,0.07,5.21,357
CPT,J0696,Ceftriaxone sodium injection,,,0.52,0.52,44
CPT,J0697,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,24.85,18.63,0.3,22.36,238
CPT,J0697,Sterile cefuroxime injection,,,2.09,2.2,44
CPT,J0698,Cefotaxime sodium injection,,,3.74,3.74,8
CPT,J0699,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,894.11,670.58,10.73,804.7,119
CPT,J0699,Inj cefiderocol 10 mg,,,2.28,2.81,27
CPT,J0701,Inj. cefepime hcl (baxter),,,5.43,6.82,44
CPT,J0702,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,300.0,225.0,3.6,270.0,119
CPT,J0702,Betamethasone acet&sod phosp,,,6.93,8.66,44
CPT,J0703,Inj cefepime hcl (b braun),,,5.06,5.82,44
CPT,J0706,CAFFEINE CITRATE 10 MG/ML IN D5W IVPB (NEO/PED) CMPD,72.0,54.0,0.86,64.8,119
CPT,J0706,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,63.0,47.25,0.72,59.41,238
CPT,J0706,Caffeine citrate injection,,,1.31,1.31,8
CPT,J0710,Cephapirin sodium injection,,,,,0
CPT,J0712,CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,238
CPT,J0712,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,238
CPT,J0712,Ceftaroline fosamil inj,,,3.78,4.91,63
CPT,J0713,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,19.12,14.34,0.23,17.21,119
CPT,J0713,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
CPT,J0713,CEFTAZIDIME 2.25 MG/ 0.1ML OPHTHALMIC INJECTION,2.12,1.59,0.03,1.91,119
CPT,J0713,Inj ceftazidime per 500 mg,,,1.94,1.97,44
CPT,J0714,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1595.0,1196.25,19.14,1435.5,238
CPT,J0714,Ceftazidime and avibactam,,,91.36,121.59,63
CPT,J0715,Ceftizoxime sodium / 500 mg,,,,,0
CPT,J0716,Centruroides immune f(ab),,,1051.34,5665.79,27
CPT,J0717,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,15436.53,11577.4,185.24,13892.88,119
CPT,J0717,Certolizumab pegol inj 1mg,,,3.87,5.44,63
CPT,J0720,Chloramphenicol sodium injec,,,41.25,52.54,53
CPT,J0725,Chorionic gonadotropin/1000u,,,22.44,22.87,44
CPT,J0735,Clonidine hydrochloride,,,21.49,22.17,44
CPT,J0736,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,25.6,19.2,0.31,23.04,238
CPT,J0736,CLINDAMYCIN 18 MG/ML IN D5W IVPB NEO/PED,30.0,22.5,0.36,27.0,119
CPT,J0736,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,44.1,33.075,0.29,57.78,238
CPT,J0736,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,30.0,22.5,0.36,27.0,119
CPT,J0736,Inj clindamycin phosp 300mg,,,2.88,2.88,8
CPT,J0737,CLINDAMYCIN 18 MG/ML IN D5W IVPB NEO/PED,78.3,58.72,0.94,70.47,119
CPT,J0737,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.2,48.15,0.77,57.78,119
CPT,J0737,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,78.3,58.72,0.94,70.47,119
CPT,J0737,Inj clindamycin (baxter),,,3.29,3.29,8
CPT,J0738,Hiv prep inj lenacapavir,,,16.13,18.73,18
CPT,J0739,"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",14853.06,11139.8,178.24,13367.75,119
CPT,J0739,Hiv prep inj cabotegravir,,,7.02,8.15,26
CPT,J0740,Cidofovir injection,,,301.1,634.24,63
CPT,J0741,Inj cabote rilpivir 2mg 3mg,,,21.56,27.46,63
CPT,J0742,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 GRAM INTRAVENOUS SOLUTION,1178.61,883.96,14.14,1060.75,119
CPT,J0742,Inj imip 4 cilas 4 releb 2mg,,,2.38,3.03,54
CPT,J0743,Cilastatin sodium injection,,,8.14,8.22,44
CPT,J0743,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,134.91,101.18,1.62,121.42,238
CPT,J0744,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,33.0,24.75,0.29,37.8,238
CPT,J0744,Ciprofloxacin iv,,,1.09,2.17,44
CPT,J0745,Inj codeine phosphate /30 mg,,,,,0
CPT,J0750,EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,6.37,4.77,0.08,5.73,119
CPT,J0750,Hiv prep ftc/tdf 200/300mg,,,1.34,63.01,26
CPT,J0751,EMTRICITABINE 200 MG-TENOFOVIR ALAFENAMIDE FUMARATE 25 MG TABLET,304.65,228.49,3.66,274.18,119
CPT,J0751,Hiv prep ftc/taf 200/25mg,,,71.32,82.8,26
CPT,J0752,Hiv prep oral lenacapavir,,,449.03,623.15,18
CPT,J0759,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,528.9,396.67,6.35,476.01,238
CPT,J0759,CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMULSION,1057.8,793.35,12.69,952.02,238
CPT,J0759,Inj clevidipine 1 mg,,,2.85,3.31,18
CPT,J0770,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,126.0,94.5,1.51,113.4,119
CPT,J0770,Colistimethate sodium inj,,,14.37,15.78,44
CPT,J0775,Collagenase clost hist inj,,,62.5,88.13,63
CPT,J0780,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,33.99,25.495,0.38,32.56,357
CPT,J0780,Prochlorperazine injection,,,2.95,4.28,44
CPT,J0791,Inj crizanlizumab-tmca 5mg,,,125.12,150.36,63
CPT,J0795,Corticorelin ovine triflutal,,,,,0
CPT,J0799,Hiv prep fda approved noc,,,,,0
CPT,J0800,Corticotropin injection,,,3870.32,3870.32,36
CPT,J0801,Inj. acthar gel to 40 units,,,4172.53,4386.89,17
CPT,J0802,Inj. (ani) up to 40 units,,,3551.74,3997.21,17
CPT,J0834,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,442.31,331.73,5.31,398.08,119
CPT,J0834,Inj. cosyntropin 0.25 mg,,,24.41,29.35,44
CPT,J0840,Crotalidae poly immune fab,,,1779.64,2123.14,63
CPT,J0841,ANTIVENIN CROTALIDAE (EQUINE) SOLUTION FOR INJECTION,3628.02,2721.02,43.54,3265.22,119
CPT,J0841,Inj crotalidae im f(ab)2 eq,,,987.0,4925.16,63
CPT,J0850,CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,5753.68,4315.26,69.04,5178.31,119
CPT,J0850,Cytomegalovirus imm iv /vial,,,1769.56,2123.14,63
CPT,J0870,Injection imetelstat 1 mg,,,55.47,66.21,19
CPT,J0872,Daptomycin (xellia) unrefrig,,,0.04,0.05,18
CPT,J0873,Inj daptomycin (xellia),,,0.04,0.05,18
CPT,J0874,Inj daptomycin (baxter),,,0.08,0.08,8
CPT,J0875,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6564.75,4923.5599999999995,78.77,5908.49,238
CPT,J0875,Injection dalbavancin,,,14.9,18.26,63
CPT,J0877,Inj daptomycin (hospira),,,0.06,0.07,44
CPT,J0878,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,238
CPT,J0878,Daptomycin injection,,,0.04,0.04,44
CPT,J0879,Difelikefalin esrd on dialy,,,0.06,0.25,18
CPT,J0881,DARBEPOETIN ALFA 10 MCG/0.4 ML (NEO WEEKLY) (UW),235.88,176.91,2.83,212.29,238
CPT,J0881,DARBEPOETIN ALFA 10 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,235.88,176.91,2.83,212.29,238
CPT,J0881,DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE,2127.34,1595.5,25.53,1914.61,238
CPT,J0881,DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,3191.01,2393.26,38.29,2871.91,238
CPT,J0881,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,4254.68,3191.01,51.06,3829.21,119
CPT,J0881,DARBEPOETIN ALFA 25 MCG/0.42 ML (NEO WEEKLY) (UW),550.7,413.03,6.61,495.63,238
CPT,J0881,DARBEPOETIN ALFA 25 MCG/0.42 ML IN POLYSORBATE INJECTION SYRINGE,550.7,413.03,6.61,495.63,238
CPT,J0881,DARBEPOETIN ALFA 40 MCG/0.4 ML (NEO WEEKLY) (UW),881.12,660.84,10.57,793.01,238
CPT,J0881,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,881.12,660.84,10.57,793.01,238
CPT,J0881,DARBEPOETIN ALFA 60 MCG/0.3 ML (NEO WEEKLY) (UW),1276.4,957.3,15.32,1148.76,238
CPT,J0881,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,1276.4,957.3,15.32,1148.76,238
CPT,J0881,Darbepoetin alfa non-esrd,,,2.93,3.55,63
CPT,J0882,Darbepoetin alfa esrd use,,,2.93,3.55,63
CPT,J0883,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1051.385,788.54,6.95,1371.38,357
CPT,J0883,Argatroban nonesrd use 1mg,,,0.61,3.2,27
CPT,J0884,Argatroban esrd dialysis 1mg,,,3.2,3.2,8
CPT,J0885,Epoetin alfa non-esrd,,,6.46,9.91,63
CPT,J0887,Epoetin beta esrd use,,,1.42,1.43,44
CPT,J0888,Epoetin beta non esrd,,,1.21,1.71,54
CPT,J0889,Daprodustat oral 1mg esrd,,,4.22,4.22,8
CPT,J0890,Peginesatide injection,,,,,0
CPT,J0891,Argatroban nonesrd (accord),,,0.56,4.28,63
CPT,J0892,Argatroban dialysis (accord),,,0.56,4.28,44
CPT,J0893,Inj decitabine (sun pharma),,,1.57,33.23,44
CPT,J0894,DECITABINE 50 MG INTRAVENOUS SOLUTION,603.4,452.55,7.24,543.06,238
CPT,J0894,Decitabine injection,,,1.27,1.91,44
CPT,J0895,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,179.965,134.97500000000002,2.09,166.86,238
CPT,J0895,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,238
CPT,J0895,Deferoxamine mesylate inj,,,7.93,8.66,44
CPT,J0896,Inj luspatercept-aamt 0.25mg,,,38.46,48.74,63
CPT,J0896,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,11083.3,8312.47,133.0,9974.97,119
CPT,J0897,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,9030.11,6772.58,108.36,8127.1,119
CPT,J0897,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,4909.15,3681.86,58.91,4418.23,119
CPT,J0897,Denosumab injection,,,23.06,34.11,63
CPT,J0898,Argatroban nonesrd (auromed),,,1.42,4.21,54
CPT,J0899,Argatroban dialysis auromed,,,2.18,4.21,44
CPT,J0911,Inst tauro 1.35mg/hep 100u,,,5.97,9.0,27
CPT,J0945,Brompheniramine maleate inj,,,,,0
CPT,J1000,Depo-estradiol cypionate inj,,,29.69,45.22,44
CPT,J1010,Inj methylpred acetate 1 mg,,,0.12,0.14,18
CPT,J1010,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,60.0,45.0,0.72,54.0,238
CPT,J1010,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,73.44,55.08,0.88,66.1,119
CPT,J1020,Methylprednisolone 20 mg inj,,,4.61,4.61,36
CPT,J1030,Methylprednisolone 40 mg inj,,,8.05,8.05,36
CPT,J1040,Methylprednisolone 80 mg inj,,,12.21,12.21,36
CPT,J1050,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,154.76,116.07,1.86,139.28,119
CPT,J1050,Medroxyprogesterone acetate,,,0.46,0.46,8
CPT,J1071,Inj testosterone cypionate,,,0.03,0.04,44
CPT,J1071,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,60.375,45.28,0.72,54.68,238
CPT,J1072,Inj testosterone azmiro,,,1.33,1.54,18
CPT,J1073,Testosterone pellet 75 mg,,,74.4,74.4,9
CPT,J1094,Inj dexamethasone acetate,,,,,0
CPT,J1095,Injection dexamethasone 9%,,,1.24,1.24,8
CPT,J1096,Dexametha opth insert 0.1 mg,,,98.66,159.3,27
CPT,J1097,Phenylep ketorolac opth soln,,,96.84,127.44,27
CPT,J1100,DEXAMETHASONE IN D5W (0.4 MG/ML) NEO/PEDS IV,85.74,64.3,1.03,77.17,119
CPT,J1100,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,38.22,28.665,0.38,40.5,357
CPT,J1100,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,5.03,3.77,0.06,4.86,357
CPT,J1100,Dexamethasone sodium phos,,,0.12,0.13,44
CPT,J1105,Dexmedetomidine film 1 mcg,,,0.63,0.82,18
CPT,J1110,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,323.7,242.77,3.88,291.33,119
CPT,J1110,Inj dihydroergotamine mesylt,,,56.24,57.31,44
CPT,J1120,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,178.65,133.99,2.14,160.78,119
CPT,J1120,Acetazolamid sodium injectio,,,23.93,27.67,44
CPT,J1130,Inj diclofenac sodium 0.5mg,,,,,0
CPT,J1160,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,33.0,24.75,0.4,29.7,238
CPT,J1160,Digoxin injection,,,8.12,18.38,44
CPT,J1162,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,17649.27,13236.95,211.79,15884.34,119
CPT,J1162,Digoxin immune fab (ovine),,,4597.02,6000.32,63
CPT,J1163,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,24.65,18.49,0.11,34.8,476
CPT,J1165,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,10.155000000000001,7.62,0.1,10.77,476
CPT,J1165,Phenytoin sodium injection,,,0.52,0.56,44
CPT,J1170,Hydromorphone injection,,,4.22,4.22,36
CPT,J1171,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,23.25,17.435000000000002,0.26,22.41,357
CPT,J1171,HYDROMORPHONE (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,502.5,376.88,6.03,452.25,119
CPT,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,25.92,19.44,0.31,23.33,119
CPT,J1171,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,22.41,16.81,0.26,22.41,476
CPT,J1171,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,735.0,551.25,7.45,918.27,357
CPT,J1171,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,18.0,13.5,0.22,16.2,238
CPT,J1171,Inj hydromorphone 0.1 mg,,,0.09,0.1,9
CPT,J1180,Dyphylline injection,,,,,0
CPT,J1190,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,1135.55,851.67,13.63,1022.0,119
CPT,J1190,Dexrazoxane hcl injection,,,58.01,125.25,63
CPT,J1200,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,7.03,5.27,0.08,6.33,238
CPT,J1200,Diphenhydramine hcl injectio,,,0.87,1.16,44
CPT,J1201,Inj. cetirizine hcl 0.5mg,,,15.1,19.18,63
CPT,J1202,Miglustat oral 65 mg,,,35.64,35.64,8
CPT,J1203,Inj cipaglucosidase 5 mg,,,89.38,105.89,27
CPT,J1205,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,195.78,146.835,1.71,224.1,238
CPT,J1205,Chlorothiazide sodium inj,,,40.51,46.67,44
CPT,J1212,DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,3127.5,2345.62,37.53,2814.75,119
CPT,J1212,Dimethyl sulfoxide 50% 50 ml,,,637.7,869.41,63
CPT,J1230,METHADONE 10 MG/ML INJECTION SOLUTION,1923.75,1442.81,23.08,1731.38,119
CPT,J1230,Methadone injection,,,16.07,24.38,44
CPT,J1240,Dimenhydrinate injection,,,8.18,9.71,44
CPT,J1245,Dipyridamole injection,,,3.7,4.47,44
CPT,J1250,"DOBUTAMINE 1,000 MG/250 ML (4 MG/ML) IN 5 % DEXTROSE IV DRIP",175.5,131.62,2.11,157.95,119
CPT,J1250,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,38.88,29.16,0.47,34.99,238
CPT,J1250,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,103.5,77.625,0.86,121.5,238
CPT,J1250,Inj dobutamine hcl/250 mg,,,6.96,9.27,44
CPT,J1260,Dolasetron mesylate,,,,,0
CPT,J1265,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,24.03,18.02,0.29,21.63,238
CPT,J1265,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",127.5,95.63,1.42,122.85,238
CPT,J1265,Dopamine injection,,,0.62,0.84,44
CPT,J1267,Doripenem injection,,,,,0
CPT,J1270,Injection doxercalciferol,,,0.32,0.45,44
CPT,J1271,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,94.5,70.88,0.94,106.63,476
CPT,J1290,ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,58549.48,43912.11,702.59,52694.53,119
CPT,J1290,Ecallantide injection,,,516.6,673.35,63
CPT,J1299,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,18564.43,13923.32,222.77,16707.99,119
CPT,J1299,Inj eculizumab 2 mg,,,44.82,52.04,18
CPT,J1300,Eculizumab injection,,,224.16,262.78,45
CPT,J1301,Injection edaravone 1 mg,,,17.47,25.9,63
CPT,J1302,Inj sutimlimab-jome 10 mg,,,18.13,21.9,27
CPT,J1303,Inj. ravulizumab-cwvz 10 mg,,,220.59,261.35,63
CPT,J1304,Inj tofersen intrathec 1 mg,,,155.34,185.06,27
CPT,J1305,Inj evinacumab-dgnb 5mg,,,172.25,224.96,63
CPT,J1306,INCLISIRAN 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,12603.49,9452.62,151.24,11343.14,119
CPT,J1306,Injection inclisiran 1 mg,,,11.99,14.3,63
CPT,J1307,Inj crovalimab-akkz 10 mg,,,535.9,640.3,19
CPT,J1308,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,5.37,4.025,0.06,4.86,357
CPT,J1308,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
CPT,J1320,Amitriptyline injection,,,,,0
CPT,J1322,Elosulfase alfa injection,,,262.72,358.38,63
CPT,J1323,Inj elranatamab-bcmm 1 mg,,,177.65,213.71,27
CPT,J1324,Enfuvirtide injection,,,0.72,22.14,9
CPT,J1325,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,124.34,93.25,1.49,111.91,119
CPT,J1325,EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,119
CPT,J1325,"EPOPROSTENOL 750,000 NG/50 ML (15,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",144.0,108.0,1.73,129.6,119
CPT,J1325,"EPOPROSTENOL 90,000 NG/30 ML (3,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",49.68,37.26,0.6,44.71,119
CPT,J1325,Epoprostenol injection,,,15.2,18.55,44
CPT,J1326,Inj zolbetuximab-clzb 2 mg,,,33.67,39.14,18
CPT,J1326,ZOLBETUXIMAB-CLZB 100 MG INTRAVENOUS SOLUTION,4397.6,3298.2,52.77,3957.84,119
CPT,J1327,Eptifibatide injection,,,3.52,13.5,17
CPT,J1330,Ergonovine maleate injection,,,,,0
CPT,J1335,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,180.0,135.0,1.08,224.1,357
CPT,J1335,Ertapenem injection,,,12.18,15.36,44
CPT,J1364,ERYTHROMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD,1200.0,900.0,14.4,1080.0,119
CPT,J1364,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,396.03,297.02,4.75,356.43,238
CPT,J1364,Erythro lactobionate /500 mg,,,76.48,83.57,44
CPT,J1380,Estradiol valerate 10 mg inj,,,8.78,11.15,44
CPT,J1410,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1447.22,1085.42,17.37,1302.5,119
CPT,J1410,Inj estrogen conjugate 25 mg,,,355.52,455.18,63
CPT,J1411,Inj hemgenix per tx dose,,,3685266.67,4278594.6,27
CPT,J1412,Inj roctavian ml 2x10^13vc g,,,11667.97,14574.86,27
CPT,J1413,Inj delandistrogene mox rokl,,,3316462.59,3850413.07,27
CPT,J1414,Inj beqvez per tx dose,,,3710000.0,3710000.0,1
CPT,J1426,Injection casimersen 10 mg,,,166.06,192.8,26
CPT,J1427,Inj. viltolarsen,,,60.91,60.91,8
CPT,J1428,Inj eteplirsen 10 mg,,,167.35,194.29,26
CPT,J1429,Inj golodirsen 10 mg,,,172.8,172.8,8
CPT,J1430,Ethanolamine oleate 100 mg,,,457.0,590.9,63
CPT,J1434,Inj focinvez 1mg,,,2.63,3.3,27
CPT,J1435,Injection estrone per 1 mg,,,1.93,1.93,1
CPT,J1436,Etidronate disodium inj,,,,,0
CPT,J1437,Inj. fe derisomaltose 10 mg,,,20.77,25.57,63
CPT,J1438,Etanercept injection,,,790.78,1254.9,18
CPT,J1439,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,6111.27,4583.45,73.34,5500.14,119
CPT,J1439,Inj ferric carboxymaltos 1mg,,,1.1,1.29,63
CPT,J1440,Fecal microbiota jslm 1 ml,,,63.6,74.12,27
CPT,J1442,INV FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J1442,Inj filgrastim excl biosimil,,,0.98,1.16,63
CPT,J1443,Inj ferric pyrophosphate cit,,,0.04,0.04,8
CPT,J1444,Fe pyro cit pow 0.1 mg iron,,,0.04,0.04,8
CPT,J1445,Inj triferic avnu 0.1mg iron,,,0.17,0.17,8
CPT,J1447,Inj tbo filgrastim 1 microg,,,0.25,0.45,63
CPT,J1447,TBO-FILGRASTIM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,711.1,533.33,8.53,639.99,119
CPT,J1447,TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1138.09,853.57,13.66,1024.28,119
CPT,J1448,Injection trilaciclib 1mg,,,5.0,6.34,63
CPT,J1449,Inj eflapegrastim-xnst 0.1mg,,,20.87,26.62,27
CPT,J1450,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,12.27,9.2,0.01,21.6,238
CPT,J1450,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,55.2,41.4,0.32,75.6,238
CPT,J1450,FLUCONAZOLE PEDIATRIC IVPB (2 MG/ML)(UW),18.41,13.81,0.22,16.57,119
CPT,J1450,Fluconazole,,,2.32,3.06,44
CPT,J1451,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,6389.64,4792.23,76.68,5750.68,119
CPT,J1451,Fomepizole 15 mg,,,6.16,13.64,27
CPT,J1452,Intraocular fomivirsen na,,,,,0
CPT,J1453,FOSAPREPITANT 150 MG IN 250ML NS (0.6 MG/ML) IVPB CMPD,690.62,517.97,8.29,621.56,119
CPT,J1453,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,198.09,148.57,2.38,178.28,119
CPT,J1453,FOSAPREPITANT 150 MG/5 ML (30 MG/ML) INTRAVENOUS SOLUTION (UW),224.265,168.2,2.38,225.4,238
CPT,J1453,Fosaprepitant injection,,,0.16,0.17,44
CPT,J1454,Inj fosnetupitant palonoset,,,467.05,794.9,63
CPT,J1455,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,2024.595,1518.4450000000002,24.11,1836.0,238
CPT,J1455,Foscarnet sodium injection,,,16.08,64.8,18
CPT,J1456,Inj fosaprepitant (teva),,,0.44,2.39,27
CPT,J1457,Gallium nitrate injection,,,,,0
CPT,J1458,Galsulfase injection,,,432.79,567.07,53
CPT,J1459,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",9249.255000000001,6936.945,37.0,22198.21,476
CPT,J1459,Inj ivig privigen 500 mg,,,47.56,58.91,63
CPT,J1460,Gamma globulin 1 cc inj,,,47.87,58.32,63
CPT,J1551,Inj cutaquig 100 mg,,,12.62,16.96,53
CPT,J1552,Inj alyglo 500 mg,,,123.84,151.21,19
CPT,J1554,Inj. asceniv,,,481.77,576.72,63
CPT,J1555,Inj cuvitru 100 mg,,,15.05,19.68,63
CPT,J1556,Inj imm glob bivigam 500mg,,,70.48,87.94,53
CPT,J1557,Gammaplex injection,,,52.37,73.93,63
CPT,J1558,Inj. xembify 100 mg,,,12.97,17.24,63
CPT,J1559,Hizentra injection,,,12.62,16.65,63
CPT,J1560,Gamma globulin > 10 cc inj,,,104.52,583.18,63
CPT,J1561,Gamunex-c/gammaked,,,47.79,57.09,63
CPT,J1561,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),7172.25,5379.1849999999995,28.69,17213.4,476
CPT,J1561,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,4781.5,3586.12,57.38,4303.35,119
CPT,J1561,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,9563.0,7172.25,114.76,8606.7,119
CPT,J1561,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,19126.0,14344.5,229.51,17213.4,119
CPT,J1561,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2390.75,1793.06,28.69,2151.68,119
CPT,J1562,Vivaglobin  inj,,,15.91,15.91,1
CPT,J1566,"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",3128.07,2346.05,37.54,2815.26,119
CPT,J1566,Immune globulin powder,,,73.58,96.15,63
CPT,J1568,Octagam injection,,,41.06,57.32,63
CPT,J1569,Gammagard liquid injection,,,45.31,58.13,63
CPT,J1569,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",8577.72,6433.289999999999,34.31,15439.89,476
CPT,J1570,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,300.83500000000004,225.625,2.38,363.3,357
CPT,J1570,Ganciclovir sodium injection,,,41.4,42.59,44
CPT,J1571,Hepagam b im injection,,,65.94,80.32,63
CPT,J1572,Flebogamma injection,,,41.53,90.74,63
CPT,J1573,Hepagam b intravenous inj,,,65.94,96.11,27
CPT,J1574,Inj ganciclovir (exela),,,54.0,54.0,8
CPT,J1575,Hyqvia 100mg immuneglobulin,,,16.04,21.07,63
CPT,J1576,Inj panzyga 500 mg,,,69.1,84.75,27
CPT,J1580,GENTAMICIN 40 MG/ML INJECTION SOLUTION,113.88,85.41,0.33,179.93,476
CPT,J1580,GENTAMICIN IN D5W (5 MG/ML) IV SOLUTION (NEO/PEDS) CMPD,7.77,5.83,0.09,6.99,119
CPT,J1580,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,37.02,27.76,0.44,33.32,238
CPT,J1580,Garamycin gentamicin inj,,,2.79,3.21,44
CPT,J1595,Injection glatiramer acetate,,,167.31,194.77,18
CPT,J1596,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,24.48,18.36,0.2,29.38,476
CPT,J1596,Inj glycopyrrolate 0.1 mg,,,0.46,0.6,18
CPT,J1597,Inj glycopyrrolate glyrx-pf,,,1.73,1.73,8
CPT,J1598,Inj glycopyrrolate fres kabi,,,1.34,2.11,17
CPT,J1599,Ivig non-lyophilized nos,,,107.37,107.37,8
CPT,J1600,Gold sodium thiomaleate inj,,,,,0
CPT,J1602,GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,5689.7,4267.28,68.28,5120.73,119
CPT,J1602,Golimumab for iv use 1mg,,,10.54,13.84,63
CPT,J1610,Glucagon hydrochloride/1 mg,,,164.86,224.96,63
CPT,J1611,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,672.3,504.22,8.07,605.07,238
CPT,J1611,Inj glucagon hcl fresenius,,,111.91,172.98,63
CPT,J1612,Inj glucagon (gvoke) 0.01 mg,,,2.6,4.01,18
CPT,J1620,Gonadorelin hydroch/ 100 mcg,,,,,0
CPT,J1626,Granisetron hcl injection,,,0.33,0.36,44
CPT,J1627,Inj granisetron xr 0.1 mg,,,4.29,6.67,63
CPT,J1628,Inj. guselkumab 1 mg,,,72.94,149.82,27
CPT,J1630,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,35.94,26.96,0.43,32.35,238
CPT,J1630,Haloperidol injection,,,0.85,1.21,44
CPT,J1631,Haloperidol decanoate inj,,,7.65,7.93,44
CPT,J1632,Inj. brexanolone 1 mg,,,80.46,80.46,8
CPT,J1640,Hemin 1 mg,,,29.03,39.68,63
CPT,J1642,HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,6.15,4.61,0.07,5.54,119
CPT,J1642,"HEPARIN, PORCINE (PF) 1 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
CPT,J1642,"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",3.6,2.7,0.04,3.24,119
CPT,J1642,"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
CPT,J1642,Inj heparin sodium per 10 u,,,0.01,0.02,44
CPT,J1643,Inj heparin pfizer 1000u,,,4.37,4.37,8
CPT,J1644,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",42.0,31.5,0.5,37.8,119
CPT,J1644,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",33.03,24.775000000000002,0.19,39.26,952
CPT,J1644,HEPARIN (PORCINE) 100 UNIT/ML IN 0.45 % SODIUM CHLORIDE IV BOLUS (UW),63.75,47.81,0.76,57.38,119
CPT,J1644,HEPARIN (PORCINE) 100 UNIT/ML IN DEXTROSE 5 % IV BOLUS (UW),65.25,48.94,0.77,59.4,238
CPT,J1644,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",65.25,48.94,0.77,59.4,238
CPT,J1644,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",52.065,39.045,0.48,57.38,238
CPT,J1644,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",12.12,9.09,0.13,22.46,595
CPT,J1644,"HEPARIN 20,000 UNITS IN 20 ML (1,000 UNIT/ML) SYRINGE FOR CRRT",40.44,30.33,0.49,36.4,119
CPT,J1644,"HEPARIN 20,000 UNITS IN NS 500 ML IRRIGATION (OR ONLY) CMPD",6060.0,4545.0,72.72,5454.0,119
CPT,J1644,Inj heparin sodium per 1000u,,,0.12,0.26,44
CPT,J1645,Dalteparin sodium,,,13.3,20.13,44
CPT,J1650,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,55.92,41.94,0.67,50.33,238
CPT,J1650,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.91,37.43,0.6,44.92,238
CPT,J1650,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,62.82,47.12,0.75,56.54,238
CPT,J1650,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,16.060000000000002,12.04,0.19,14.96,357
CPT,J1650,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,22.08,16.56,0.26,19.87,238
CPT,J1650,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,32.22,24.16,0.39,29.0,119
CPT,J1650,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,44.4,33.3,0.53,39.96,238
CPT,J1650,Inj enoxaparin sodium,,,0.67,0.81,44
CPT,J1652,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,241.12,180.84,2.89,217.01,119
CPT,J1652,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,103.86,77.9,1.25,93.47,119
CPT,J1652,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,225.43,169.07,2.71,202.89,119
CPT,J1652,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,241.735,181.305,2.89,218.49,238
CPT,J1652,Fondaparinux sodium,,,1.0,1.08,44
CPT,J1655,Tinzaparin sodium injection,,,,,0
CPT,J1670,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2492.81,1869.61,29.91,2243.53,119
CPT,J1670,Tetanus immune globulin inj,,,524.41,688.47,63
CPT,J1675,Histrelin acetate,,,,,0
CPT,J1700,Hydrocortisone acetate inj,,,,,0
CPT,J1710,Hydrocortisone sodium ph inj,,,,,0
CPT,J1720,HYDROCORTISONE IN NS (1 MG/ML) NEO/PEDS SYRINGE,12.48,9.36,0.15,11.23,119
CPT,J1720,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,102.195,76.65,1.22,92.83,238
CPT,J1720,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,82.08,61.56,0.98,73.87,119
CPT,J1720,Hydrocortisone sodium succ i,,,17.88,22.69,44
CPT,J1726,Makena 10 mg,,,21.83,21.83,8
CPT,J1729,Inj hydroxyprogst capoat nos,,,16.64,16.64,8
CPT,J1730,Diazoxide injection,,,820.38,820.38,1
CPT,J1737,Inj meloxicam (azurity) 1mg,,,1.06,1.06,9
CPT,J1738,Inj. meloxicam 1 mg,,,3.0,3.38,44
CPT,J1740,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,731.4,548.55,8.78,658.26,119
CPT,J1740,Ibandronate sodium injection,,,31.74,34.03,44
CPT,J1741,Ibuprofen injection,,,3.33,3.33,8
CPT,J1742,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,2300.5150000000003,1725.385,27.33,2090.97,238
CPT,J1742,Ibutilide fumarate injection,,,172.31,335.59,27
CPT,J1743,Idursulfase injection,,,542.22,648.37,63
CPT,J1744,Icatibant injection,,,130.39,381.24,18
CPT,J1745,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,2280.8,1710.605,16.22,2888.78,238
CPT,J1745,Infliximab not biosimil 10mg,,,30.53,37.69,63
CPT,J1746,Inj. ibalizumab-uiyk 10 mg,,,69.61,92.02,63
CPT,J1747,Inj spesolimab-sbzo 1 mg,,,61.43,76.31,27
CPT,J1748,Inj zymfentra 10 mg,,,99.76,278.15,17
CPT,J1749,Inj iloprost 0.1 mcg,,,,,0
CPT,J1750,IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,122.11,91.58,1.47,109.9,238
CPT,J1750,Inj iron dextran,,,16.57,21.03,63
CPT,J1756,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,212.5,159.38,2.55,191.25,238
CPT,J1756,IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION,425.0,318.75,5.1,382.5,119
CPT,J1756,IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,113.5,85.13,1.36,102.15,119
CPT,J1756,Iron sucrose injection,,,0.22,0.27,44
CPT,J1786,Imuglucerase injection,,,43.19,51.02,63
CPT,J1790,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,46.41,34.81,0.35,57.4,357
CPT,J1790,Droperidol injection,,,10.46,10.46,8
CPT,J1800,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CPT,J1800,Propranolol injection,,,8.64,8.64,8
CPT,J1805,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,119
CPT,J1805,"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
CPT,J1805,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",869.25,651.94,6.7,1744.2,1309
CPT,J1805,Inj esmolol hcl 10mg,,,0.23,0.23,8
CPT,J1806,Inj esmolol hcl wg crit care,,,0.42,0.42,8
CPT,J1807,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,7011.0,5258.25,84.13,6309.9,119
CPT,J1807,Inj ethacrynate sod 1 mg,,,12.88,24.35,18
CPT,J1808,FOLIC ACID 5 MG/ML INJECTION SOLUTION,273.21000000000004,204.91,2.52,302.78,238
CPT,J1809,Inj fosdenopterin 0.1mg,,,16.97,19.7,18
CPT,J1810,Droperidol/fentanyl inj,,,,,0
CPT,J1811,Fiasp for insulin pump use,,,7.9,9.59,18
CPT,J1812,Inj. insulin (fiasp),,,1.57,1.57,8
CPT,J1813,Lyumjev for insulin pump use,,,18.17,18.17,8
CPT,J1814,Inj. insulin (lyumjev),,,1.49,1.49,8
CPT,J1815,INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,434.04,325.53,5.21,390.64,119
CPT,J1815,INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,600.0,450.0,7.2,540.0,119
CPT,J1815,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,385.56,289.17,4.63,347.0,119
CPT,J1815,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,267.66,200.74,3.21,240.89,119
CPT,J1815,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,289.2,216.9,1.8,529.58,476
CPT,J1815,INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,512.46,384.34,6.15,461.21,119
CPT,J1815,INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,267.66,200.74,3.21,240.89,119
CPT,J1815,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6171.05,4628.29,74.05,5553.95,119
CPT,J1815,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,278.43,208.82,3.21,260.28,238
CPT,J1815,Insulin injection,,,0.24,0.24,8
CPT,J1817,Insulin for insulin pump use,,,2.88,8.44,44
CPT,J1823,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,125602.14,94201.6,1507.23,113041.93,119
CPT,J1823,Inj. inebilizumab-cdon 1 mg,,,462.86,575.33,63
CPT,J1826,Interferon beta-1a inj,,,2203.14,2557.85,18
CPT,J1830,Interferon beta-1b / .25 mg,,,571.88,571.88,8
CPT,J1833,ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,1089.7,817.28,13.08,980.73,119
CPT,J1833,Injection isavuconazonium,,,0.99,1.17,27
CPT,J1834,Inj isoniazid 1 mg,,,0.3,0.37,18
CPT,J1835,Itraconazole injection,,,0.39,0.39,1
CPT,J1836,Inj metronidazole 10 mg,,,0.03,0.03,8
CPT,J1836,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,13.2,9.899999999999999,0.15,12.42,238
CPT,J1837,Inj posaconazole 1 mg,,,0.35,0.35,9
CPT,J1885,KETOROLAC 15 MG/ML INJECTION SOLUTION,18.05,13.54,0.22,16.24,119
CPT,J1885,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,4.859999999999999,3.6449999999999996,0.05,4.97,476
CPT,J1885,Ketorolac tromethamine inj,,,0.3,0.8,63
CPT,J1890,Cephalothin sodium injection,,,,,0
CPT,J1920,Inj labetalol hcl 5mg,,,0.31,0.31,8
CPT,J1920,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.5,40.88,0.65,49.05,119
CPT,J1920,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,20.520000000000003,15.39,0.21,21.38,357
CPT,J1921,Inj labetalol hcl hikma 5mg,,,1.91,1.91,8
CPT,J1930,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE (UW),21619.68,16214.76,259.44,19457.71,119
CPT,J1930,LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRINGE (UW),13764.97,10323.73,165.18,12388.47,119
CPT,J1930,LANREOTIDE 90 MG/0.3 ML SUBCUTANEOUS SYRINGE (UW),18332.19,13749.14,219.99,16498.97,119
CPT,J1930,Lanreotide injection,,,34.05,61.56,63
CPT,J1931,Laronidase injection,,,36.09,46.29,63
CPT,J1932,Inj lanreotide (cipla) 1mg,,,29.84,60.37,63
CPT,J1932,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,20106.3,15079.73,241.28,18095.67,119
CPT,J1938,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,12.0,9.0,0.08,31.54,1666
CPT,J1939,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,17.28,12.96,0.16,22.95,714
CPT,J1939,BUMETANIDE 0.25 MG/ML ORAL SOLUTION (FROM INJECTION) (UW),0.2,0.15,0.01,0.18,119
CPT,J1939,Inj bumetanide 0.5 mg,,,0.37,0.73,18
CPT,J1940,FUROSEMIDE 2 MG/ML IN NS NEO/PEDS CMPD INJECTABLE NEO/PEDS,97.5,73.12,1.17,87.75,119
CPT,J1940,Furosemide injection,,,0.46,0.66,44
CPT,J1941,Inj furoscix 20 mg,,,242.47,242.47,8
CPT,J1943,Inj. aristada initio 1 mg,,,2.97,3.77,63
CPT,J1944,Aripiprazole lauroxil 1 mg,,,2.98,3.89,63
CPT,J1945,Lepirudin,,,,,0
CPT,J1950,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,4950.35,3712.76,59.4,4455.32,119
CPT,J1950,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,13902.87,10427.15,166.83,12512.58,119
CPT,J1950,Leuprolide acetate /3.75 mg,,,1474.17,2008.9,63
CPT,J1951,Inj fensolvi 0.25 mg,,,132.76,164.5,63
CPT,J1952,Leuprolide inj camcevi 1mg,,,55.91,91.63,63
CPT,J1953,"LEVETIRACETAM 1,000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK",180.0,135.0,2.16,162.0,238
CPT,J1953,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,15.719999999999999,11.785,0.1,21.01,357
CPT,J1953,Levetiracetam injection,,,0.06,0.08,44
CPT,J1954,Inj leu acet lutr dpt 7.5 mg,,,235.28,820.44,27
CPT,J1955,Inj levocarnitine per 1 gm,,,30.22,32.43,44
CPT,J1955,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,223.635,167.73000000000002,2.57,209.92,357
CPT,J1955,LEVOCARNITINE 25 MG/ML INTRAVENOUS SOLUTION (CMPD),225.12,168.84,2.7,202.61,119
CPT,J1956,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,42.0,31.5,0.5,37.8,119
CPT,J1956,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,34.8,26.1,0.15,32.94,357
CPT,J1956,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,37.8,28.35,0.26,70.47,357
CPT,J1956,Levofloxacin injection,,,0.97,1.35,44
CPT,J1960,Levorphanol tartrate inj,,,,,0
CPT,J1961,Inj lenacapavir (hiv tx) 1mg,,,21.98,25.73,27
CPT,J1980,Hyoscyamine sulfate inj,,,31.68,36.14,44
CPT,J1990,Chlordiazepoxide injection,,,,,0
CPT,J2001,Lidocaine injection,,,0.02,0.02,36
CPT,J2002,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,37.19,27.89,0.45,33.47,119
CPT,J2003,Inj lidocaine hcl 1 mg,,,0.01,0.01,8
CPT,J2003,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,14.76,11.07,0.09,18.31,1190
CPT,J2003,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,48.9,36.67,0.59,44.01,119
CPT,J2003,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,16.69,12.52,0.08,19.39,833
CPT,J2003,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,21.36,16.02,0.11,30.78,595
CPT,J2003,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,23.04,17.28,0.28,20.74,238
CPT,J2004,Inj lidocaine w epinephrine,,,0.01,0.01,8
CPT,J2004,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",48.96,36.72,0.35,61.56,476
CPT,J2004,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.88,22.41,0.36,26.89,238
CPT,J2004,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",81.0,60.75,0.97,72.9,238
CPT,J2004,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",123.72,92.79,1.48,111.35,119
CPT,J2004,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",48.0,36.0,0.58,43.2,238
CPT,J2010,Lincomycin injection,,,9.82,10.94,44
CPT,J2020,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,113.4,85.05,1.36,102.06,119
CPT,J2020,Linezolid injection,,,3.23,3.6,44
CPT,J2021,Inj linezolid (hospira),,,16.43,17.27,44
CPT,J2060,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.53,6.4,0.08,54.0,952
CPT,J2060,Lorazepam injection,,,0.9,1.7,44
CPT,J2062,Loxapine for inhalation 1 mg,,,15.9,18.46,26
CPT,J2150,Mannitol injection,,,3.05,4.98,44
CPT,J2151,MANNITOL 20 % INTRAVENOUS SOLUTION,207.0,155.25,1.37,270.0,238
CPT,J2151,MANNITOL 25 % INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,238
CPT,J2170,Mecasermin injection,,,158.81,158.81,8
CPT,J2175,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,17.38,13.03,0.21,15.64,238
CPT,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,15.22,11.41,0.18,13.7,238
CPT,J2175,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,47.33,35.495000000000005,0.43,52.58,238
CPT,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,15.85,11.89,0.19,14.26,119
CPT,J2175,MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE,45.32,33.99,0.54,40.79,119
CPT,J2175,Meperidine hydrochl /100 mg,,,7.62,9.59,44
CPT,J2180,Meperidine/promethazine inj,,,,,0
CPT,J2182,Injection mepolizumab 1mg,,,29.64,36.3,63
CPT,J2182,MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION,9708.2,7281.15,116.5,8737.38,119
CPT,J2183,Inj meropenem (wg crit care),,,1.62,1.89,18
CPT,J2184,Inj meropenem (b. braun),,,2.12,2.46,44
CPT,J2185,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,39.03,29.27,0.42,38.39,476
CPT,J2185,MEROPENEM 500 MG INTRAVENOUS SOLUTION,22.68,17.01,0.22,32.4,595
CPT,J2185,Meropenem,,,0.41,0.62,44
CPT,J2186,Inj. meropenem vaborbactam,,,2.1,2.53,27
CPT,J2210,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,136.66,102.5,1.64,122.99,238
CPT,J2210,Methylergonovin maleate inj,,,20.19,26.25,44
CPT,J2212,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,652.53,489.4,7.83,587.28,119
CPT,J2212,Methylnaltrexone injection,,,1.44,1.44,8
CPT,J2246,Inj micafungin (baxter),,,0.86,0.86,8
CPT,J2247,Inj micafungin (par pharm),,,0.4,0.48,44
CPT,J2247,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,620.84,465.63,7.45,558.76,238
CPT,J2248,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,216.0,162.0,2.59,194.4,238
CPT,J2248,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,108.0,81.0,1.3,97.2,238
CPT,J2248,Micafungin sodium injection,,,0.33,0.92,44
CPT,J2249,Inj remimazolam 1 mg,,,2.23,2.23,8
CPT,J2250,Inj midazolam hydrochloride,,,0.15,0.15,44
CPT,J2250,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,7.08,5.31,0.08,6.37,238
CPT,J2250,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,6.93,5.195,0.08,6.27,357
CPT,J2250,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,3.99,2.99,0.05,3.67,476
CPT,J2250,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,41.4,31.05,0.5,37.26,238
CPT,J2251,Inj midazolam in 0.9% nacl,,,0.21,0.3,44
CPT,J2251,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLOR IV SYRINGE,34.5,25.88,0.41,31.05,119
CPT,J2252,Inj midazolam in 0.8% nacl,,,0.07,0.07,8
CPT,J2253,Inj midazolam (seizalam),,,,,0
CPT,J2260,Inj milrinone lactate / 5 mg,,,1.65,1.91,44
CPT,J2260,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,46.29,34.715,0.45,49.57,476
CPT,J2260,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,91.2,68.4,1.09,82.08,119
CPT,J2265,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,955.2,716.4000000000001,11.01,893.38,238
CPT,J2265,Minocycline hydrochloride,,,2.59,3.1,27
CPT,J2267,Inj mirikizumab-mrkz 1 mg,,,41.92,49.98,27
CPT,J2270,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,15.29,11.47,0.18,13.76,238
CPT,J2270,MORPHINE 2 MG/ML PF INJECTION SYRINGE,17.22,12.92,0.21,15.5,119
CPT,J2270,MORPHINE 2 MG/ML PF INTRAVENOUS SYRINGE,12.77,9.58,0.15,11.49,238
CPT,J2270,MORPHINE 20 MG/20 ML (1 MG/ML) IN NS IV DRIP (NEO/PED),43.08,32.31,0.52,38.77,119
CPT,J2270,MORPHINE 250 MG/50 ML (5 MG/ML) IN NS HIGH DOSE PCA,135.0,101.25,1.62,121.5,119
CPT,J2270,MORPHINE 30 MG/30 ML (1 MG/ML) IN D5W IV DRIP (NEO/PED),72.0,54.0,0.86,64.8,119
CPT,J2270,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,13.52,10.14,0.14,13.48,238
CPT,J2270,MORPHINE 6 MG/30 ML (0.2 MG/ML) IN NS IV DRIP (NEO/PED),2.04,1.53,0.02,1.84,119
CPT,J2270,Morphine sulfate injection,,,2.46,5.66,44
CPT,J2272,Inj morphine (fresenius),,,5.93,7.45,44
CPT,J2272,MORPHINE 2 MG/ML INJECTION SOLUTION,17.22,12.92,0.21,15.5,238
CPT,J2272,MORPHINE 2 MG/ML PF INJECTION SYRINGE,17.22,12.92,0.21,15.5,119
CPT,J2274,Inj morphine pf epid ithc,,,9.1,12.24,44
CPT,J2274,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,120.9,90.68,1.45,108.81,238
CPT,J2277,Inj motixafortide 0.25 mg,,,25.22,29.5,27
CPT,J2278,Ziconotide injection,,,9.1,11.77,63
CPT,J2280,Inj moxifloxacin 100 mg,,,10.22,10.26,44
CPT,J2281,Inj moxifloxacin (fres kabi),,,8.44,9.72,44
CPT,J2290,NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,339.8,254.85,4.08,305.82,238
CPT,J2290,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
CPT,J2300,Inj nalbuphine hydrochloride,,,2.77,4.23,44
CPT,J2300,NALBUPHINE 10 MG/ML INJECTION SOLUTION,31.935,23.95,0.32,33.41,357
CPT,J2305,Inj nitroglycerin 5 mg,,,1.65,1.65,8
CPT,J2305,NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,147.0,110.25,1.76,132.3,119
CPT,J2305,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,123.0,92.25,1.48,110.7,119
CPT,J2305,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,93.3,69.97,1.12,83.97,238
CPT,J2310,Inj naloxone hydrochloride,,,10.21,10.3,44
CPT,J2311,Inj  naloxone hcl (zimhi),,,1.75,1.75,8
CPT,J2312,NALOXONE 0.4 MG/ML INJECTION SOLUTION,36.0,27.0,0.32,540.0,952
CPT,J2315,Naltrexone depot form,,,3.73,4.92,63
CPT,J2320,Nandrolone decanoate 50 mg,,,,,0
CPT,J2323,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,24298.34,18223.75,291.58,21868.51,119
CPT,J2323,Natalizumab injection,,,23.82,28.26,63
CPT,J2325,Nesiritide injection,,,,,0
CPT,J2326,Inj nusinersen 0.1mg,,,1246.99,1486.37,27
CPT,J2327,Inj risankizumab-rzaa 1 mg,,,14.93,17.35,63
CPT,J2327,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,29222.11,21916.58,350.67,26299.9,119
CPT,J2329,Inj ublituximab-xiiy 1 mg,,,69.03,82.14,27
CPT,J2329,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,28783.67,21587.75,345.4,25905.3,119
CPT,J2350,Injection ocrelizumab 1 mg,,,58.77,69.95,63
CPT,J2350,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,56731.68,42548.76,680.78,51058.51,119
CPT,J2351,Inj ocrelizumab 1mg hya-ocsq,,,47.05,54.83,18
CPT,J2353,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",12687.9,9515.93,152.25,11419.11,119
CPT,J2353,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17786.02,13339.51,213.43,16007.42,119
CPT,J2353,Octreotide injection depot,,,199.17,251.37,63
CPT,J2354,"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",1514.24,1135.68,18.17,1362.82,119
CPT,J2354,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,42.24,31.68,0.51,38.02,238
CPT,J2354,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,19.12,14.34,0.23,17.21,238
CPT,J2354,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,162.74,122.05,1.95,146.47,238
CPT,J2354,Octreotide inj non-depot,,,1.01,1.42,44
CPT,J2355,Oprelvekin injection,,,,,0
CPT,J2356,Inj tezepelumab-ekko 1mg,,,17.82,21.18,63
CPT,J2357,OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE,3892.21,2919.15,46.71,3502.99,119
CPT,J2357,OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,1946.1,1459.58,23.35,1751.49,119
CPT,J2357,Omalizumab injection,,,37.76,51.78,63
CPT,J2358,Olanzapine long-acting inj,,,2.91,3.41,54
CPT,J2359,Inj. olanzapine 0.5mg,,,1.07,1.07,8
CPT,J2359,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,90.0,67.5,1.08,81.0,119
CPT,J2360,Orphenadrine injection,,,4.29,10.28,44
CPT,J2371,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,18.84,14.13,0.23,16.96,357
CPT,J2371,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,23.41,17.56,0.09,21.6,476
CPT,J2372,Inj biorphen 20 micrograms,,,0.2,0.2,8
CPT,J2373,Inj immphentiv 20 mcg,,,0.14,0.18,18
CPT,J2401,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,134.28,100.71,1.61,120.85,119
CPT,J2401,Chloroprocaine hcl injection,,,0.03,0.03,44
CPT,J2402,Chloroprocaine (clorotekal),,,0.33,0.33,8
CPT,J2403,Chloroprocaine opht gel 1mg,,,0.58,0.74,27
CPT,J2404,Inj nicardipine 0.1 mg,,,0.63,0.63,8
CPT,J2404,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,127.44,95.58,1.53,114.7,238
CPT,J2404,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,727.8,545.85,5.76,878.04,357
CPT,J2405,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,3.84,2.88,0.04,3.67,476
CPT,J2405,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,43.2,32.4,0.4,42.44,357
CPT,J2405,Ondansetron hcl injection,,,0.09,0.1,44
CPT,J2406,Injection oritavancin 10 mg,,,41.4,49.72,63
CPT,J2407,Injection oritavancin,,,26.0,33.3,63
CPT,J2410,Oxymorphone hcl injection,,,,,0
CPT,J2425,Palifermin injection,,,25.12,41.27,63
CPT,J2426,Inj invega sustenna 1 mg,,,13.33,17.54,63
CPT,J2426,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,6374.29,4780.72,76.49,5736.86,119
CPT,J2426,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,9561.21,7170.9,114.73,8605.09,119
CPT,J2427,Inj invega hafyera/trinza,,,12.62,15.09,27
CPT,J2428,Inj erzofri 1 mg,,,15.3,19.46,18
CPT,J2430,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,162.0,121.5,1.94,145.8,119
CPT,J2430,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,561.36,421.02,6.74,505.22,119
CPT,J2430,Pamidronate disodium /30 mg,,,10.38,14.76,44
CPT,J2440,PAPAVERINE 30 MG/ML INJECTION SOLUTION,166.29500000000002,124.725,1.76,167.71,476
CPT,J2440,Papaverin hcl injection,,,40.5,40.5,8
CPT,J2460,Oxytetracycline injection,,,,,0
CPT,J2468,Inj palonosetron (posfrea),,,58.24,67.62,27
CPT,J2469,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,138.125,103.595,0.76,191.25,238
CPT,J2469,Palonosetron hcl,,,0.72,1.01,44
CPT,J2470,Inj pantoprazole sodium 40mg,,,5.48,5.48,8
CPT,J2470,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,17.82,13.36,0.2,26.41,714
CPT,J2470,PANTOPRAZOLE 80 MG IN NS 100 ML IV DRIP BATCHED,63.0,47.25,0.76,56.7,119
CPT,J2471,Inj pantoprazole(hikma) 40mg,,,7.02,7.02,8
CPT,J2501,PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,36.36,27.27,0.44,32.72,119
CPT,J2501,Paricalcitol,,,0.62,0.88,44
CPT,J2502,Inj pasireotide long acting,,,533.5,1544.48,27
CPT,J2503,Pegaptanib sodium injection,,,,,0
CPT,J2504,Pegademase bovine  25 iu,,,,,0
CPT,J2506,Inj pegfilgrast ex bio 0.5mg,,,19.98,135.16,63
CPT,J2506,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15438.0,11578.5,185.26,13894.2,119
CPT,J2506,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15438.0,11578.5,185.26,13894.2,119
CPT,J2507,PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION,66289.81,49717.36,795.48,59660.83,119
CPT,J2507,Pegloticase injection,,,3194.98,4250.22,63
CPT,J2508,Pegunigalsidase alfa-iwxj,,,225.95,264.89,27
CPT,J2510,Penicillin g procaine inj,,,38.12,54.79,54
CPT,J2513,Pentastarch 10% solution,,,,,0
CPT,J2515,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,7589.54,5692.155,60.27,9140.85,238
CPT,J2515,Pentobarbital sodium inj,,,22.6,57.05,53
CPT,J2540,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,225.0,168.75,2.7,202.5,238
CPT,J2540,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,238
CPT,J2540,"PENICILLIN G POTASSIUM/NS 100,000 UNITS/ML (PEDS/NEO/INFANT/NICU)",91.2,68.4,1.09,82.08,119
CPT,J2540,Penicillin g potassium inj,,,0.78,1.19,44
CPT,J2543,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.25,29.7,833
CPT,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,36.33,27.244999999999997,0.4,35.1,595
CPT,J2543,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (4 GM PIP NEO/PED)(UW),36.33,27.244999999999997,0.4,35.1,357
CPT,J2543,PIPERACILLIN-TAZOBACTAM 40 MG PIPERACILLIN/ML IN NS IVPB (NEO/PED) CMPD,0.74,0.56,0.01,0.67,119
CPT,J2543,Piperacillin/tazobactam,,,1.29,1.52,44
CPT,J2545,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,599.67,449.76,4.48,623.33,357
CPT,J2545,Pentamidine non-comp unit,,,99.76,100.06,44
CPT,J2547,Injection peramivir,,,1.68,1.95,27
CPT,J2550,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,15.66,11.745000000000001,0.13,18.21,357
CPT,J2550,Promethazine hcl injection,,,3.21,3.88,44
CPT,J2560,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,281.99,211.49,3.38,253.79,238
CPT,J2560,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,117.81,88.36,0.94,106.73,714
CPT,J2560,Phenobarbital sodium inj,,,36.71,45.85,44
CPT,J2561,Inj sezaby 1 mg,,,0.65,1.44,27
CPT,J2562,INV PLERIXAFOR 20 MG/ML SUBCUTANEOUS SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J2562,Plerixafor injection,,,25.33,401.92,63
CPT,J2590,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,20.7,15.52,0.11,75.6,595
CPT,J2590,Oxytocin injection,,,0.94,0.94,8
CPT,J2597,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,1958.21,1468.6599999999999,17.36,2223.07,238
CPT,J2597,Inj desmopressin acetate,,,3.52,7.33,54
CPT,J2598,Inj vasopressin 1 unit,,,1.89,1.89,8
CPT,J2598,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,207.375,155.53,1.24,280.12,357
CPT,J2599,Inj vasopressin (am reg) 1 u,,,1.55,1.55,8
CPT,J2599,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,238
CPT,J2601,Inj vasopressin (baxter),,,2.01,4.05,27
CPT,J2650,Prednisolone acetate inj,,,,,0
CPT,J2670,Totazoline hcl injection,,,,,0
CPT,J2675,Inj progesterone per 50 mg,,,0.85,0.93,44
CPT,J2679,Inj fluphenazine hcl 1.25 mg,,,7.34,8.6,18
CPT,J2680,Fluphenazine decanoate 25 mg,,,9.59,11.94,44
CPT,J2690,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,2304.0,1728.0,27.65,2073.6,119
CPT,J2690,Procainamide hcl injection,,,95.44,638.79,63
CPT,J2700,Oxacillin sodium injeciton,,,1.01,1.28,44
CPT,J2704,Inj propofol 10 mg,,,0.1,0.14,44
CPT,J2704,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,67.8,50.85,0.17,162.0,1071
CPT,J2704,PROPOFOL 10 MG/ML IV BOLUS (UW),60.6,45.45,0.17,162.0,595
CPT,J2710,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,48.0,36.0,0.43,48.6,714
CPT,J2710,Neostigmine methylslfte inj,,,0.86,0.86,8
CPT,J2720,Inj protamine sulfate/10 mg,,,1.02,1.26,44
CPT,J2720,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,205.14,153.85500000000002,1.11,285.66,357
CPT,J2724,Protein c concentrate,,,15.01,17.61,63
CPT,J2725,Inj protirelin per 250 mcg,,,37.21,37.21,1
CPT,J2730,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,359.8,269.85,4.32,323.82,119
CPT,J2730,Pralidoxime chloride inj,,,93.64,93.64,8
CPT,J2760,PHENTOLAMINE 5 MG INJECTION SOLUTION,1742.17,1306.63,19.34,1693.31,357
CPT,J2760,Phentolaine mesylate inj,,,394.63,501.58,63
CPT,J2765,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,16.65,12.49,0.16,18.09,357
CPT,J2765,Metoclopramide hcl injection,,,1.1,1.16,44
CPT,J2770,Quinupristin/dalfopristin,,,4.26,503.29,54
CPT,J2777,Inj faricimab-svoa 0.1mg,,,32.9,40.06,63
CPT,J2778,Ranibizumab injection,,,65.44,237.19,63
CPT,J2779,Inj susvimo 0.1 mg,,,76.22,92.51,63
CPT,J2781,Inj pegcetacoplan 1mg,,,138.05,172.38,27
CPT,J2782,Inj avacincaptad pegol 0.1mg,,,102.92,128.13,27
CPT,J2783,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4024.44,3018.33,48.29,3622.0,119
CPT,J2783,Rasburicase,,,340.86,438.3,63
CPT,J2785,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,120.0,90.0,1.44,108.0,119
CPT,J2785,Regadenoson injection,,,3.37,61.15,44
CPT,J2786,Injection reslizumab 1mg,,,10.1,12.71,63
CPT,J2787,Riboflavin 5phos opth<3ml,,,2241.0,2241.0,8
CPT,J2788,Rho d immune globulin 50 mcg,,,24.34,28.12,44
CPT,J2790,HC RHO D IMMUNE GLOBULIN INJ 300 MCG,739.05,554.29,8.87,665.14,119
CPT,J2790,Rho d immune globulin inj,,,81.77,93.75,44
CPT,J2791,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",706.12,529.59,8.47,635.51,119
CPT,J2791,Rhophylac injection,,,4.97,5.61,44
CPT,J2792,Rho(d) immune globulin h sd,,,25.46,40.17,63
CPT,J2793,Rilonacept injection,,,27.74,27.74,8
CPT,J2794,Inj risperdal consta 0.5 mg,,,10.98,13.22,63
CPT,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL SOLUTION 50 ML,66.9,50.175000000000004,0.4,90.18,357
CPT,J2795,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,33.12,24.84,0.4,29.81,119
CPT,J2795,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,135.54,101.66,1.63,121.99,238
CPT,J2795,Ropivacaine hcl injection,,,0.07,0.07,44
CPT,J2796,Romiplostim injection,,,91.24,118.21,44
CPT,J2797,Inj. rolapitant 0.5 mg,,,,,0
CPT,J2798,Inj. perseris 0.5 mg,,,11.21,14.26,63
CPT,J2799,Inj uzedy 1 mg,,,24.72,29.07,27
CPT,J2800,Methocarbamol injection,,,6.22,8.49,44
CPT,J2801,Inj rykindo 0.5 mg,,,13.03,15.13,27
CPT,J2802,Inj romiplostim 1 microgram,,,10.54,12.78,19
CPT,J2802,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,4837.52,3628.14,58.05,4353.77,119
CPT,J2804,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,741.02,555.77,8.89,666.92,119
CPT,J2805,SINCALIDE 5 MCG SOLUTION FOR INJECTION,567.02,425.26,6.8,510.32,238
CPT,J2805,Sincalide injection,,,123.08,144.61,44
CPT,J2806,Inj sincalide- maia- 5 mcg,,,147.56,147.56,8
CPT,J2810,Inj theophylline per 40 mg,,,,,0
CPT,J2820,Sargramostim injection,,,50.37,70.51,63
CPT,J2840,Inj sebelipase alfa 1 mg,,,539.52,626.84,27
CPT,J2850,Inj secretin synthetic human,,,40.44,47.04,27
CPT,J2860,Injection siltuximab,,,133.1,192.53,63
CPT,J2865,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,222.3,166.725,2.63,203.15,238
CPT,J2910,Aurothioglucose injeciton,,,,,0
CPT,J2916,Na ferric gluconate complex,,,2.09,2.56,44
CPT,J2919,Inj methylpred sod succ 5mg,,,0.21,0.36,18
CPT,J2919,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,55.629999999999995,41.725,0.62,54.0,476
CPT,J2919,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,38.81,29.11,0.47,34.93,238
CPT,J2919,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",188.5,141.38,2.26,169.65,119
CPT,J2919,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,109.26,81.94,1.31,98.33,119
CPT,J2920,Methylprednisolone injection,,,4.07,4.07,36
CPT,J2930,Methylprednisolone injection,,,5.94,5.94,36
CPT,J2940,Somatrem injection,,,,,0
CPT,J2941,Somatropin injection,,,48.92,163.93,18
CPT,J2950,Promazine hcl injection,,,,,0
CPT,J2993,Reteplase injection,,,2777.14,3372.22,27
CPT,J2995,Inj streptokinase /250000 iu,,,,,0
CPT,J2997,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,768.46,576.34,9.22,691.61,119
CPT,J2997,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,18260.83,13695.62,219.13,16434.75,119
CPT,J2997,ALTEPLASE IN NS 10 MG/30 ML (CHEST TUBE ONLY),4166.37,3124.78,50.0,3749.73,119
CPT,J2997,ALTEPLASE IN NS 5 MG/15 ML (CHEST TUBE ONLY),1615.95,1211.96,19.39,1454.36,119
CPT,J2997,Alteplase recombinant,,,88.03,109.66,63
CPT,J2998,Inj plasminogen tvmh 1mg,,,32.52,38.05,27
CPT,J3000,Streptomycin injection,,,38.16,38.31,44
CPT,J3010,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,14.040000000000001,10.530000000000001,0.1,116.64,1071
CPT,J3010,"FENTANYL 1,500 MCG/30 ML (50 MCG/ML) IV DRIP NEO/PED CMPD",95.58000000000001,71.685,1.14,86.18,238
CPT,J3010,"FENTANYL 2,500 MCG IN NS 50 ML (50 MCG/ML) DRIP",141.3,105.975,1.57,136.89,238
CPT,J3010,Fentanyl citrate injection,,,0.91,1.06,44
CPT,J3030,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,49.5,37.12,0.59,44.55,238
CPT,J3030,Sumatriptan succinate / 6 mg,,,82.98,82.98,8
CPT,J3031,Inj. fremanezumab-vfrm 1 mg,,,3.52,3.52,8
CPT,J3032,EPTINEZUMAB-JJMR 100 MG/ML INTRAVENOUS SOLUTION,5189.58,3892.19,62.27,4670.62,119
CPT,J3032,Inj. eptinezumab-jjmr 1 mg,,,16.88,23.19,63
CPT,J3055,Inj talquetamab-tgvs 0.25 mg,,,69.97,84.31,27
CPT,J3060,Inj taliglucerase alfa 10 u,,,40.94,49.81,63
CPT,J3070,Pentazocine injection,,,,,0
CPT,J3090,Inj tedizolid phosphate,,,1.74,2.28,63
CPT,J3095,TELAVANCIN 750 MG INTRAVENOUS SOLUTION,1868.91,1401.68,22.43,1682.02,119
CPT,J3095,Telavancin injection,,,6.98,8.25,63
CPT,J3101,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,24822.565000000002,18616.925,255.22,25538.97,476
CPT,J3101,TENECTEPLASE 50 MG KIT FOR ISCHEMIC STROKE (UW),24822.565000000002,18616.925,255.22,25538.97,238
CPT,J3101,Tenecteplase injection,,,143.65,199.95,63
CPT,J3105,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,48.225,36.169999999999995,0.09,79.79,357
CPT,J3105,Terbutaline sulfate inj,,,1.32,2.65,44
CPT,J3110,Teriparatide injection,,,71.22,71.22,8
CPT,J3111,Inj. romosozumab-aqqg 1 mg,,,9.95,14.01,63
CPT,J3111,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,3440.76,2580.57,41.29,3096.68,119
CPT,J3121,Inj testostero enanthate 1mg,,,0.04,0.06,44
CPT,J3145,Testosterone undecanoate 1mg,,,1.79,2.4,63
CPT,J3230,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,130.0,97.5,1.56,117.0,119
CPT,J3230,Chlorpromazine hcl injection,,,32.42,36.37,44
CPT,J3240,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,5434.44,4075.83,65.21,4891.0,119
CPT,J3240,Thyrotropin injection,,,1924.94,2457.05,63
CPT,J3241,Inj. teprotumumab-trbw 10 mg,,,321.88,417.02,63
CPT,J3241,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,38476.84,28857.63,461.72,34629.16,119
CPT,J3243,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,238
CPT,J3243,Tigecycline injection,,,0.61,0.7,44
CPT,J3244,Inj. tigecycline (accord),,,3.04,3.04,8
CPT,J3245,Inj. tildrakizumab 1 mg,,,123.79,159.0,63
CPT,J3246,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,552.0,414.0,6.62,496.8,119
CPT,J3246,Tirofiban hcl,,,4.48,4.48,8
CPT,J3247,Inj secukinumab intrav 1mg,,,17.72,20.71,27
CPT,J3250,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,272.82,204.61,3.27,245.54,119
CPT,J3250,Trimethobenzamide hcl inj,,,43.04,59.93,44
CPT,J3260,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,328.885,246.665,3.74,311.87,357
CPT,J3260,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,71.91,53.934999999999995,0.14,118.75,238
CPT,J3260,Tobramycin sulfate injection,,,2.66,2.71,44
CPT,J3262,INV TOCILIZUMAB 20 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,357
CPT,J3262,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,4046.81,3035.1,48.56,3642.13,119
CPT,J3262,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,8093.61,6070.21,97.12,7284.25,119
CPT,J3262,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1618.71,1214.03,19.42,1456.84,119
CPT,J3262,Tocilizumab injection,,,5.61,6.98,63
CPT,J3263,Inj toripalimab-tpzi 1 mg,,,39.32,45.76,27
CPT,J3263,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,24928.54,18696.4,299.14,22435.69,119
CPT,J3265,Injection torsemide 10 mg/ml,,,,,0
CPT,J3280,Thiethylperazine maleate inj,,,,,0
CPT,J3285,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,5020.09,3765.07,57.07,4755.85,357
CPT,J3285,TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,46450.71,34838.04,557.41,41805.64,119
CPT,J3285,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,12550.18,9412.64,150.6,11295.16,119
CPT,J3285,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,23225.4,17419.05,278.7,20902.86,119
CPT,J3285,Treprostinil injection,,,54.48,65.29,63
CPT,J3290,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",27.9,20.925,0.27,29.7,476
CPT,J3290,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",124.5,93.375,1.48,113.4,357
CPT,J3299,Inj xipere 1 mg,,,47.61,56.62,63
CPT,J3300,Triamcinolone a inj prs-free,,,4.18,28.44,62
CPT,J3301,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,72.54,54.4,0.87,65.29,119
CPT,J3301,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,260.1,195.08,0.61,244.62,714
CPT,J3301,Triamcinolone acet inj nos,,,1.06,1.06,44
CPT,J3302,Triamcinolone diacetate inj,,,,,0
CPT,J3303,Triamcinolone hexacetonl inj,,,,,0
CPT,J3304,Inj triamcinolone ace xr 1mg,,,16.95,21.25,63
CPT,J3305,Inj trimetrexate glucoronate,,,,,0
CPT,J3310,Perphenazine injeciton,,,,,0
CPT,J3315,Triptorelin pamoate,,,374.54,551.29,63
CPT,J3316,Inj. triptorelin xr 3.75 mg,,,3512.09,4431.86,27
CPT,J3320,Spectinomycn di-hcl inj,,,,,0
CPT,J3350,Urea injection,,,,,0
CPT,J3355,Urofollitropin  75 iu,,,157.71,157.71,1
CPT,J3357,Ustekinumab sub cu inj 1 mg,,,149.4,187.07,54
CPT,J3358,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,6169.71,4627.28,74.04,5552.74,119
CPT,J3358,Ustekinumab iv inject 1 mg,,,12.24,15.17,63
CPT,J3360,DIAZEPAM 5 MG/ML INJECTION SYRINGE,131.66,98.745,1.34,136.33,476
CPT,J3360,Diazepam injection,,,6.82,8.54,44
CPT,J3364,Urokinase 5000 iu injection,,,,,0
CPT,J3365,Urokinase 250 000 iu inj,,,312.44,312.44,1
CPT,J3370,Vancomycin hcl injection,,,2.53,2.85,44
CPT,J3371,Inj  vancomycin hcl (mylan),,,6.39,6.64,44
CPT,J3372,Inj  vancomycin hcl (xellia),,,6.49,7.51,44
CPT,J3373,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",28.35,21.259999999999998,0.19,65.93,714
CPT,J3373,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,120.0,90.0,1.44,108.0,119
CPT,J3373,VANCOMYCIN 1.5 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,169.5,127.12,2.03,152.55,119
CPT,J3373,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,239.465,179.595,1.76,298.8,238
CPT,J3373,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,33.485,25.11,0.22,44.07,476
CPT,J3374,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",72.18,54.14,0.87,64.96,238
CPT,J3380,Inj vedolizumab iv 1 mg,,,21.31,26.04,63
CPT,J3380,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,24083.05,18062.29,289.0,21674.74,119
CPT,J3385,Velaglucerase alfa,,,357.52,442.76,63
CPT,J3387,Inj elivaldogene autotemecel,,,3180000.0,3180000.0,9
CPT,J3389,Topi adm prad zami per treat,,,3335820.0,3335820.0,9
CPT,J3391,Inj atidarsagene autotemcel,,,4505000.0,5230305.0,18
CPT,J3392,Inj exagamglogene autotem,,,2332000.0,2707452.0,19
CPT,J3393,Inj betibeglogene autotemce,,,2939968.89,3420004.14,27
CPT,J3394,Inj lovotibeglogene autotem,,,3193000.0,3771445.48,27
CPT,J3396,Verteporfin injection,,,11.3,13.49,63
CPT,J3397,Inj. vestronidase alfa-vjbk,,,279.93,325.0,26
CPT,J3398,Inj luxturna 1 billion vec g,,,3002.58,3486.0,27
CPT,J3399,Inj onase abepar-xioi treat,,,2403458.75,2850383.42,27
CPT,J3400,Triflupromazine hcl inj,,,,,0
CPT,J3401,Vyjuvek 5x10^9pfu/ml 0.1 ml,,,1014.79,1190.54,27
CPT,J3402,Inj. remestemcel-l-rknd/ td,,,201669.02,238748.04,18
CPT,J3403,Revakinagene per implant,,,257500.0,298957.5,18
CPT,J3410,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,138.92,104.19,1.67,125.03,119
CPT,J3410,Hydroxyzine hcl injection,,,10.67,14.51,44
CPT,J3411,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,56.32,42.24,0.5,53.73,714
CPT,J3411,Thiamine hcl 100 mg,,,2.09,2.8,44
CPT,J3415,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,97.78,73.34,1.17,88.0,238
CPT,J3415,Pyridoxine hcl 100 mg,,,12.69,20.64,44
CPT,J3420,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",10.68,8.01,0.13,9.61,238
CPT,J3420,Vitamin b12 injection,,,1.34,2.05,44
CPT,J3424,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,3832.32,2874.24,45.99,3449.09,119
CPT,J3424,Inj hydroxocobalamin iv 25mg,,,5.18,6.03,27
CPT,J3425,Hydroxocobalamin im 10mcg,,,0.01,0.01,18
CPT,J3430,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,111.28,83.46,1.34,100.15,119
CPT,J3430,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,192.45,144.34,2.31,173.2,238
CPT,J3430,PHYTONADIONE 1 MG/ML CMPD NEO/PED ORAL SOLUTION,26.28,19.71,0.32,23.65,119
CPT,J3430,Vitamin k phytonadione inj,,,2.94,3.19,44
CPT,J3465,Injection voriconazole,,,0.91,1.15,44
CPT,J3465,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,176.05,132.035,1.24,224.1,238
CPT,J3465,VORICONAZOLE 4 MG/ML IN NS IVPB (NEO/PED) CMPD,1479.6,1109.7,17.76,1331.64,119
CPT,J3470,HYALURONIDASE 150 UNIT/ML INJECTION SOLUTION,231.57,173.68,2.78,208.41,119
CPT,J3470,Hyaluronidase injection,,,60.26,60.26,8
CPT,J3471,Ovine up to 999 usp units,,,0.48,0.54,44
CPT,J3472,Ovine 1000 usp units,,,,,0
CPT,J3473,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",231.57,173.68,2.78,208.41,238
CPT,J3473,Hyaluronidase recombinant,,,0.35,0.43,44
CPT,J3475,Inj magnesium sulfate,,,0.55,0.66,44
CPT,J3475,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,77.1,57.82,0.93,69.39,119
CPT,J3475,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,34.5,25.875,0.4,32.4,238
CPT,J3475,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,48.0,36.0,0.58,43.2,119
CPT,J3475,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,15.870000000000001,11.905,0.16,48.92,714
CPT,J3480,Inj potassium chloride,,,0.12,0.14,44
CPT,J3480,POTASSIUM CHLORIDE 0.4 MEQ/ML IN SW IVPB NEO/PED (CENTRAL LINE ONLY) (UW),0.34,0.26,0.01,0.31,119
CPT,J3480,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,13.8,10.35,0.14,126.9,714
CPT,J3480,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),13.8,10.35,0.14,126.9,714
CPT,J3480,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,16.2,12.15,0.19,14.58,119
CPT,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,42.0,31.5,0.5,37.8,238
CPT,J3480,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,66.0,49.5,0.79,59.4,119
CPT,J3480,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,29.400000000000002,22.049999999999997,0.3,30.78,238
CPT,J3485,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,124.1,93.07,1.49,111.69,238
CPT,J3485,Zidovudine,,,1.51,1.77,53
CPT,J3486,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,107.39,80.54,1.29,96.65,238
CPT,J3486,Ziprasidone mesylate,,,8.69,10.15,44
CPT,J3489,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,765.0,573.75,9.18,688.5,119
CPT,J3489,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,245.62,184.22,2.95,221.06,119
CPT,J3489,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1487.5,1115.62,17.85,1338.75,119
CPT,J3489,Zoledronic acid 1mg,,,7.57,11.14,44
CPT,J3490,ARGININE 25 MG/ML-LYSINE 25 MG/ML IN 0.9 % NACL INTRAVENOUS SOLUTION,510.0,382.5,6.12,459.0,119
CPT,J3490,"BUPIVACAINE (PF) 0.125 %(1,250 MCG/ML)IN 0.9% SODIUM CHLORIDE EPIDURAL",118.2,88.65,1.42,106.38,119
CPT,J3490,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,85.2,63.9,0.72,99.36,357
CPT,J3490,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1217.25,912.94,14.61,1095.53,238
CPT,J3490,DOXYCYCLINE 500 MG IN 20 ML NS (25 MG/ML) FOR SCLEROTHERAPY,800.64,600.48,9.61,720.58,119
CPT,J3490,Drugs unclassified injection,,,,,0
CPT,J3490,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,31.85,23.89,0.38,28.67,238
CPT,J3490,EPHEDRINE (PF) 25 MG/5 ML (5 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,155.7,116.78,1.87,140.13,119
CPT,J3490,EPINEPHRINE HCL 50 MCG/5 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,53.88,40.41,0.65,48.49,119
CPT,J3490,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,22.89,17.17,0.2,36.29,714
CPT,J3490,FAT EMULSION 20 % INTRAVENOUS,264.0,198.0,3.17,237.6,119
CPT,J3490,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV DRIP,158.85000000000002,119.14,1.41,179.82,357
CPT,J3490,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,158.85000000000002,119.14,1.41,179.82,238
CPT,J3490,FENTANYL 300 MCG/30 ML (10 MCG/ML) IN D5W IV DRIP NEO/PED,90.0,67.5,1.08,81.0,119
CPT,J3490,FENTANYL(PF) 100 MCG/50 ML (2 MCG/ML)-BUPIV 0.125 % NACL EPIDURAL SYRG,83.51,62.63,1.0,75.16,238
CPT,J3490,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,357
CPT,J3490,HC DESFLURANE ANESTHESIA GAS PER MINUTE,4.39,3.29,0.05,3.95,119
CPT,J3490,HC ISOFLURANE ANESTHESIA GAS PER MINUTE,0.41,0.31,0.01,0.37,119
CPT,J3490,HC SEVOFLURANE ANESTHESIA GAS PER MINUTE,4.39,3.29,0.05,3.95,119
CPT,J3490,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,85.8,64.345,0.88,88.29,238
CPT,J3490,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,91.05,68.285,0.88,211.41,476
CPT,J3490,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,830.0,622.5,9.96,747.0,238
CPT,J3490,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J3490,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,45.0,33.75,0.54,40.5,119
CPT,J3490,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",39.66,29.74,0.48,35.69,119
CPT,J3490,METHADONE 10 MG/ML INTRAVENOUS SYRINGE,96.19,72.14,1.15,86.57,119
CPT,J3490,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,81.54,61.16,0.98,73.39,119
CPT,J3490,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV DRIP,47.4,35.55,0.57,42.66,119
CPT,J3490,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,65.7,49.275,0.57,75.6,238
CPT,J3490,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV DRIP,58.5,43.88,0.7,52.65,119
CPT,J3490,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,58.5,43.88,0.7,52.65,119
CPT,J3490,NOREPINEPHRINE 48 MCG/3 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,2.66,2.0,0.03,2.39,119
CPT,J3490,NOREPINEPHRINE 480 MCG/30 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,26.64,19.98,0.32,23.98,119
CPT,J3490,NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,294.0,220.5,3.53,264.6,119
CPT,J3490,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,78.0,58.5,0.79,81.0,238
CPT,J3490,PHENYLEPHRINE 20 MG/100 ML (0.2 MG/ML) IN NS IV DRIP CMPD,225.0,168.75,2.7,202.5,119
CPT,J3490,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,1349.995,1012.495,14.58,1336.46,357
CPT,J3490,POTASSIUM CHLORIDE 20 MEQ/250 ML (80 MEQ/L) IN NS IV (PERIPHERAL LINE),27.62,20.72,0.33,24.86,119
CPT,J3490,ROCURONIUM 50 MG/5 ML (10 MG/ML) INTRAVENOUS SYRINGE,53.7,40.28,0.64,48.33,119
CPT,J3490,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,118.2,88.65,1.42,106.38,119
CPT,J3490,SODIUM CHLORIDE 0.45 % (UW) IV BOLUS,27.0,20.25,0.32,24.3,119
CPT,J3490,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,0.13,0.09,0.01,0.12,119
CPT,J3490,"SUCCINYLCHOLINE(PF)200 MG/10 ML(20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE",90.0,67.5,1.08,81.0,119
CPT,J3490,"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",356.9,267.67,4.28,321.21,119
CPT,J3490,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,48.0,36.0,0.58,43.2,119
CPT,J3490,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,238
CPT,J3520,Edetate disodium per 150 mg,,,,,0
CPT,J3530,Nasal vaccine inhalation,,,,,0
CPT,J3535,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,176.1,132.075,1.64,194.29,238
CPT,J3535,INV ALBUTEROL SULFATE HFA 90 MCG/ACTUATION INHALER,0.01,0.01,0.01,0.01,119
CPT,J3535,Metered dose inhaler drug,,,,,0
CPT,J3570,Laetrile amygdalin vit b17,,,,,0
CPT,J3590,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,599.61,449.71,7.2,539.65,238
CPT,J3590,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,8187.5,6140.62,98.25,7368.75,119
CPT,J3590,Unclassified biologics,,,,,0
CPT,J3591,Esrd on dialysi drug/bio noc,,,,,0
CPT,J7030,Normal saline solution infus,,,2.64,3.0,44
CPT,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,24.0,18.0,0.18,59.45,1666
CPT,J7030,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),30.0,22.5,0.36,27.0,119
CPT,J7030,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),30.0,22.5,0.36,27.0,119
CPT,J7040,Normal saline solution infus,,,1.32,1.5,44
CPT,J7042,5% dextrose/normal saline,,,1.05,1.34,44
CPT,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE (UW) IV BOLUS,30.0,22.5,0.29,32.4,238
CPT,J7042,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,30.0,22.5,0.29,32.4,238
CPT,J7050,Normal saline solution infus,,,0.66,0.75,44
CPT,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,43.2,32.4,0.52,38.88,119
CPT,J7050,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),25.5,19.12,0.19,29.7,714
CPT,J7050,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),25.5,19.12,0.19,29.7,714
CPT,J7060,5% dextrose/water,,,1.74,2.13,44
CPT,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,40.2,30.15,0.48,36.18,119
CPT,J7060,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,15.75,11.815000000000001,0.18,14.58,238
CPT,J7060,DEXTROSE 5% IN WATER 10 ML FLUSH SYRINGE,0.36,0.27,0.01,0.32,119
CPT,J7070,D5w infusion,,,3.49,4.27,44
CPT,J7070,DEXTROSE 5 % IN WATER (D5W) (UW) IV BOLUS,29.25,21.939999999999998,0.27,32.4,238
CPT,J7070,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,24.75,18.560000000000002,0.27,32.4,476
CPT,J7100,Dextran 40 infusion,,,42.17,42.17,8
CPT,J7110,Dextran 75 infusion,,,,,0
CPT,J7120,LACTATED RINGERS (UW),28.5,21.375,0.32,27.0,357
CPT,J7120,LACTATED RINGERS INTRAVENOUS SOLUTION,28.5,21.375,0.32,27.0,357
CPT,J7120,Ringers lactate infusion,,,2.5,2.83,44
CPT,J7121,5% dextrose in lac ringers,,,8.62,8.62,8
CPT,J7121,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
CPT,J7131,Hypertonic saline sol,,,0.14,0.14,8
CPT,J7131,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,33.0,24.75,0.29,35.1,357
CPT,J7131,SODIUM CHLORIDE 3 % HYPERTONIC IV BOLUS (UW),33.0,24.75,0.29,35.1,357
CPT,J7131,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,79.2,59.4,0.48,83.16,476
CPT,J7165,Inj human-lans per i.u,,,1.55,3.4,27
CPT,J7168,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,238
CPT,J7168,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,238
CPT,J7168,Prothrombin complex kcentra,,,2.09,3.22,27
CPT,J7169,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",6871.25,5153.44,82.46,6184.12,119
CPT,J7169,Inj andexxa 10 mg,,,131.37,152.53,27
CPT,J7170,Inj. emicizumab-kxwh 0.5 mg,,,49.94,65.13,63
CPT,J7171,Inj adzynma 10 iu,,,34.57,41.32,27
CPT,J7172,Inj marstacim-hncq 0.5 mg,,,50.47,59.33,18
CPT,J7173,Inj. concizumab-mtci 0.5 mg,,,85.5,100.32,18
CPT,J7174,Injection fitusiran 0.04 mg,,,132.62,154.7,18
CPT,J7175,Inj factor x (human) 1iu,,,8.61,11.35,63
CPT,J7177,"FIBRINOGEN 1 GRAM (700 MG-1,300 MG) INTRAVENOUS SOLUTION",6.6,4.95,0.08,5.94,119
CPT,J7177,Inj. fibryga 1 mg,,,1.11,1.43,63
CPT,J7178,Inj human fibrinogen con nos,,,1.35,1.76,63
CPT,J7179,Vonvendi inj 1 iu vwf:rco,,,1.8,2.19,63
CPT,J7180,Factor xiii anti-hem factor,,,9.41,12.49,63
CPT,J7181,Factor xiii recomb a-subunit,,,15.99,21.08,63
CPT,J7182,Factor viii recomb novoeight,,,1.08,1.79,63
CPT,J7183,Wilate injection,,,1.19,1.5,63
CPT,J7185,Xyntha inj,,,1.33,1.94,63
CPT,J7186,Antihemophilic viii/vwf comp,,,1.16,1.45,63
CPT,J7187,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,7.01,5.26,0.08,6.31,119
CPT,J7187,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",7.01,5.26,0.08,6.31,119
CPT,J7187,Humate-p inj,,,1.3,1.73,63
CPT,J7188,Factor viii recomb obizur,,,3.2,3.77,63
CPT,J7189,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11.94,8.96,0.14,10.75,119
CPT,J7189,Factor viia recomb novoseven,,,2.35,3.09,63
CPT,J7190,Factor viii,,,1.09,1.37,63
CPT,J7191,Factor viii (porcine),,,0.22,5.46,10
CPT,J7192,Factor viii recombinant nos,,,1.44,1.87,63
CPT,J7193,Factor ix non-recombinant,,,1.23,1.65,63
CPT,J7194,Factor ix complex,,,1.58,1.97,63
CPT,J7195,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
CPT,J7195,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
CPT,J7195,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,7.4,5.55,0.09,6.66,119
CPT,J7195,Factor ix recombinant nos,,,1.64,2.17,63
CPT,J7196,Antithrombin recombinant,,,151.74,151.74,8
CPT,J7197,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,18.95,14.22,0.23,17.06,119
CPT,J7197,Antithrombin iii injection,,,3.17,4.76,63
CPT,J7198,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",11.48,8.61,0.14,10.33,119
CPT,J7198,Anti-inhibitor,,,2.25,2.8,63
CPT,J7199,Hemophilia clot factor noc,,,,,0
CPT,J7200,Factor ix recombinan rixubis,,,1.63,1.96,53
CPT,J7201,Factor ix alprolix recomb,,,3.37,4.2,63
CPT,J7202,Factor ix idelvion inj,,,4.77,6.18,63
CPT,J7203,Factor ix recomb gly rebinyn,,,4.13,5.34,63
CPT,J7204,Inj recombin esperoct per iu,,,2.04,2.58,63
CPT,J7205,Factor viii fc fusion recomb,,,2.13,2.82,63
CPT,J7207,Factor viii pegylated recomb,,,2.02,2.45,63
CPT,J7208,Inj. jivi 1 iu,,,2.17,3.08,63
CPT,J7209,Factor viii nuwiq recomb 1iu,,,1.12,1.46,63
CPT,J7210,Inj afstyla 1 i.u.,,,1.42,1.82,63
CPT,J7211,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 1,000 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
CPT,J7211,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 500 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
CPT,J7211,Inj kovaltry 1 i.u.,,,1.34,1.82,63
CPT,J7212,Factor viia recomb sevenfact,,,1.93,2.69,53
CPT,J7213,Inj ixinity 1 i.u.,,,1.91,2.22,27
CPT,J7214,Altuviiio per factor viii iu,,,4.61,5.49,27
CPT,J7294,Seg acet and eth estr yearly,,,2614.19,2614.19,8
CPT,J7295,Eth estr and eton monthly,,,166.86,166.86,8
CPT,J7296,Kyleena 19.5 mg,,,1110.52,1110.52,8
CPT,J7296,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
CPT,J7297,Liletta 52 mg,,,851.86,851.86,8
CPT,J7298,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
CPT,J7298,Mirena 52 mg,,,1110.52,1110.52,8
CPT,J7300,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,4202.91,3152.18,50.43,3782.62,119
CPT,J7300,Intra copp contra (paragard),,,1095.85,1095.85,8
CPT,J7301,LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,3840.0,2880.0,46.08,3456.0,119
CPT,J7301,Skyla 13.5 mg,,,924.69,924.69,8
CPT,J7304,Contraceptive hormone patch,,,45.81,45.81,8
CPT,J7306,Levonorgestrel implant sys,,,,,0
CPT,J7307,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,4481.98,3361.49,53.78,4033.78,119
CPT,J7307,Etonogestrel implant system,,,1179.41,1179.41,8
CPT,J7308,Aminolevulinic acid hcl top,,,389.83,464.38,63
CPT,J7309,Methyl aminolevulinate  top,,,,,0
CPT,J7310,Ganciclovir long act implant,,,13.92,13.92,1
CPT,J7311,Inj. retisert 0.01 mg,,,333.23,395.1,63
CPT,J7312,Dexamethasone intra implant,,,199.97,240.54,63
CPT,J7313,Inj. iluvien 0.01 mg,,,490.94,579.51,63
CPT,J7314,Inj. yutiq 0.01 mg,,,523.53,617.63,63
CPT,J7315,Ophthalmic mitomycin,,,464.4,464.4,8
CPT,J7316,Inj ocriplasmin 0.125 mg,,,,,0
CPT,J7318,Inj durolane 1 mg,,,6.52,8.19,63
CPT,J7320,Genvisc 850 inj 1mg,,,4.76,8.08,63
CPT,J7321,Hyalgan supartz visco-3 dose,,,78.68,85.66,44
CPT,J7322,Hyaluronan hymo or hymo one,,,16.64,20.46,63
CPT,J7323,Euflexxa inj per dose,,,105.46,141.91,63
CPT,J7324,Orthovisc inj per dose,,,92.14,143.79,63
CPT,J7325,Synvisc or synvisc-one,,,7.56,10.71,63
CPT,J7326,Gel-one,,,517.39,625.24,63
CPT,J7327,Monovisc inj per dose,,,564.65,799.17,63
CPT,J7328,Gelsyn-3 injection 0.1 mg,,,0.67,0.91,53
CPT,J7329,Inj trivisc 1 mg,,,3.61,9.37,63
CPT,J7330,Cultured chondrocytes implnt,,,65518.2,65518.2,8
CPT,J7331,Synojoynt inj. 1 mg,,,11.2,11.2,8
CPT,J7332,Inj. triluron 1 mg,,,9.8,12.11,63
CPT,J7336,Capsaicin 8% patch,,,3.23,3.97,63
CPT,J7340,Carbidopa levodopa ent 100ml,,,219.38,282.83,63
CPT,J7342,Ciprofloxacin otic susp 6 mg,,,30.0,30.58,44
CPT,J7345,Aminolevulinic acid 10% gel,,,1.65,2.08,63
CPT,J7351,Inj bimatoprost itc imp1mcg,,,206.14,248.27,63
CPT,J7352,Afamelanotide implant 1 mg,,,2873.33,3417.31,27
CPT,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,56.99,67.7,27
CPT,J7354,Cantharidin top applicator,,,654.76,832.62,27
CPT,J7355,Inj travoprost intra impl,,,195.72,227.23,27
CPT,J7402,Mometasone sinus sinuva,,,11.34,13.27,63
CPT,J7500,AZATHIOPRINE 50 MG TABLET,4.06,3.04,0.05,3.65,119
CPT,J7500,Azathioprine oral 50mg,,,1.89,11.84,44
CPT,J7501,Azathioprine parenteral,,,228.97,294.98,27
CPT,J7502,CYCLOSPORINE MODIFIED 100 MG CAPSULE (GENGRAF),44.08,33.06,0.53,39.67,119
CPT,J7502,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1414.8,1061.1,16.98,1273.32,119
CPT,J7502,Cyclosporine oral 100 mg,,,2.1,2.79,44
CPT,J7503,"TACROLIMUS XR 0.75 MG TABLET,EXTENDED RELEASE 24 HR",31.28,23.46,0.38,28.15,119
CPT,J7503,Tacrol envarsus ex rel oral,,,1.61,2.07,44
CPT,J7504,Lymphocyte immune globulin,,,3002.82,5961.84,63
CPT,J7505,Monoclonal antibodies,,,,,0
CPT,J7507,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",4.535,3.4,0.03,5.67,238
CPT,J7507,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",21.55,16.16,0.26,19.4,119
CPT,J7507,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",6.2,4.654999999999999,0.07,6.21,238
CPT,J7507,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",43.1,32.33,0.52,38.79,119
CPT,J7507,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",27.02,20.27,0.07,48.6,357
CPT,J7507,Tacrolimus imme rel oral 1mg,,,0.3,0.3,44
CPT,J7508,"TACROLIMUS XR 1 MG TABLET,EXTENDED RELEASE 24 HR",41.71,31.28,0.5,37.54,119
CPT,J7508,"TACROLIMUS XR 4 MG TABLET,EXTENDED RELEASE 24 HR",125.14,93.85,1.5,112.63,119
CPT,J7508,Tacrol astagraf ex rel oral,,,0.52,0.66,44
CPT,J7509,METHYLPREDNISOLONE 4 MG TABLET,2.47,1.85,0.03,2.22,119
CPT,J7509,Methylprednisolone oral,,,0.25,0.29,44
CPT,J7510,PREDNISOLONE 5 MG TABLET,60.0,45.0,0.72,54.0,119
CPT,J7510,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION (REPACKAGING),238.9,179.17,2.87,215.01,119
CPT,J7510,Prednisolone oral per 5 mg,,,0.23,0.45,44
CPT,J7511,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,3076.86,2307.65,36.92,2769.17,119
CPT,J7511,Antithymocyte globuln rabbit,,,888.99,1160.27,63
CPT,J7512,PREDNISONE 1 MG TABLET,0.6,0.45,0.01,0.54,119
CPT,J7512,PREDNISONE 10 MG TABLET,0.93,0.7,0.01,0.84,119
CPT,J7512,PREDNISONE 2.5 MG TABLET,0.73,0.55,0.01,0.66,119
CPT,J7512,PREDNISONE 20 MG TABLET,1.1,0.825,0.01,1.07,238
CPT,J7512,PREDNISONE 5 MG TABLET,1.01,0.76,0.01,0.91,119
CPT,J7512,PREDNISONE 50 MG TABLET,1.81,1.35,0.02,1.63,119
CPT,J7512,Prednisone ir or dr oral 1mg,,,0.01,0.01,44
CPT,J7513,Daclizumab  parenteral,,,,,0
CPT,J7515,CYCLOSPORINE MODIFIED 25 MG CAPSULE (GENGRAF),11.03,8.28,0.13,9.93,119
CPT,J7515,CYCLOSPORINE MODIFIED 25 MG CAPSULE (NEORAL),16.07,12.05,0.19,14.46,119
CPT,J7515,Cyclosporine oral 25 mg,,,0.7,0.99,44
CPT,J7516,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION (SANDIMMUNE),307.87,230.89999999999998,3.69,277.1,238
CPT,J7516,Inj cyclosporine 250mg,,,50.11,73.88,44
CPT,J7517,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,2714.88,2036.16,0.25,7456.32,833
CPT,J7517,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,1.19,0.89,0.01,1.07,119
CPT,J7517,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.6,4.95,0.08,5.94,119
CPT,J7517,Mycophenolate mofetil oral,,,0.2,0.21,44
CPT,J7518,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",22.35,16.76,0.27,20.12,119
CPT,J7518,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",45.65,34.24,0.55,41.08,119
CPT,J7518,Mycophenolic acid,,,0.52,0.77,44
CPT,J7519,Inj. mycophenolate mofetil,,,0.61,0.61,8
CPT,J7519,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,220.94,165.71,2.65,198.85,238
CPT,J7520,SIROLIMUS 0.5 MG TABLET,34.82,26.11,0.42,31.34,119
CPT,J7520,SIROLIMUS 1 MG TABLET,45.01,33.75,0.54,40.51,119
CPT,J7520,SIROLIMUS 1 MG/ML ORAL SOLUTION,3570.12,2677.59,42.84,3213.11,119
CPT,J7520,Sirolimus oral,,,1.55,3.14,44
CPT,J7521,TACROLIMUS 1 MG/ML ORAL SUSPENSION COMPOUND,27.02,20.27,0.32,24.32,238
CPT,J7525,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,704.67,528.5,8.46,634.2,119
CPT,J7525,Tacrolimus injection,,,233.75,305.52,63
CPT,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,44.51,33.39,0.53,40.06,119
CPT,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,50.0,37.5,0.6,45.0,119
CPT,J7527,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,60.0,45.0,0.72,54.0,238
CPT,J7527,Oral everolimus,,,2.58,3.59,44
CPT,J7599,Immunosuppressive drug noc,,,,,0
CPT,J7604,Acetylcysteine comp unit,,,,,0
CPT,J7605,Arformoterol non-comp unit,,,0.8,3.17,44
CPT,J7606,Formoterol fumarate inh,,,2.79,6.46,44
CPT,J7607,Levalbuterol comp con,,,,,0
CPT,J7608,Acetylcysteine non-comp unit,,,6.88,9.09,44
CPT,J7609,Albuterol comp unit,,,0.2,0.2,8
CPT,J7610,Albuterol comp con,,,,,0
CPT,J7611,Albuterol non-comp con,,,0.18,0.21,44
CPT,J7612,Levalbuterol non-comp con,,,0.22,0.27,44
CPT,J7613,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,1.8,1.35,0.02,1.62,119
CPT,J7613,Albuterol non-comp unit,,,0.03,0.08,44
CPT,J7614,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,9.59,7.2,0.12,8.63,238
CPT,J7614,Levalbuterol non-comp unit,,,0.05,0.09,44
CPT,J7615,Levalbuterol comp unit,,,,,0
CPT,J7620,Albuterol ipratrop non-comp,,,0.12,0.22,44
CPT,J7620,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,3.89,2.92,0.05,3.5,238
CPT,J7622,Beclomethasone comp unit,,,,,0
CPT,J7624,Betamethasone comp unit,,,,,0
CPT,J7626,Budesonide non-comp unit,,,0.86,1.44,44
CPT,J7627,Budesonide comp unit,,,,,0
CPT,J7628,Bitolterol mesylate comp con,,,,,0
CPT,J7629,Bitolterol mesylate comp unt,,,,,0
CPT,J7631,Cromolyn sodium noncomp unit,,,0.51,1.64,44
CPT,J7632,Cromolyn sodium comp unit,,,,,0
CPT,J7633,Budesonide non-comp con,,,,,0
CPT,J7634,Budesonide comp con,,,,,0
CPT,J7635,Atropine comp con,,,,,0
CPT,J7636,Atropine comp unit,,,,,0
CPT,J7637,Dexamethasone comp con,,,,,0
CPT,J7638,Dexamethasone comp unit,,,,,0
CPT,J7639,Dornase alfa non-comp unit,,,50.12,62.56,44
CPT,J7640,Formoterol comp unit,,,,,0
CPT,J7641,Flunisolide comp unit,,,,,0
CPT,J7642,Glycopyrrolate comp con,,,,,0
CPT,J7643,Glycopyrrolate comp unit,,,,,0
CPT,J7644,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,2.4,1.8,0.03,2.16,119
CPT,J7644,Ipratropium bromide non-comp,,,0.22,0.43,44
CPT,J7645,Ipratropium bromide comp,,,,,0
CPT,J7647,Isoetharine comp con,,,,,0
CPT,J7648,Isoetharine non-comp con,,,,,0
CPT,J7649,Isoetharine non-comp unit,,,,,0
CPT,J7650,Isoetharine comp unit,,,,,0
CPT,J7657,Isoproterenol comp con,,,,,0
CPT,J7658,Isoproterenol non-comp con,,,,,0
CPT,J7659,Isoproterenol non-comp unit,,,,,0
CPT,J7660,Isoproterenol comp unit,,,,,0
CPT,J7665,Mannitol for inhaler,,,1.06,1.06,8
CPT,J7667,Metaproterenol comp con,,,,,0
CPT,J7668,Metaproterenol non-comp con,,,,,0
CPT,J7669,Metaproterenol non-comp unit,,,,,0
CPT,J7670,Metaproterenol comp unit,,,,,0
CPT,J7674,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,344.45,258.34,4.13,310.0,238
CPT,J7674,Methacholine chloride neb,,,0.68,1.82,44
CPT,J7676,Pentamidine comp unit dose,,,,,0
CPT,J7677,Revefenacin inh non-com 1mcg,,,0.18,0.22,44
CPT,J7680,Terbutaline sulf comp con,,,,,0
CPT,J7681,Terbutaline sulf comp unit,,,,,0
CPT,J7682,Tobramycin non-comp unit,,,18.66,29.17,44
CPT,J7683,Triamcinolone comp con,,,,,0
CPT,J7684,Triamcinolone comp unit,,,,,0
CPT,J7685,Tobramycin comp unit,,,,,0
CPT,J7686,Treprostinil non-comp unit,,,704.65,889.33,44
CPT,J7699,Inhalation solution for dme,,,,,0
CPT,J7699,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,12.0,9.0,0.14,10.8,238
CPT,J7799,Non-inhalation drug for dme,,,,,0
CPT,J7999,Compounded drug noc,,,,,0
CPT,J7999,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,40.08,30.06,0.43,40.12,238
CPT,J7999,FENTANYL (PF) 2 MCG/ML NEONATAL IV SYRINGE,0.41,0.31,0.01,0.37,119
CPT,J7999,"HEPARIN (PORCINE) 15,000 UNIT/500 ML IN 0.9% SODIUM CHLORIDE",33.0,24.75,0.4,29.7,119
CPT,J7999,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,62.25,46.685,0.61,66.15,238
CPT,J7999,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,62.25,46.685,0.61,66.15,238
CPT,J7999,METHOHEXITAL 100 MG/10 ML (10 MG/ML) IN STERILE WATER (PF)  IV SYRINGE,139.5,104.62,1.67,125.55,119
CPT,J7999,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,285.0,213.75,3.42,256.5,119
CPT,J7999,VANCOMYCIN 750 MG/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,66.0,49.5,0.79,59.4,119
CPT,J8498,Antiemetic rectal/supp nos,,,,,0
CPT,J8499,MIDAZOLAM 2 MG/ML ORAL SYRUP,33.06,24.8,0.4,29.75,119
CPT,J8499,Oral prescrip drug non chemo,,,,,0
CPT,J8499,TERAZOSIN 10 MG CAPSULE,1.08,0.81,0.01,0.97,119
CPT,J8501,APREPITANT 40 MG CAPSULE,364.985,273.74,4.38,328.49,238
CPT,J8501,Oral aprepitant,,,3.23,3.83,44
CPT,J8510,Oral busulfan,,,10.12,311.9,27
CPT,J8515,CABERGOLINE 0.5 MG TABLET,12.19,9.14,0.15,10.97,119
CPT,J8515,Cabergoline oral 0.25mg,,,16.5,16.5,8
CPT,J8520,Capecitabine- oral- 150 mg,,,0.59,0.59,36
CPT,J8521,Capecitabine- oral- 500 mg,,,1.39,1.39,36
CPT,J8522,CAPECITABINE 500 MG TABLET,3.0,2.25,0.04,2.7,119
CPT,J8522,Capecitabine oral 50 mg,,,0.04,0.07,27
CPT,J8530,CYCLOPHOSPHAMIDE 25 MG CAPSULE,10.1,7.58,0.12,9.09,119
CPT,J8530,CYCLOPHOSPHAMIDE 50 MG CAPSULE,17.57,13.18,0.21,15.81,119
CPT,J8530,Cyclophosphamide oral 25 mg,,,0.67,1.03,44
CPT,J8540,DEXAMETHASONE 0.5 MG TABLET,0.69,0.52,0.01,0.62,119
CPT,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR,264.49,198.37,3.17,238.04,119
CPT,J8540,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,305.28,228.96,3.66,274.75,119
CPT,J8540,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),143.1,107.32,1.72,128.79,119
CPT,J8540,DEXAMETHASONE 2 MG TABLET,3.71,2.78,0.04,3.34,119
CPT,J8540,DEXAMETHASONE 4 MG TABLET,6.02,4.52,0.07,5.42,119
CPT,J8540,Oral dexamethasone,,,0.05,0.1,44
CPT,J8541,Oral hemady 0.25 mg,,,0.37,0.37,8
CPT,J8560,Etoposide oral 50 mg,,,76.4,89.68,53
CPT,J8562,Oral fludarabine phosphate,,,,,0
CPT,J8565,Gefitinib oral,,,257.27,257.27,8
CPT,J8597,Antiemetic drug oral nos,,,,,0
CPT,J8600,Melphalan oral 2 mg,,,10.99,10.99,8
CPT,J8610,METHOTREXATE SODIUM 2.5 MG TABLET,4.24,3.18,0.05,3.82,119
CPT,J8610,Methotrexate oral 2.5 mg,,,0.22,0.26,44
CPT,J8611,Oral methotrexate (jylamvo),,,18.47,21.44,27
CPT,J8612,Oral methotrexate (xatmep),,,20.65,26.33,27
CPT,J8650,Nabilone oral,,,45.41,45.41,1
CPT,J8655,Oral netupitant palonosetro,,,380.19,490.98,63
CPT,J8670,Rolapitant oral 1mg,,,1.62,2.16,63
CPT,J8700,TEMOZOLOMIDE 100 MG CAPSULE,112.44,84.33,1.35,101.2,119
CPT,J8700,TEMOZOLOMIDE 20 MG CAPSULE,36.78,27.58,0.44,33.1,119
CPT,J8700,Temozolomide,,,0.21,0.31,44
CPT,J8705,Topotecan oral,,,104.36,146.06,53
CPT,J8999,Oral prescription drug chemo,,,,,0
CPT,J9000,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,566.52,424.89,6.78,535.5,357
CPT,J9000,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,748.58,561.44,8.98,673.72,119
CPT,J9000,Doxorubicin hcl injection,,,2.39,3.86,44
CPT,J9011,Datopotamab deruxtecan 1 mg,,,51.55,59.86,18
CPT,J9015,Aldesleukin injection,,,3338.87,6154.76,27
CPT,J9017,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,476
CPT,J9017,ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLUTION,3657.0,2742.75,43.88,3291.3,238
CPT,J9017,Arsenic trioxide injection,,,4.68,15.9,54
CPT,J9019,Erwinaze injection,,,,,0
CPT,J9020,Asparaginase  nos,,,,,0
CPT,J9021,Inj aspara rylaze 0.1 mg,,,48.08,64.4,63
CPT,J9022,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",32022.68,24017.01,384.27,28820.41,119
CPT,J9022,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,22415.88,16811.91,268.99,20174.29,119
CPT,J9022,Inj atezolizumab10 mg,,,80.79,106.05,63
CPT,J9023,Injection avelumab 10 mg,,,89.33,116.2,63
CPT,J9024,Inj atezolizumb 5mg hya-tqjs,,,31.58,36.66,18
CPT,J9025,AZACITIDINE 100 MG SOLUTION FOR INJECTION,147.38,110.53,1.77,132.64,119
CPT,J9025,Azacitidine injection,,,0.37,0.45,44
CPT,J9026,Inj tarlatamab-dlle 1 mg,,,1564.64,1816.55,19
CPT,J9027,Clofarabine injection,,,4.19,38.01,63
CPT,J9028,Inj nogapendekin pmln 1mcg,,,94.66,109.9,19
CPT,J9029,Instill adstiladrin tx dose,,,63342.28,74113.13,27
CPT,J9030,Bcg live intravesical 1mg,,,2.86,3.5,53
CPT,J9032,Injection belinostat 10mg,,,46.15,60.92,63
CPT,J9033,Inj bendamustine hcl 1mg,,,1.8,14.82,63
CPT,J9034,Inj. bendeka 1 mg,,,12.83,16.8,63
CPT,J9035,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,6071.6900000000005,4553.765,29.14,8743.23,238
CPT,J9035,Bevacizumab injection,,,70.75,85.05,63
CPT,J9036,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,7392.46,5544.35,88.71,6653.21,119
CPT,J9036,Inj. belrapzo/bendamustine,,,12.28,28.08,63
CPT,J9037,Inj belantamab mafodot blmf,,,41.73,47.66,45
CPT,J9038,Inj axatilimab-csfr 0.1 mg,,,55.65,64.61,18
CPT,J9039,Injection blinatumomab,,,135.61,190.69,63
CPT,J9040,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,124.00999999999999,93.005,1.01,147.38,238
CPT,J9040,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,244.275,183.20499999999998,2.44,256.78,238
CPT,J9040,Bleomycin sulfate injection,,,25.24,28.88,44
CPT,J9041,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,131.0,98.25,1.38,123.8,357
CPT,J9041,BORTEZOMIB 3.5 MG SOLUTION FOR SUBCUTANEOUS INJECTION (UW),126.08500000000001,94.565,1.38,123.8,238
CPT,J9041,Injection bortezomib 0.1mg,,,1.84,9.01,44
CPT,J9042,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,27584.2,20688.15,331.01,24825.78,119
CPT,J9042,Brentuximab vedotin inj,,,213.65,300.28,63
CPT,J9043,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,36945.01,27708.76,443.34,33250.51,119
CPT,J9043,Cabazitaxel injection,,,199.2,263.87,63
CPT,J9045,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,201.195,150.89499999999998,1.07,226.29,714
CPT,J9045,Carboplatin injection,,,2.48,3.98,44
CPT,J9046,Inj bortezomib dr. reddys,,,3.46,49.46,63
CPT,J9047,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,1553.52,1165.14,18.64,1398.17,119
CPT,J9047,CARFILZOMIB 30 MG INTRAVENOUS SOLUTION,4500.92,3375.69,54.01,4050.83,119
CPT,J9047,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,9001.83,6751.37,108.02,8101.65,119
CPT,J9047,Injection carfilzomib 1 mg,,,45.06,64.61,63
CPT,J9048,Inj bortezomib freseniuskab,,,2.67,49.46,63
CPT,J9049,Inj bortezomib hospira,,,1.75,7.13,44
CPT,J9050,Carmustine injection,,,232.62,387.06,63
CPT,J9051,Inj bortezomib (maia),,,3.7,3.7,8
CPT,J9052,Inj carmustine (accord),,,0.05,2029.51,18
CPT,J9054,Inj bortezomib boruzu 0.1 mg,,,25.63,30.36,18
CPT,J9055,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,2659.79,1994.84,31.92,2393.81,119
CPT,J9055,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,5319.58,3989.69,63.83,4787.62,119
CPT,J9055,Cetuximab injection,,,70.35,90.99,63
CPT,J9056,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,7040.44,5280.33,84.49,6336.4,119
CPT,J9056,Inj vivimusta 1 mg,,,28.65,34.66,27
CPT,J9057,Inj. copanlisib 1 mg,,,89.16,94.56,9
CPT,J9058,Inj apotex/bendamustine 1 mg,,,17.8,17.8,8
CPT,J9059,Inj bendamustine- baxter 1mg,,,17.8,17.8,8
CPT,J9060,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,128.35,96.265,1.05,157.59,476
CPT,J9060,Cisplatin 10 mg injection,,,1.69,2.77,44
CPT,J9061,AMIVANTAMAB-VMJW 50 MG/ML INTRAVENOUS SOLUTION,10377.51,7783.13,124.53,9339.76,119
CPT,J9061,Inj amivantamab-vmjw,,,19.0,26.17,63
CPT,J9063,Inj elahere 1 mg,,,68.11,80.68,27
CPT,J9064,Inj cabazitaxel (sandoz),,,,,0
CPT,J9065,Inj cladribine per 1 mg,,,7.42,23.03,63
CPT,J9070,Cyclophosphamide 100 mg inj,,,22.13,22.13,36
CPT,J9071,Inj cyclophosphamd auromedic,,,0.61,3.57,63
CPT,J9072,Inj cyclophos frindovyx 5 mg,,,8.99,10.58,26
CPT,J9073,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,4464.59,3348.44,53.58,4018.13,119
CPT,J9073,Inj cyclophos dr reddys 5 mg,,,0.7,2.19,27
CPT,J9074,Inj cyclophosphamd sandoz,,,3.84,4.73,27
CPT,J9075,Inj cyclophosphamide nos,,,0.48,1.18,27
CPT,J9076,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,1637.5,1228.12,19.65,1473.75,119
CPT,J9076,Inj cyclophos (baxter) 5mg,,,4.92,5.82,18
CPT,J9098,Cytarabine liposome inj,,,,,0
CPT,J9100,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,26.97,20.23,0.32,24.27,238
CPT,J9100,Cytarabine hcl 100 mg inj,,,0.9,1.02,44
CPT,J9118,Inj. calaspargase pegol-mknl,,,70.76,95.29,62
CPT,J9119,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,29152.67,21864.5,349.83,26237.4,119
CPT,J9119,Inj. cemiplimab-rwlc 1 mg,,,27.23,34.01,63
CPT,J9120,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,1423.0,1067.25,17.08,1280.7,119
CPT,J9120,Dactinomycin injection,,,307.99,604.79,63
CPT,J9130,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,238
CPT,J9130,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,238
CPT,J9130,Dacarbazine 100 mg inj,,,4.23,4.99,44
CPT,J9144,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",28524.39,21393.29,342.29,25671.95,119
CPT,J9144,Daratumumab hyaluronidase,,,46.78,64.52,63
CPT,J9145,Injection daratumumab 10 mg,,,58.92,82.86,63
CPT,J9150,Daunorubicin injection,,,21.7,41.64,54
CPT,J9151,Daunorubicin citrate inj,,,,,0
CPT,J9153,INV DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J9153,Inj daunorubicin cytarabine,,,219.05,297.32,63
CPT,J9155,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,2168.91,1626.68,26.03,1952.02,119
CPT,J9155,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1390.13,1042.6,16.68,1251.12,119
CPT,J9155,Degarelix injection,,,4.12,5.17,63
CPT,J9165,Diethylstilbestrol injection,,,,,0
CPT,J9171,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,524.0,393.0,6.29,471.6,238
CPT,J9171,Docetaxel injection,,,0.57,0.93,44
CPT,J9172,Docetaxel (docivyx) 1 mg,,,49.76,58.96,19
CPT,J9173,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,11982.94,8987.21,143.8,10784.65,119
CPT,J9173,Inj. durvalumab 10 mg,,,78.9,98.82,63
CPT,J9174,Inj docetaxel (beizray) 1mg,,,47.44,60.92,18
CPT,J9175,Elliotts b solution per ml,,,11.02,11.02,8
CPT,J9176,Injection elotuzumab 1mg,,,7.06,9.16,63
CPT,J9177,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,7720.54,5790.4,92.65,6948.49,119
CPT,J9177,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,11580.8,8685.6,138.97,10422.72,119
CPT,J9177,Inj enfort vedo-ejfv 0.25mg,,,32.57,42.98,63
CPT,J9178,Inj epirubicin hcl 2 mg,,,1.35,1.9,44
CPT,J9179,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,4012.86,3009.64,48.15,3611.57,119
CPT,J9179,Eribulin mesylate injection,,,72.61,158.84,63
CPT,J9181,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,264.35,198.26,3.17,237.92,119
CPT,J9181,Etoposide injection,,,0.89,1.61,44
CPT,J9184,Inj gemcitabin (avyxa) 200mg,,,401.7,401.7,9
CPT,J9185,Fludarabine phosphate inj,,,68.2,168.3,54
CPT,J9190,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,29.07,21.8,0.35,26.16,238
CPT,J9190,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,94.24,70.685,0.75,113.6,238
CPT,J9190,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,124.52,93.39,1.49,112.07,119
CPT,J9190,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,21.295,15.969999999999999,0.17,25.24,476
CPT,J9190,Fluorouracil injection,,,2.51,2.8,44
CPT,J9196,Inj gemcitabine hcl (accord),,,9.97,9.97,8
CPT,J9198,Inj. infugem 100 mg,,,27.29,41.04,44
CPT,J9200,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,10356.43,7767.32,124.28,9320.79,119
CPT,J9200,Floxuridine injection,,,2890.16,4792.63,63
CPT,J9201,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,163.75,122.81,1.96,147.38,119
CPT,J9201,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,128.655,96.49000000000001,1.12,147.38,238
CPT,J9201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,580.675,435.505,2.27,875.01,238
CPT,J9201,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,35.769999999999996,26.825,0.38,35.69,238
CPT,J9201,In gemcitabine hcl nos 200mg,,,3.27,3.5,44
CPT,J9202,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,8025.68,6019.26,96.31,7223.11,119
CPT,J9202,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,2889.77,2167.33,34.68,2600.79,119
CPT,J9202,Goserelin acetate implant,,,567.92,851.79,63
CPT,J9203,Gemtuzumab ozogamicin 0.1 mg,,,217.43,274.72,63
CPT,J9204,Inj mogamulizumab-kpkc 1 mg,,,217.57,288.51,63
CPT,J9205,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,8270.48,6202.86,99.25,7443.43,119
CPT,J9205,Inj irinotecan liposome 1 mg,,,60.06,76.63,63
CPT,J9206,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,85.785,64.34,0.76,97.04,238
CPT,J9206,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,62.18,46.635000000000005,0.74,56.3,238
CPT,J9206,Irinotecan injection,,,2.42,2.92,44
CPT,J9207,Ixabepilone injection,,,118.64,161.62,63
CPT,J9208,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,120.32,90.24,1.44,108.29,119
CPT,J9208,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,327.73,245.8,3.93,294.96,119
CPT,J9208,Ifosfamide injection,,,25.65,29.16,44
CPT,J9209,MESNA 100 MG/ML INTRAVENOUS SOLUTION,106.25,79.69,1.28,95.62,238
CPT,J9209,Mesna injection,,,1.71,2.21,44
CPT,J9210,Inj. emapalumab-lzsg 1 mg,,,376.57,446.81,63
CPT,J9211,Idarubicin hcl injection,,,40.43,54.64,44
CPT,J9212,Interferon alfacon-1 inj,,,,,0
CPT,J9213,Interferon alfa-2a inj,,,,,0
CPT,J9214,Interferon alfa-2b inj,,,32.57,33.19,44
CPT,J9215,Interferon alfa-n3 inj,,,32.53,32.53,8
CPT,J9216,Interferon gamma 1-b inj,,,8793.47,8793.47,8
CPT,J9217,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,22089.72,16567.29,265.08,19880.75,119
CPT,J9217,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,5899.13,4424.35,70.79,5309.22,119
CPT,J9217,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,29117.14,21837.85,349.41,26205.43,119
CPT,J9217,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,16567.24,12425.43,198.81,14910.52,119
CPT,J9217,Leuprolide acetate suspnsion,,,170.78,206.48,63
CPT,J9218,Leuprolide acetate injeciton,,,10.77,12.59,44
CPT,J9219,Leuprolide acetate implant,,,200.31,200.31,1
CPT,J9220,Indigotindisulfonate sod 1mg,,,9.3,11.56,18
CPT,J9223,Inj. lurbinectedin 0.1 mg,,,185.98,240.48,63
CPT,J9223,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,20661.19,15495.89,247.93,18595.07,119
CPT,J9225,Vantas implant,,,5263.77,5263.77,8
CPT,J9226,Supprelin la implant,,,43185.34,53051.2,63
CPT,J9227,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,7706.62,5779.96,30.83,11559.94,238
CPT,J9227,Inj. isatuximab-irfc 10 mg,,,71.94,95.09,63
CPT,J9228,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,25264.51,18948.38,303.17,22738.06,119
CPT,J9228,Ipilimumab injection,,,165.76,213.02,63
CPT,J9229,Inj inotuzumab ozogam 0.1 mg,,,2477.62,3132.44,63
CPT,J9230,Mechlorethamine hcl inj,,,,,0
CPT,J9245,Inj melpha hydroch nos 50 mg,,,86.94,220.66,63
CPT,J9246,Inj. evomela 1 mg,,,16.04,21.48,63
CPT,J9247,Inj- melphalan flufenami 1mg,,,513.0,513.0,8
CPT,J9248,Inj melphalan (hepzato) 1 mg,,,773.8,923.0,27
CPT,J9249,Inj melphalan (apotex) 1 mg,,,64.78,75.21,18
CPT,J9250,Methotrexate sodium inj,,,0.21,0.21,36
CPT,J9255,Inj methotrexate (accord),,,,,0
CPT,J9256,Inj nipocalimab-aahu 3 mg,,,32.74,32.74,9
CPT,J9259,Paclitaxel (american regent),,,17.3,17.3,8
CPT,J9260,Inj methotrexate sodium 50mg,,,2.19,3.19,44
CPT,J9260,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,85.17,63.875,0.17,140.45,357
CPT,J9260,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,476
CPT,J9261,Nelarabine injection,,,65.16,135.28,63
CPT,J9262,Inj omacetaxine mep 0.01mg,,,3.64,4.1,45
CPT,J9263,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,127.5,95.625,1.02,153.0,238
CPT,J9263,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,85.0,63.75,1.02,76.5,119
CPT,J9263,Oxaliplatin,,,0.07,0.07,44
CPT,J9264,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,4504.71,3378.53,54.06,4054.24,119
CPT,J9264,Paclitaxel protein bound,,,8.18,15.24,63
CPT,J9266,Pegaspargase injection,,,23577.0,33000.33,63
CPT,J9267,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",311.20500000000004,233.405,3.06,330.67,238
CPT,J9267,Paclitaxel injection,,,0.11,0.12,44
CPT,J9268,Pentostatin injection,,,2320.11,3028.07,63
CPT,J9269,Inj. tagraxofusp-erzs 10 mcg,,,319.98,414.4,63
CPT,J9270,Plicamycin (mithramycin) inj,,,,,0
CPT,J9271,Inj pembrolizumab,,,53.91,70.0,63
CPT,J9271,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,15892.05,11919.04,190.7,14302.84,119
CPT,J9272,DOSTARLIMAB-GXLY 50 MG/ML INTRAVENOUS SOLUTION,32416.85,24312.64,389.0,29175.16,119
CPT,J9272,Inj dostarlimab-gxly 10 mg,,,223.96,282.95,63
CPT,J9273,Inj tisotu vedotin-tftv 1mg,,,155.99,219.15,63
CPT,J9273,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,18327.48,13745.61,219.93,16494.73,119
CPT,J9274,Inj tebentafusp-tebn 1 mcg,,,198.85,252.04,63
CPT,J9275,Inj cosibelimab-ipdl 2 mg,,,22.92,22.92,9
CPT,J9276,Inj zanidatamab-hrii 2 mg,,,25.0,29.08,18
CPT,J9280,MITOMYCIN 0.02% (0.1 MG/0.5 ML) OPHTHALMIC SOLUTION COMPOUNDED,148.26,111.2,1.78,133.43,119
CPT,J9280,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,1798.67,1349.0,21.58,1618.8,119
CPT,J9280,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,692.35,519.26,8.31,623.12,119
CPT,J9280,Mitomycin injection,,,20.35,49.72,63
CPT,J9281,Mitomycin instillation,,,290.3,369.81,63
CPT,J9282,Mitomycin intravesical inst,,,276.81,276.81,9
CPT,J9285,Inj olaratumab 10 mg,,,,,0
CPT,J9286,Inj glofitamab gxbm 2.5 mg,,,2767.88,3213.51,27
CPT,J9289,Inj nivolumab 2 mg hyaluron,,,27.36,31.76,18
CPT,J9292,Inj pemetrexed dipotassium,,,81.23,95.6,18
CPT,J9293,Mitoxantrone hydrochl / 5 mg,,,23.88,63.93,63
CPT,J9294,Inj pemetrexed hospira 10mg,,,0.72,4.19,27
CPT,J9295,Injection necitumumab 1 mg,,,5.73,6.7,63
CPT,J9296,Inj pemetrexed (accord) 10mg,,,9.74,11.31,27
CPT,J9297,Inj pemetrexed (sandoz) 10mg,,,1.5,1.5,8
CPT,J9298,Inj nivol relatlimab 3mg/1mg,,,180.38,229.68,63
CPT,J9298,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,43030.32,32272.74,516.36,38727.29,119
CPT,J9299,Injection nivolumab,,,30.0,38.27,63
CPT,J9299,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,9234.44,6925.83,110.81,8311.0,119
CPT,J9299,NIVOLUMAB 120 MG/12 ML INTRAVENOUS SOLUTION,11081.37,8311.03,132.98,9973.23,119
CPT,J9299,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,22162.74,16622.05,265.95,19946.47,119
CPT,J9299,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,3693.8,2770.35,44.33,3324.42,119
CPT,J9301,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",24511.8,18383.85,294.14,22060.62,119
CPT,J9301,Obinutuzumab inj,,,66.94,91.72,63
CPT,J9302,Ofatumumab injection,,,62.23,72.25,63
CPT,J9303,PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,4910.43,3682.82,58.93,4419.39,119
CPT,J9303,PANITUMUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,19641.73,14731.29,235.7,17677.56,119
CPT,J9303,Panitumumab injection,,,143.51,200.89,63
CPT,J9304,Inj. pemetrexed 10 mg,,,39.93,81.56,63
CPT,J9305,Inj. pemetrexed nos 10mg,,,3.59,27.68,63
CPT,J9305,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,98.25,73.69,1.18,88.42,119
CPT,J9305,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,457.12,342.84,5.49,411.41,119
CPT,J9306,Injection pertuzumab 1 mg,,,14.4,19.76,63
CPT,J9306,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,19411.12,14558.34,232.93,17470.01,119
CPT,J9307,Pralatrexate injection,,,339.33,455.84,63
CPT,J9308,Injection ramucirumab,,,66.86,86.33,63
CPT,J9308,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,13451.91,10088.935,53.81,20177.86,238
CPT,J9309,Inj polatuzumab vedotin 1mg,,,118.11,158.67,63
CPT,J9309,POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION,42080.4,31560.3,504.96,37872.36,119
CPT,J9309,POLATUZUMAB VEDOTIN-PIIQ 30 MG INTRAVENOUS SOLUTION,10961.49,8221.11,131.54,9865.34,119
CPT,J9311,Inj rituximab hyaluronidase,,,36.58,43.22,63
CPT,J9312,Inj. rituximab 10 mg,,,74.77,90.44,63
CPT,J9312,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",8589.565,6442.17,34.36,12884.35,238
CPT,J9313,Inj. lumoxiti 0.01 mg,,,23.39,27.16,63
CPT,J9314,Inj pemetrexed (teva) 10mg,,,6.46,18.04,27
CPT,J9316,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",39606.46,29704.84,475.28,35645.81,119
CPT,J9316,PERTUZUMAB 600 MG-TRASTUZUMAB 600 MG-HYALURONID-ZZXF/10 ML SUBCUT SOLN,26403.25,19802.44,316.84,23762.92,119
CPT,J9316,Pertuzu trastuzu 10 mg,,,60.96,75.54,63
CPT,J9317,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,6772.2,5079.15,81.27,6094.98,119
CPT,J9317,Sacituzumab govitecan-hziy,,,32.58,42.12,63
CPT,J9318,Inj romidepsin non-lyo 0.1mg,,,28.52,34.54,27
CPT,J9319,Inj romidepsin lyophil 0.1mg,,,30.39,35.74,63
CPT,J9319,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,8709.04,6531.78,104.51,7838.14,119
CPT,J9320,Streptozocin injection,,,370.18,377.17,44
CPT,J9321,Inj epcoritamab-bysp 0.16 mg,,,55.19,64.83,27
CPT,J9322,Inj pemetrexed (bluepoint),,,10.6,12.31,18
CPT,J9323,Inj pemetrexed ditromethamin,,,0.13,11.88,27
CPT,J9324,Inj pemrydi rtu 10 mg,,,73.32,88.02,27
CPT,J9325,Inj talimogene laherparepvec,,,62.67,85.84,63
CPT,J9326,Telisotuzumab vedotin-tllv,,,145.87,145.87,9
CPT,J9328,Temozolomide injection,,,10.39,12.16,63
CPT,J9329,Inj tislelizumab-jsgr,,,56.21,551.62,27
CPT,J9330,Temsirolimus injection,,,20.32,37.68,63
CPT,J9331,Inj sirolimus prot part 1 mg,,,84.57,133.6,63
CPT,J9332,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,17617.82,13213.37,211.41,15856.04,119
CPT,J9332,Inj efgartigimod 2mg,,,31.52,38.1,63
CPT,J9333,Inj rozanolixizum-noli 1 mg,,,22.82,26.9,27
CPT,J9334,"EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN",44219.13,33164.35,530.63,39797.22,119
CPT,J9334,Inj efgart-alfa 2mg hya-qvfc,,,33.1,39.35,27
CPT,J9340,Thiotepa injection,,,221.75,318.16,45
CPT,J9342,Inj thiotepa nos 1 mg,,,8.86,12.24,18
CPT,J9345,Inj retifanlimab-dlwr 1 mg,,,29.26,35.48,27
CPT,J9347,Inj tremelimumab-actl 1 mg,,,138.43,163.58,27
CPT,J9347,TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION,111522.04,83641.53,1338.26,100369.84,119
CPT,J9348,Inj. naxitamab-gqgk 1 mg,,,642.29,796.45,27
CPT,J9349,Inj. tafasitamab-cxix,,,13.14,16.61,63
CPT,J9350,Inj mosunetuzumab-axgb 1 mg,,,641.07,760.03,27
CPT,J9351,Topotecan injection,,,0.82,1.89,44
CPT,J9352,Injection trabectedin 0.1mg,,,331.83,454.03,63
CPT,J9353,Inj. margetuximab-cmkb 5 mg,,,44.98,60.94,63
CPT,J9354,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,10965.5,8224.12,131.59,9868.95,119
CPT,J9354,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,16424.49,12318.37,197.09,14782.04,119
CPT,J9354,Inj ado-trastuzumab emt 1mg,,,36.27,48.95,63
CPT,J9355,Inj trastuzumab excl biosimi,,,73.48,91.17,63
CPT,J9355,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,4283.32,3212.49,51.4,3854.99,119
CPT,J9356,Inj. herceptin hylecta 10mg,,,61.07,74.62,63
CPT,J9357,Valrubicin injection,,,1303.34,1681.11,63
CPT,J9358,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,8066.16,6049.62,96.79,7259.54,119
CPT,J9358,Inj fam-trastu deru-nxki 1mg,,,25.71,34.81,63
CPT,J9359,Inj lon tesirin-lpyl 0.075mg,,,188.97,251.82,63
CPT,J9360,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,228.48,171.36,2.74,205.63,119
CPT,J9360,Vinblastine sulfate inj,,,3.93,5.19,44
CPT,J9361,Inj efbemalenograstim alfa-,,,,,0
CPT,J9370,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,41.665,31.25,0.3,52.32,238
CPT,J9370,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,68.85,51.64,0.79,65.03,238
CPT,J9370,Vincristine sulfate 1 mg inj,,,4.94,9.61,44
CPT,J9376,Inj pozelimab-bbfg 1 mg,,,91.73,106.5,26
CPT,J9380,Inj teclistamab cqyv 0.5 mg,,,32.55,38.99,27
CPT,J9380,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,24997.49,18748.12,299.97,22497.74,119
CPT,J9381,Inj teplizumab mzwv 5 mcg,,,37.24,43.72,27
CPT,J9382,Inj zenocutuzumab-zbco 1 mg,,,32.91,38.21,18
CPT,J9390,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,81.88,61.41,0.98,73.69,119
CPT,J9390,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,294.75,221.06,3.54,265.28,119
CPT,J9390,Vinorelbine tartrate inj,,,8.88,9.25,44
CPT,J9393,Inj fulvestrant (teva),,,15.44,94.24,63
CPT,J9394,Inj fulvestrant (fresenius),,,7.84,62.0,63
CPT,J9395,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,532.19,399.14,6.39,478.97,119
CPT,J9395,Injection fulvestrant,,,6.66,12.66,54
CPT,J9400,Inj ziv-aflibercept 1mg,,,7.0,9.15,63
CPT,J9400,ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION,4553.6,3415.2,54.64,4098.24,119
CPT,J9600,Porfimer sodium injection,,,24228.42,28129.2,27
CPT,J9999,Chemotherapy drug,,,,,0
CPT,J9999,INV AMG 509 0.1 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J9999,INV AMG 509 0.5 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J9999,INV DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J9999,INV NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
CPT,J9999,INV SIGVOTATUG VEDOTIN 10 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
CPT,K0001,Standard wheelchair,,,93.67,111.76,8
CPT,K0002,Stnd hemi (low seat) whlchr,,,162.94,194.42,8
CPT,K0003,Lightweight wheelchair,,,148.37,177.03,8
CPT,K0004,High strength ltwt whlchr,,,200.91,239.73,8
CPT,K0005,Ultralightweight wheelchair,,,625.22,746.0,8
CPT,K0006,Heavy duty wheelchair,,,238.6,284.7,8
CPT,K0007,Extra heavy duty wheelchair,,,346.23,413.11,8
CPT,K0009,Other manual wheelchair/base,,,251.44,300.02,8
CPT,K0010,Stnd wt frame power whlchr,,,1440.74,1719.07,8
CPT,K0011,Stnd wt pwr whlchr w control,,,1732.58,2067.28,8
CPT,K0012,Ltwt portbl power whlchr,,,1098.92,1311.21,8
CPT,K0015,Detach non-adj ht armrst rep,,,46.36,55.31,8
CPT,K0017,Detach adjust armrest base,,,14.06,16.78,8
CPT,K0018,Detach adjust armrst upper,,,7.91,9.44,8
CPT,K0019,Arm pad repl each,,,4.29,5.12,8
CPT,K0020,Fixed adjust armrest pair,,,12.11,14.45,8
CPT,K0037,Hi mount flip-up footrest ea,,,12.51,14.93,8
CPT,K0038,Leg strap each,,,6.94,8.28,8
CPT,K0039,Leg strap h style each,,,15.03,17.93,8
CPT,K0040,Adjustable angle footplate,,,16.83,20.09,8
CPT,K0041,Large size footplate each,,,14.47,17.26,8
CPT,K0042,Standard size ftplate rep ea,,,9.0,10.74,8
CPT,K0043,Ftrst lowr exten tube rep ea,,,5.62,6.71,8
CPT,K0044,Ftrst upr hanger brac rep ea,,,4.86,5.8,8
CPT,K0045,Ftrst compl assembly repl ea,,,14.45,17.24,8
CPT,K0046,Elev lgrst lwr exten repl ea,,,5.65,6.74,8
CPT,K0047,Elev legrst upr hangr rep ea,,,20.52,24.49,8
CPT,K0050,Ratchet assembly replacement,,,9.28,11.08,8
CPT,K0051,Cam rel asm ft/legrst rep ea,,,14.83,17.69,8
CPT,K0052,Swingaway detach ftrest repl,,,22.89,27.31,8
CPT,K0053,Elevate footrest articulate,,,25.66,30.62,8
CPT,K0056,Seat ht <17 or >21 ltwt wc,,,28.81,34.38,8
CPT,K0065,Spoke protectors,,,13.81,16.47,8
CPT,K0069,Rr whl compl sol tire rep ea,,,29.35,35.02,8
CPT,K0070,Rr whl compl pne tire rep ea,,,49.61,59.2,8
CPT,K0071,Fr cstr comp pne tire rep ea,,,31.86,38.02,8
CPT,K0072,Fr cstr semi-pne tire rep ea,,,19.91,23.76,8
CPT,K0073,Caster pin lock each,,,10.55,12.59,8
CPT,K0077,Fr cstr asmb sol tire rep ea,,,17.37,20.73,8
CPT,K0098,Drive belt for pwc repl,,,7.0,8.35,8
CPT,K0105,Iv hanger,,,29.5,35.2,8
CPT,K0195,Elevating whlchair leg rests,,,38.61,46.06,8
CPT,K0455,Pump uninterrupted infusion,,,895.79,1068.84,8
CPT,K0552,Sup/ext non-ins inf pump syr,,,8.34,9.95,8
CPT,K0553,Ther cgm supply allowance,,,596.63,711.89,8
CPT,K0554,Ther cgm receiver/monitor,,,65.79,78.5,8
CPT,K0601,Repl batt silver oxide 1.5 v,,,3.71,4.43,8
CPT,K0602,Repl batt silver oxide 3 v,,,20.95,25.0,8
CPT,K0603,Repl batt alkaline 1.5 v,,,1.88,2.25,8
CPT,K0604,Repl batt lithium 3.6 v,,,20.2,24.1,8
CPT,K0605,Repl batt lithium 4.5 v,,,48.29,57.62,8
CPT,K0606,Aed garment w elec analysis,,,8517.15,10162.51,8
CPT,K0607,Repl batt for aed,,,65.72,78.41,8
CPT,K0608,Repl garment for aed,,,41.07,49.0,8
CPT,K0609,Repl electrode for aed,,,2726.26,3252.92,8
CPT,K0672,Removable soft interface le,,,103.3,298.35,27
CPT,K0730,Ctrl dose inh drug deliv sys,,,583.05,695.69,8
CPT,K0733,12-24hr sealed lead acid,,,8.49,10.13,8
CPT,K0738,Portable gas oxygen system,,,121.59,145.08,8
CPT,K0739,Repair/svc dme non-oxygen eq,,,47.05,56.14,8
CPT,K0800,Pov group 1 std up to 300lbs,,,272.3,324.9,8
CPT,K0801,Pov group 1 hd 301-450 lbs,,,485.06,578.77,8
CPT,K0802,Pov group 1 vhd 451-600 lbs,,,604.62,721.42,8
CPT,K0806,Pov group 2 std up to 300lbs,,,420.14,501.3,8
CPT,K0807,Pov group 2 hd 301-450 lbs,,,647.42,772.5,8
CPT,K0808,Pov group 2 vhd 451-600 lbs,,,1001.03,1194.41,8
CPT,K0813,Pwc gp 1 std port seat/back,,,834.86,996.14,8
CPT,K0814,Pwc gp 1 std port cap chair,,,936.3,1117.18,8
CPT,K0815,Pwc gp 1 std seat/back,,,1003.65,1197.54,8
CPT,K0816,Pwc gp 1 std cap chair,,,966.95,1153.75,8
CPT,K0820,Pwc gp 2 std port seat/back,,,872.4,1040.93,8
CPT,K0821,Pwc gp 2 std port cap chair,,,960.41,1145.95,8
CPT,K0822,Pwc gp 2 std seat/back,,,1065.52,1271.36,8
CPT,K0823,Pwc gp 2 std cap chair,,,1038.69,1239.35,8
CPT,K0824,Pwc gp 2 hd seat/back,,,1464.86,1747.84,8
CPT,K0825,Pwc gp 2 hd cap chair,,,1342.63,1602.01,8
CPT,K0826,Pwc gp 2 vhd seat/back,,,2288.93,2731.11,8
CPT,K0827,Pwc gp vhd cap chair,,,1923.17,2294.69,8
CPT,K0828,Pwc gp 2 xtra hd seat/back,,,2728.06,3255.07,8
CPT,K0829,Pwc gp 2 xtra hd cap chair,,,2605.81,3109.21,8
CPT,K0835,Pwc gp2 std sing pow opt s/b,,,1230.17,1467.82,8
CPT,K0836,Pwc gp2 std sing pow opt cap,,,1275.88,1522.35,8
CPT,K0837,Pwc gp 2 hd sing pow opt s/b,,,1538.33,1835.51,8
CPT,K0838,Pwc gp 2 hd sing pow opt cap,,,1367.86,1632.11,8
CPT,K0839,Pwc gp2 vhd sing pow opt s/b,,,2025.61,2416.92,8
CPT,K0840,Pwc gp2 xhd sing pow opt s/b,,,3095.99,3694.08,8
CPT,K0841,Pwc gp2 std mult pow opt s/b,,,1358.58,1621.03,8
CPT,K0842,Pwc gp2 std mult pow opt cap,,,1357.3,1619.51,8
CPT,K0843,Pwc gp2 hd mult pow opt s/b,,,1619.23,1932.03,8
CPT,K0848,Pwc gp 3 std seat/back,,,2310.7,2757.09,8
CPT,K0849,Pwc gp 3 std cap chair,,,2221.56,2650.73,8
CPT,K0850,Pwc gp 3 hd seat/back,,,2680.25,3198.03,8
CPT,K0851,Pwc gp 3 hd cap chair,,,2577.1,3074.95,8
CPT,K0852,Pwc gp 3 vhd seat/back,,,3096.88,3695.14,8
CPT,K0853,Pwc gp 3 vhd cap chair,,,3181.31,3795.89,8
CPT,K0854,Pwc gp 3 xhd seat/back,,,4214.51,5028.68,8
CPT,K0855,Pwc gp 3 xhd cap chair,,,3981.23,4750.33,8
CPT,K0856,Pwc gp3 std sing pow opt s/b,,,2480.2,2959.33,8
CPT,K0857,Pwc gp3 std sing pow opt cap,,,2529.95,3018.69,8
CPT,K0858,Pwc gp3 hd sing pow opt s/b,,,3077.25,3671.71,8
CPT,K0859,Pwc gp3 hd sing pow opt cap,,,2934.75,3501.69,8
CPT,K0860,Pwc gp3 vhd sing pow opt s/b,,,4396.25,5245.53,8
CPT,K0861,Pwc gp3 std mult pow opt s/b,,,2484.2,2964.1,8
CPT,K0862,Pwc gp3 hd mult pow opt s/b,,,3077.25,3671.71,8
CPT,K0863,Pwc gp3 vhd mult pow opt s/b,,,4396.25,5245.53,8
CPT,K0864,Pwc gp3 xhd mult pow opt s/b,,,5231.54,6242.18,8
CPT,K1001,N/A,,,88.1,105.12,8
CPT,K1002,N/A,,,124.31,148.32,8
CPT,K1006,Suct pum ext urine mgmt sys,,,154.85,184.77,8
CPT,K1009,Speech volume modulation sys,,,581.05,693.29,8
CPT,K1014,Ak 4 bar link hydl swg/stanc,,,18839.23,22478.63,8
CPT,K1016,N/A,,,124.31,148.32,8
CPT,K1017,N/A,,,97.45,116.28,8
CPT,K1018,N/A,,,1063.97,1269.51,8
CPT,K1019,N/A,,,1250.31,1491.85,8
CPT,K1020,N/A,,,124.31,148.32,8
CPT,K1022,Endoskel posit rotat unit,,,1752.47,2091.01,8
CPT,K1024,Non pneum comp control cal,,,1524.06,1818.48,8
CPT,K1025,Non pneum compress full arm,,,149.44,178.31,8
CPT,K1031,Non pneu comp control w/o ca,,,310.62,370.63,8
CPT,K1032,Non pneum seq comp full leg,,,105.42,125.78,8
CPT,K1033,Non pneum seq comp half leg,,,62.0,73.98,8
CPT,L0112,Cranial cervical orthosis,,,1704.83,4924.03,27
CPT,L0113,Cranial cervical torticollis,,,347.38,1003.33,27
CPT,L0113,HC CRANIAL CERVICAL TORTICOLLIS,260.82,195.62,3.13,234.74,119
CPT,L0120,Cerv flex n/adj foam pre ots,,,29.9,86.36,27
CPT,L0120,HC PREFAB CERV COLLAR FLEXIBLE FOAM NON-ADJUST OTS,21.5,16.12,0.26,19.35,119
CPT,L0130,Flex thermoplastic collar mo,,,183.8,530.89,27
CPT,L0140,Cervical semi-rigid adjustab,,,81.43,235.18,27
CPT,L0140,HC CERVICAL SEMI RIGID ADJUSTAB,62.9,47.18,0.75,56.61,119
CPT,L0150,Cerv semi-rig adj molded chn,,,121.74,351.63,27
CPT,L0150,HC MOLDED CERV COLLAR PLAST SEMI-RIG ADJ CHIN CUP W MAND,6.8,5.1,0.08,6.12,119
CPT,L0160,Cerv sr wire occ/man pre ots,,,176.45,509.62,27
CPT,L0170,Cervical collar molded to pt,,,726.55,2098.51,27
CPT,L0172,Cerv col sr foam 2pc pre ots,,,148.58,429.14,27
CPT,L0172,HC PREFAB CERV COLLAR SEMI-RIGID 2PC THERMOPL FOAM OTS,187.55,140.66,2.25,168.8,119
CPT,L0174,Cerv sr 2pc thor ext pre ots,,,361.98,1045.51,27
CPT,L0174,HC PREFAB CERV COLLAR THOR SEMI RIGID 2PC OTS,282.9,212.18,3.39,254.61,119
CPT,L0180,Cer post col occ/man sup adj,,,417.43,1205.64,27
CPT,L0180,HC CERV MULTI POST COLLAR ADJ,1866.8,1400.1,22.4,1680.12,119
CPT,L0190,Cerv collar supp adj cerv ba,,,579.46,1673.65,27
CPT,L0200,Cerv col supp adj bar & thor,,,629.31,1817.63,27
CPT,L0200,HC CERV COLLAR THORAC,1724.0,1293.0,20.69,1551.6,119
CPT,L0220,Thor rib belt custom fabrica,,,137.98,398.52,27
CPT,L0450,HC PREFAB TLSO THOR RIGD OTS,458.95,344.21,5.51,413.06,119
CPT,L0450,Tlso flex trunk/thor pre ots,,,92.75,346.3,27
CPT,L0454,Tlso trnk sj-t9 pre cst,,,422.44,1220.14,27
CPT,L0455,Tlso flex trnk sj-t9 pre ots,,,172.17,685.46,27
CPT,L0456,HC PREFAB CUS TSLO FLEX TRNK SJ-SS,3433.85,2575.39,41.21,3090.46,119
CPT,L0456,Tlso flex trnk sj-ss pre cst,,,1211.48,3499.11,27
CPT,L0457,HC PREFAB TLSO SCAPULAR OTS,3912.0,2934.0,46.94,3520.8,119
CPT,L0457,Tlso flex trnk sj-ss pre ots,,,493.74,1965.72,27
CPT,L0458,Tlso 2mod symphis-xipho pre,,,1086.33,3137.64,27
CPT,L0460,HC PREFAB CUS TLSO POST FRAME,1407.625,1055.72,13.62,1512.09,238
CPT,L0460,Tlso 2 shl symphys-stern cst,,,1222.76,3531.68,27
CPT,L0462,Tlso 3mod sacro-scap pre,,,1520.89,4392.74,27
CPT,L0464,HC PREFAB FIT & ADJ TLSO 4 SHELL LINR,1287.0,965.25,15.44,1158.3,119
CPT,L0464,Tlso 4mod sacro-scap pre,,,1810.59,5229.47,27
CPT,L0466,Tlso r fram soft ant pre cst,,,439.78,1270.22,27
CPT,L0467,Tlso r fram soft pre ots,,,193.09,744.21,27
CPT,L0468,Tlso rig fram pelvic pre cst,,,516.41,1491.55,27
CPT,L0469,Tlso rig fram pelvic pre ots,,,246.04,916.51,27
CPT,L0470,Tlso rigid frame pre subclav,,,718.26,2074.54,27
CPT,L0472,HC PREFAB FIT & ADJ TLSO ANT HYPTIXT,1594.1,1195.58,19.13,1434.69,119
CPT,L0472,Tlso rigid frame hyperex pre,,,455.53,1315.7,27
CPT,L0480,Tlso rigid plastic custom fa,,,1993.43,5757.6,27
CPT,L0482,Tlso rigid lined custom fab,,,2229.01,6438.02,27
CPT,L0484,HC TLSO RIGID PLASTIC CUST FAB,7483.6,5612.7,89.8,6735.24,119
CPT,L0484,Tlso rigid plastic cust fab,,,2405.73,6948.43,27
CPT,L0486,HC CUS TLSO 2SHELLS LINR,7577.05,5682.79,90.92,6819.34,119
CPT,L0486,Tlso rigidlined cust fab two,,,2437.52,7040.25,27
CPT,L0488,Tlso rigid lined pre one pie,,,1222.76,3531.68,27
CPT,L0490,Tlso rigid plastic pre one,,,344.54,995.11,27
CPT,L0491,Tlso 2 piece rigid shell,,,935.5,2701.98,27
CPT,L0492,Tlso 3 piece rigid shell,,,589.55,1702.77,27
CPT,L0621,HC PREFAB SI BELT OTS,323.35,242.51,3.88,291.02,119
CPT,L0621,Sio flex pelvic/sacr pre ots,,,48.89,200.85,27
CPT,L0622,Sio flex pelvisacral custom,,,291.04,840.62,27
CPT,L0623,Sio rig pnl pelv/sac pre ots,,,87.65,349.34,27
CPT,L0625,HC LO FLEX L1-BELOW L5 PRE OTS,303.3,227.48,3.64,272.97,119
CPT,L0625,Lo flex l1-below l5 pre ots,,,27.36,109.0,27
CPT,L0626,Lo sag rig pnl stays pre cst,,,95.12,274.74,27
CPT,L0627,HC PREFAB CUS LO SAG CONT RIGD ANT/POS,599.4,449.55,7.19,539.46,119
CPT,L0627,Lo sag ri an/pos pnl pre cst,,,501.69,1449.0,27
CPT,L0628,HC PREFAB LUMBOSACRAL SUPP OTS,160.5,120.38,1.93,144.45,119
CPT,L0628,Lso flex no ri stays pre ots,,,41.65,165.95,27
CPT,L0630,HC PREFAB CUS LSO POST RIG PANEL,720.65,540.49,8.65,648.58,119
CPT,L0630,Lso r post pnl sj-t9 pre cst,,,197.64,570.85,27
CPT,L0631,Lso sag r an/pos pnl pre cst,,,1252.95,3618.86,27
CPT,L0633,Lso sc r pos/lat pnl pre cst,,,349.98,1010.86,27
CPT,L0635,Lso sagit rigid panel prefab,,,1078.37,3114.62,27
CPT,L0636,Lso sagittal rigid panel cus,,,1876.56,5420.04,27
CPT,L0637,HC PREFAB CUS LSO SAG COR RIG ANT/POST PANEL,888.65,666.49,10.66,799.78,119
CPT,L0637,Lso sc r ant/pos pnl pre cst,,,1263.33,3648.87,27
CPT,L0638,Lso sag-coronal panel custom,,,1606.56,4640.2,27
CPT,L0639,HC LUMBAR SACRAL ORTH SHELL PANEL PREFAB,4315.0,3236.25,51.78,3883.5,119
CPT,L0639,Lso s/c shell/panel prefab,,,1263.33,3648.87,27
CPT,L0640,Lso s/c shell/panel custom,,,1274.57,3681.33,27
CPT,L0641,Lo rig pos pnl l1-l5 pre ots,,,38.7,154.21,27
CPT,L0642,Lo sag ri an/pos pnl pre ots,,,204.11,813.25,27
CPT,L0643,Lso sag ctr rigi pos pre ots,,,80.41,320.39,27
CPT,L0648,HC PREFAB LSO SAGI CTRL RIGID OTS,4045.85,3034.39,48.55,3641.26,119
CPT,L0648,Lso sag r an/pos pnl pre ots,,,509.74,2031.03,27
CPT,L0649,Lso sc r pos/lat pnl pre ots,,,142.39,567.33,27
CPT,L0650,HC PREFAB LSO SAG RDG OTS,2689.7,2017.28,32.28,2420.73,119
CPT,L0650,Lso sc r ant/pos pnl pre ots,,,589.8,2215.43,27
CPT,L0651,Lso sag-co shell pnl pre ots,,,589.8,2215.43,27
CPT,L0700,Ctlso a-p-l control molded,,,2304.13,6654.99,27
CPT,L0710,Ctlso a-p-l control w/ inter,,,2688.76,7765.89,27
CPT,L0720,Ctlso a-p-l control custom,,,2228.02,2586.73,18
CPT,L0810,Halo cervical into jckt vest,,,3035.91,8768.58,27
CPT,L0820,Halo cervical into body jack,,,2626.45,7585.91,27
CPT,L0830,Halo cerv into milwaukee typ,,,3532.74,10203.56,27
CPT,L0859,HC HALO ADD MRI COMPATIBLE SYS INCL RINGS/PINS,454.35,340.76,5.45,408.92,119
CPT,L0859,Mri compatible system,,,1829.93,5285.34,27
CPT,L0861,Halo repl liner/interface,,,262.54,758.29,27
CPT,L0970,Tlso corset front,,,171.68,495.86,27
CPT,L0972,Lso corset front,,,124.71,360.19,27
CPT,L0974,Tlso full corset,,,201.7,582.56,27
CPT,L0976,Lso full corset,,,228.56,660.12,27
CPT,L0978,Axillary crutch extension,,,216.86,626.35,27
CPT,L0980,Peroneal straps pair pre ots,,,19.67,56.81,27
CPT,L0982,Stocking sup grips 4 pre ots,,,18.35,52.98,27
CPT,L0984,HC PREFAB PROTECTIVE BODY SOCK EACH OTS,558.25,418.69,6.7,502.42,119
CPT,L0984,Protect body sock ea pre ots,,,75.07,216.81,27
CPT,L1000,Ctlso milwauke initial model,,,2665.3,7698.13,27
CPT,L1001,HC CTLSO INFANT IMMOBILIZER,807.45,605.59,9.69,726.7,119
CPT,L1005,Tension based scoliosis orth,,,3898.62,11260.34,27
CPT,L1006,Scoliosis orth sag/ cor,,,1283.42,1490.05,19
CPT,L1010,Ctlso axilla sling,,,75.61,218.39,27
CPT,L1020,Kyphosis pad,,,97.38,281.26,27
CPT,L1025,Kyphosis pad floating,,,140.49,405.74,27
CPT,L1030,Lumbar bolster pad,,,71.67,206.99,27
CPT,L1040,Lumbar or lumbar rib pad,,,87.89,253.84,27
CPT,L1050,Sternal pad,,,93.8,270.92,27
CPT,L1060,Thoracic pad,,,107.74,311.19,27
CPT,L1070,Trapezius sling,,,101.38,292.8,27
CPT,L1080,Outrigger,,,80.1,231.35,27
CPT,L1085,Outrigger bil w/ vert extens,,,173.41,500.87,27
CPT,L1090,Lumbar sling,,,111.54,322.17,27
CPT,L1100,Ring flange plastic/leather,,,179.16,517.47,27
CPT,L1110,Ring flange plas/leather mol,,,287.73,831.05,27
CPT,L1120,Covers for upright each,,,48.38,139.73,27
CPT,L1200,Furnsh initial orthosis only,,,2116.78,6113.88,27
CPT,L1210,Lateral thoracic extension,,,393.04,1135.24,27
CPT,L1220,Anterior thoracic extension,,,260.23,751.61,27
CPT,L1230,Milwaukee type superstructur,,,851.25,2458.64,27
CPT,L1240,Lumbar derotation pad,,,87.48,252.65,27
CPT,L1250,Anterior asis pad,,,81.39,235.08,27
CPT,L1260,Anterior thoracic derotation,,,85.23,246.16,27
CPT,L1270,Abdominal pad,,,87.29,252.14,27
CPT,L1280,Rib gusset (elastic) each,,,97.19,280.72,27
CPT,L1290,Lateral trochanteric pad,,,88.55,255.75,27
CPT,L1300,Body jacket mold to patient,,,2338.69,6754.8,27
CPT,L1300,HC BODY JACKET MOLD TO PATIENT,6486.2,4864.65,77.83,5837.58,119
CPT,L1310,Post-operative body jacket,,,2476.51,7152.86,27
CPT,L1600,Ho flex frejka w/cov pre cst,,,148.47,428.83,27
CPT,L1610,Ho frejka cov only pre cst,,,49.46,142.86,27
CPT,L1620,HC HO FLEX PAVLIK HARNS PRE CST,279.25,209.44,3.35,251.32,119
CPT,L1620,Ho flex pavlik harns pre cst,,,150.94,435.97,27
CPT,L1630,Abduct control hip semi-flex,,,190.9,551.37,27
CPT,L1640,Pelv band/spread bar thigh c,,,637.81,1842.18,27
CPT,L1650,Ho abduction hip adjustable,,,293.93,848.97,27
CPT,L1652,Ho bi thighcuffs w sprdr bar,,,434.21,1254.1,27
CPT,L1653,Ho abduction static ots,,,434.21,504.12,19
CPT,L1660,Ho abduction static plastic,,,192.8,556.86,27
CPT,L1680,Pelvic & hip control thigh c,,,1372.66,3964.63,27
CPT,L1681,Ho bilateral hip abduction,,,2316.56,6690.89,27
CPT,L1685,Post-op hip abduct custom fa,,,1340.06,3870.48,27
CPT,L1686,HC PREFAB POSTOP HIP ORT L1686,1563.75,1172.81,18.76,1407.38,119
CPT,L1686,Ho post-op hip abduction,,,1158.28,3345.45,27
CPT,L1690,Combination bilateral ho,,,2355.43,6803.14,27
CPT,L1700,Leg perthes orth toronto typ,,,1720.43,4969.08,27
CPT,L1710,Legg perthes orth newington,,,2013.95,5816.83,27
CPT,L1720,Legg perthes orthosis trilat,,,1484.52,4287.72,27
CPT,L1730,Legg perthes orth scottish r,,,1277.19,3688.89,27
CPT,L1755,Legg perthes patten bottom t,,,1783.67,5151.73,27
CPT,L1810,Ko elastic with joints,,,113.76,328.55,27
CPT,L1812,HC PREFAB KNEE ELAS JNT OTS,90.15,67.61,1.08,81.14,119
CPT,L1812,Ko elastic w/joints pre ots,,,69.56,235.84,27
CPT,L1820,HC PREFAB FIT & ADJ KO,244.45,183.34,2.93,220.0,119
CPT,L1820,Ko elas w/ condyle pads & jo,,,159.75,461.42,27
CPT,L1821,Ko elas w/ condyle pads otf,,,159.75,185.47,19
CPT,L1830,HC PREFAB KNEE BRACE 16 INCHES OTS,108.5,81.38,1.3,97.65,119
CPT,L1830,Ko immob canvas long pre ots,,,62.68,213.65,27
CPT,L1831,Knee orth pos locking joint,,,358.5,1035.46,27
CPT,L1832,HC PREFAB CUS KO ADJ JNT POS R SUP,473.3,354.98,5.68,425.97,119
CPT,L1832,Ko adj jnt pos r sup pre cst,,,684.93,1978.25,27
CPT,L1833,HC PREFAB RDG KNEE BRAC OTS,473.3,354.98,5.68,425.97,119
CPT,L1833,Ko adj jnt pos r sup pre ots,,,451.52,1492.25,27
CPT,L1834,Ko w/0 joint rigid molded to,,,923.8,2668.21,27
CPT,L1836,Ko rigid w/o joints pre ots,,,88.63,313.23,27
CPT,L1840,Ko derot ant cruciate custom,,,1035.88,2991.92,27
CPT,L1843,Ko single upright pre cst,,,1092.96,3156.76,27
CPT,L1844,Ko w/adj jt rot cntrl molded,,,2022.2,5840.69,27
CPT,L1845,Ko double upright pre cst,,,951.04,2746.86,27
CPT,L1846,Ko w adj flex/ext rotat mold,,,1264.46,3652.11,27
CPT,L1847,Ko dbl upright w/air pre cst,,,700.59,2023.5,27
CPT,L1848,Ko dbl upright w/air pre ots,,,700.59,2023.5,27
CPT,L1850,Ko swedish type pre ots,,,204.13,717.69,27
CPT,L1851,Ko single upright prefab ots,,,595.98,2106.04,27
CPT,L1852,Ko double upright prefab ots,,,568.55,1942.99,27
CPT,L1860,Ko supracondylar socket mold,,,1208.89,3491.65,27
CPT,L1900,Afo sprng wir drsflx calf bd,,,331.43,957.26,27
CPT,L1902,Afo ankle gauntlet pre ots,,,89.93,259.75,27
CPT,L1902,HC PREFAB ANKLE GAUNTLET PRE OTS,108.3,81.22,1.3,97.47,119
CPT,L1904,Afo molded ankle gauntlet,,,529.76,1530.11,27
CPT,L1906,Afo multilig ank sup pre ots,,,180.65,521.79,27
CPT,L1906,HC PREFAB ANKLE FOOT ORTHOSIS MULTILIGAMENTUS ANKLE SUPPORT OTS,108.5,81.38,1.3,97.65,119
CPT,L1907,Afo supramalleolar custom,,,685.38,1979.59,27
CPT,L1910,Afo sing bar clasp attach sh,,,304.59,879.73,27
CPT,L1920,Afo sing upright w/ adjust s,,,495.37,1430.77,27
CPT,L1930,Afo plastic,,,290.88,840.14,27
CPT,L1930,HC PREFAB FIT & ADJ AFO PLASTIC,808.8,606.6,9.71,727.92,119
CPT,L1932,Afo rig ant tib tcf/ custom,,,1086.91,3139.31,27
CPT,L1933,Afo rig ant tib tcf/ ots,,,1086.91,1261.9,18
CPT,L1940,Afo molded to patient plasti,,,557.15,1609.23,27
CPT,L1940,HC CUS PLASTIC AFO,3756.45,2817.34,45.08,3380.8,119
CPT,L1945,Afo molded plas rig ant tib,,,1073.03,3099.22,27
CPT,L1950,Afo spiral molded to pt plas,,,907.89,2622.23,27
CPT,L1951,Afo spiral prefab custom,,,1022.99,2954.66,27
CPT,L1952,Afo spiral prefab ots,,,1022.99,1187.69,18
CPT,L1960,Afo pos solid ank plastic mo,,,624.46,1803.62,27
CPT,L1970,Afo plastic molded w/ankle j,,,842.18,2432.45,27
CPT,L1970,HC CUS AFO W/ANK-JNT,2994.65,2245.99,35.94,2695.18,119
CPT,L1971,Afo w/ankle joint prefab,,,570.92,1648.97,27
CPT,L1980,Afo sing solid stirrup calf,,,445.8,1287.59,27
CPT,L1990,Afo doub solid stirrup calf,,,502.18,1450.43,27
CPT,L2000,Kafo sing fre stirr thi/calf,,,1183.94,3419.55,27
CPT,L2005,Kafo sng/dbl mechanical act,,,5001.34,14445.28,27
CPT,L2006,Kaf sng/dbl swg/stn mcpr cus,,,39482.4,114036.33,27
CPT,L2010,Kafo sng solid stirrup w/o j,,,1218.8,3520.23,27
CPT,L2020,Kafo dbl solid stirrup band/,,,1315.46,3799.44,27
CPT,L2030,Kafo dbl solid stirrup w/o j,,,1141.28,3296.35,27
CPT,L2034,Kafo pla sin up w/wo k/a cus,,,2535.13,7322.15,27
CPT,L2035,Kafo plastic pediatric size,,,211.03,609.51,27
CPT,L2036,Kafo plas doub free knee mol,,,2294.43,6626.95,27
CPT,L2037,Kafo plas sing free knee mol,,,1876.44,5419.71,27
CPT,L2038,Kafo w/o joint multi-axis an,,,1610.72,4652.22,27
CPT,L2040,Hkafo torsion bil rot straps,,,259.9,750.68,27
CPT,L2050,Hkafo torsion cable hip pelv,,,593.77,1714.98,27
CPT,L2060,Hkafo torsion ball bearing j,,,666.77,1925.82,27
CPT,L2070,Hkafo torsion unilat rot str,,,151.51,437.61,27
CPT,L2080,Hkafo unilat torsion cable,,,405.22,1170.37,27
CPT,L2090,Hkafo unilat torsion ball br,,,549.17,1586.16,27
CPT,L2106,Afo tib fx cast plaster mold,,,765.99,2212.39,27
CPT,L2108,Afo tib fx cast molded to pt,,,1370.72,3959.03,27
CPT,L2112,Afo tibial fracture soft,,,525.62,1518.16,27
CPT,L2114,Afo tib fx semi-rigid,,,659.27,1904.15,27
CPT,L2116,Afo tibial fracture rigid,,,802.01,2316.45,27
CPT,L2126,Kafo fem fx cast thermoplas,,,1514.95,4375.6,27
CPT,L2128,Kafo fem fx cast molded to p,,,1931.8,5579.6,27
CPT,L2132,Kafo femoral fx cast soft,,,1175.1,3394.03,27
CPT,L2134,Kafo fem fx cast semi-rigid,,,1089.61,3147.11,27
CPT,L2136,Kafo femoral fx cast rigid,,,1497.49,4325.16,27
CPT,L2180,Plas shoe insert w ank joint,,,171.81,496.23,27
CPT,L2182,Drop lock knee,,,109.95,317.56,27
CPT,L2184,Limited motion knee joint,,,152.87,441.55,27
CPT,L2186,Adj motion knee jnt lerman t,,,203.09,586.57,27
CPT,L2188,Quadrilateral brim,,,337.4,974.49,27
CPT,L2190,Waist belt,,,101.9,294.32,27
CPT,L2192,Pelvic band & belt thigh fla,,,401.69,1160.21,27
CPT,L2200,Limited ankle motion ea jnt,,,71.41,206.25,27
CPT,L2210,Dorsiflexion assist each joi,,,100.97,291.65,27
CPT,L2220,Dorsi & plantar flex ass/res,,,119.54,345.26,27
CPT,L2220,HC DORS/PLANTAR FLEX ASSIST L2220,977.0,732.75,11.72,879.3,119
CPT,L2230,Split flat caliper stirr & p,,,94.3,272.38,27
CPT,L2232,Rocker bottom contact afo,,,117.04,338.05,27
CPT,L2240,Round caliper and plate atta,,,94.23,272.16,27
CPT,L2250,Foot plate molded stirrup at,,,473.89,1368.71,27
CPT,L2260,Reinforced solid stirrup,,,258.24,745.88,27
CPT,L2265,Long tongue stirrup,,,132.68,383.2,27
CPT,L2270,Varus/valgus strap padded/li,,,66.43,191.87,27
CPT,L2275,HC VARUS/VALGUS PLSTC CORCTN L2275,624.05,468.04,7.49,561.64,119
CPT,L2275,Plastic mod low ext pad/line,,,167.81,484.7,27
CPT,L2280,HC MOLDED INNER BOOT L2280,2679.6,2009.7,32.16,2411.64,119
CPT,L2280,Molded inner boot,,,510.13,1473.4,27
CPT,L2300,Abduction bar jointed adjust,,,303.33,876.09,27
CPT,L2310,Abduction bar-straight,,,150.43,434.48,27
CPT,L2320,Non-molded lacer,,,295.8,854.36,27
CPT,L2330,Lacer molded to patient mode,,,487.58,1408.25,27
CPT,L2335,Anterior swing band,,,268.56,775.68,27
CPT,L2340,HC MOLDED PRE TIBILA PT SHELL L2340,2407.75,1805.81,28.89,2166.98,119
CPT,L2340,Pre-tibial shell molded to p,,,503.51,1454.28,27
CPT,L2350,Prosthetic type socket molde,,,1172.5,3386.5,27
CPT,L2360,Extended steel shank,,,64.77,187.08,27
CPT,L2370,Patten bottom,,,289.2,835.31,27
CPT,L2375,Torsion ank & half solid sti,,,127.29,367.66,27
CPT,L2380,Torsion straight knee joint,,,184.93,534.14,27
CPT,L2385,Straight knee joint heavy du,,,201.2,581.11,27
CPT,L2387,Add le poly knee custom kafo,,,186.44,538.5,27
CPT,L2390,Offset knee joint each,,,164.43,474.93,27
CPT,L2395,Offset knee joint heavy duty,,,209.43,604.89,27
CPT,L2397,Suspension sleeve lower ext,,,145.07,419.0,27
CPT,L2405,Knee joint drop lock ea jnt,,,106.19,306.69,27
CPT,L2415,Knee joint cam lock each joi,,,148.02,427.53,27
CPT,L2425,Knee disc/dial lock/adj flex,,,174.63,504.4,27
CPT,L2430,Knee jnt ratchet lock ea jnt,,,174.63,504.4,27
CPT,L2492,Knee lift loop drop lock rin,,,143.85,415.49,27
CPT,L2500,Thi/glut/ischia wgt bearing,,,355.41,1026.54,27
CPT,L2510,Th/wght bear quad-lat brim m,,,818.33,2363.57,27
CPT,L2520,Th/wght bear quad-lat brim c,,,555.45,1604.28,27
CPT,L2525,Th/wght bear nar m-l brim mo,,,1544.09,4459.77,27
CPT,L2526,Th/wght bear nar m-l brim cu,,,999.53,2886.9,27
CPT,L2530,Thigh/wght bear lacer non-mo,,,352.93,1019.38,27
CPT,L2540,Thigh/wght bear lacer molded,,,540.61,1561.43,27
CPT,L2550,Thigh/wght bear high roll cu,,,431.42,1246.06,27
CPT,L2570,Hip clevis type 2 posit jnt,,,536.6,1549.87,27
CPT,L2580,Pelvic control pelvic sling,,,683.89,1975.28,27
CPT,L2600,Hip clevis/thrust bearing fr,,,251.25,725.67,27
CPT,L2610,Hip clevis/thrust bearing lo,,,286.41,827.23,27
CPT,L2620,Pelvic control hip heavy dut,,,301.22,870.02,27
CPT,L2622,Hip joint adjustable flexion,,,345.48,997.84,27
CPT,L2624,Hip adj flex ext abduct cont,,,373.06,1077.52,27
CPT,L2627,Plastic mold recipro hip & c,,,2575.08,7437.56,27
CPT,L2628,Metal frame recipro hip & ca,,,2516.63,7268.75,27
CPT,L2630,Pelvic control band & belt u,,,371.96,1074.34,27
CPT,L2640,Pelvic control band & belt b,,,378.59,1093.48,27
CPT,L2650,Pelv & thor control gluteal,,,135.2,390.48,27
CPT,L2660,Thoracic control thoracic ba,,,279.96,808.61,27
CPT,L2670,Thorac cont paraspinal uprig,,,256.23,740.08,27
CPT,L2680,Thorac cont lat support upri,,,235.06,678.91,27
CPT,L2750,Plating chrome/nickel pr bar,,,94.16,271.95,27
CPT,L2755,Carbon graphite lamination,,,159.11,459.54,27
CPT,L2755,HC CUS ADDL LWR EXT ORTHOS FOR CUS FAB ONLY,611.95,458.96,7.34,550.76,119
CPT,L2760,Extension per extension per,,,91.27,263.6,27
CPT,L2768,Ortho sidebar disconnect,,,158.71,458.39,27
CPT,L2780,Non-corrosive finish,,,76.25,220.22,27
CPT,L2785,Drop lock retainer each,,,35.7,103.11,27
CPT,L2795,HC KNEE CONTROL FULL KNEECAP L2795,67.05,50.29,0.8,60.34,119
CPT,L2795,Knee control full kneecap,,,95.73,276.51,27
CPT,L2800,Knee cap medial or lateral p,,,131.8,380.68,27
CPT,L2810,Knee control condylar pad,,,87.99,254.14,27
CPT,L2820,HC SOFT INTERFACE BELOW KNEE L2820,658.05,493.54,7.9,592.24,119
CPT,L2820,Soft interface below knee se,,,130.44,376.76,27
CPT,L2830,Soft interface above knee se,,,141.12,407.59,27
CPT,L2840,Tibial length sock fx or equ,,,49.22,142.17,27
CPT,L2850,Femoral lgth sock fx or equa,,,89.58,258.72,27
CPT,L3000,Ft insert ucb berkeley shell,,,382.6,1105.04,27
CPT,L3001,Foot insert remov molded spe,,,161.11,465.31,27
CPT,L3002,Foot insert plastazote or eq,,,196.7,568.12,27
CPT,L3003,Foot insert silicone gel eac,,,212.23,613.0,27
CPT,L3010,Foot longitudinal arch suppo,,,212.23,613.0,27
CPT,L3010,"HC MOLDED FOOT, INSERT REMOVABLE, EA",260.67,195.5,3.13,234.6,119
CPT,L3020,Foot longitud/metatarsal sup,,,241.65,697.97,27
CPT,L3020,"HC MOLDED, FOOT, INSERT, REMOVABLE W METATARSAL PAD OR BAR, EA",2.2,1.65,0.03,1.98,119
CPT,L3030,Foot arch support remov prem,,,92.92,268.37,27
CPT,L3031,Foot lamin/prepreg composite,,,149.21,430.96,27
CPT,L3040,Ft arch suprt premold longit,,,57.34,165.63,27
CPT,L3050,Foot arch supp premold metat,,,57.34,165.63,27
CPT,L3060,Foot arch supp longitud/meta,,,89.86,259.54,27
CPT,L3060,HC PREMOLDED METATARS REMOVBLE ARCH SUPP EA L3060,71.15,53.36,0.85,64.04,119
CPT,L3070,Arch suprt att to sho longit,,,38.73,111.86,27
CPT,L3080,Arch supp att to shoe metata,,,38.73,111.86,27
CPT,L3090,Arch supp att to shoe long/m,,,49.53,143.04,27
CPT,L3100,Hallus-valgus nt dyn pre ots,,,52.65,152.09,27
CPT,L3140,Abduction rotation bar shoe,,,108.44,313.23,27
CPT,L3150,Abduct rotation bar w/o shoe,,,99.13,286.34,27
CPT,L3170,Foot plas heel stabi pre ots,,,61.97,179.0,27
CPT,L3224,Womans shoe oxford brace,,,68.88,198.98,27
CPT,L3225,Mans shoe oxford brace,,,91.93,265.52,27
CPT,L3300,Sho lift taper to metatarsal,,,63.52,183.47,27
CPT,L3310,Shoe lift elev heel/sole neo,,,99.13,286.34,27
CPT,L3330,Lifts elevation metal extens,,,689.34,1991.0,27
CPT,L3332,Shoe lifts tapered to one-ha,,,89.86,259.54,27
CPT,L3334,Shoe lifts elevation heel /i,,,46.5,134.31,27
CPT,L3340,Shoe wedge sach,,,103.78,299.74,27
CPT,L3350,Shoe heel wedge,,,27.84,80.42,27
CPT,L3360,Shoe sole wedge outside sole,,,43.36,125.23,27
CPT,L3370,Shoe sole wedge between sole,,,60.43,174.51,27
CPT,L3380,Shoe clubfoot wedge,,,60.43,174.51,27
CPT,L3390,Shoe outflare wedge,,,60.43,174.51,27
CPT,L3400,Shoe metatarsal bar wedge ro,,,49.53,143.04,27
CPT,L3410,Shoe metatarsal bar between,,,113.13,326.76,27
CPT,L3420,Full sole/heel wedge btween,,,66.6,192.36,27
CPT,L3430,Sho heel count plast reinfor,,,195.21,563.81,27
CPT,L3440,Heel leather reinforced,,,92.92,268.37,27
CPT,L3450,Shoe heel sach cushion type,,,128.54,371.27,27
CPT,L3455,Shoe heel new leather standa,,,49.53,143.04,27
CPT,L3460,Shoe heel new rubber standar,,,41.86,120.9,27
CPT,L3465,Shoe heel thomas with wedge,,,71.27,205.86,27
CPT,L3470,Shoe heel thomas extend to b,,,75.95,219.37,27
CPT,L3480,Shoe heel pad & depress for,,,75.95,219.37,27
CPT,L3500,Ortho shoe add leather insol,,,35.6,102.84,27
CPT,L3510,Orthopedic shoe add rub insl,,,35.6,102.84,27
CPT,L3520,O shoe add felt w leath insl,,,38.73,111.86,27
CPT,L3530,Ortho shoe add half sole,,,38.73,111.86,27
CPT,L3540,Ortho shoe add full sole,,,61.97,179.0,27
CPT,L3550,O shoe add standard toe tap,,,10.87,31.41,27
CPT,L3560,O shoe add horseshoe toe tap,,,27.84,80.42,27
CPT,L3570,O shoe add instep extension,,,103.78,299.74,27
CPT,L3580,O shoe add instep velcro clo,,,78.99,228.17,27
CPT,L3590,O shoe convert to sof counte,,,65.06,187.93,27
CPT,L3595,Ortho shoe add march bar,,,51.09,147.57,27
CPT,L3600,Trans shoe calip plate exist,,,92.92,268.37,27
CPT,L3610,Trans shoe caliper plate new,,,122.39,353.49,27
CPT,L3620,Trans shoe solid stirrup exi,,,92.92,268.37,27
CPT,L3630,Trans shoe solid stirrup new,,,122.39,353.49,27
CPT,L3640,Shoe dennis browne splint bo,,,52.65,152.09,27
CPT,L3650,HC PREFAB SHOULDER ORTHO FIG 8 RESTRAINER OTS,72.65,54.49,0.87,65.39,119
CPT,L3650,So 8 abd restraint pre ots,,,65.38,188.83,27
CPT,L3660,HC PREFAB SHOULDER ORTHOSIS FIGURE 8 ABDUCTION RESTRAINER OTS,26.0,19.5,0.31,23.4,119
CPT,L3660,So 8 ab rstr can/web pre ots,,,147.9,427.17,27
CPT,L3670,HC PREFAB ULTRA SLING OTS,250.55,187.91,3.01,225.5,119
CPT,L3670,So acro/clav can web pre ots,,,124.66,360.05,27
CPT,L3671,So cap design w/o jnts cf,,,998.86,2884.99,27
CPT,L3674,So airplane w/wo joint cf,,,1310.39,3784.78,27
CPT,L3675,So vest canvas/web pre ots,,,194.5,561.78,27
CPT,L3702,Eo w/o joints cf,,,320.1,924.56,27
CPT,L3710,Eo elas w/metal jnts pre ots,,,136.28,393.6,27
CPT,L3710,HC PREFAB ELB ELAS BRC W/MET OTS,301.85,226.39,3.62,271.67,119
CPT,L3720,Forearm/arm cuffs free motio,,,721.07,2082.66,27
CPT,L3730,Forearm/arm cuffs ext/flex a,,,993.78,2870.3,27
CPT,L3730,HC CUS EO DBL UPRT W/FLEX ASST,571.26,428.44,6.86,514.13,119
CPT,L3740,Cuffs adj lock w/ active con,,,1178.21,3403.01,27
CPT,L3760,Eo adj jt prefab custom fit,,,554.38,1601.22,27
CPT,L3760,HC PREFAB FIT & ADJ ELBOW W/JT,407.6,305.7,4.89,366.84,119
CPT,L3761,Eo adj lock joint prefab ot,,,554.38,1601.22,27
CPT,L3762,Eo rigid w/o joints pre ots,,,119.17,344.2,27
CPT,L3762,"HC PREFAB ELBOW ORTHOSIS, NO JNTS OTS",118.79,89.09,1.43,106.91,119
CPT,L3763,Ewho rigid w/o jnts cf,,,744.64,2150.74,27
CPT,L3764,Ewho w/joint(s) cf,,,851.22,2458.55,27
CPT,L3765,Ewhfo rigid w/o jnts cf,,,1421.46,4105.55,27
CPT,L3766,Ewhfo w/joint(s) cf,,,1505.21,4347.47,27
CPT,L3806,Whfo w/joint(s) custom fab,,,503.55,1454.41,27
CPT,L3807,HC PREFAB CUS RESTING HAND SPLINT,122.15,91.61,1.47,109.94,119
CPT,L3807,Whfo w/o joints pre cst,,,277.16,800.5,27
CPT,L3808,HC CUS FIT& ADJ WHFO RIDGID W/O JNT,270.11,202.58,3.24,243.1,119
CPT,L3808,Whfo rigid w/o joints,,,402.3,1161.94,27
CPT,L3809,HC PREFAB WRS-FNG WO JNT OTS,194.15,145.61,2.33,174.74,119
CPT,L3809,Whfo w/o joints pre ots,,,277.16,800.5,27
CPT,L3900,Hinge extension/flex wrist/f,,,1426.48,4120.1,27
CPT,L3901,Hinge ext/flex wrist finger,,,2269.88,6556.06,27
CPT,L3904,Whfo electric custom fitted,,,4304.52,12432.68,27
CPT,L3905,Who w/nontorsion jnt(s) cf,,,1099.37,3175.27,27
CPT,L3906,HC CUS FIT & ADJ WRST/HAND ORTH W/O JNT,36.3,27.22,0.44,32.67,119
CPT,L3906,Who w/o joints cf,,,450.83,1302.11,27
CPT,L3908,HC PREFAB WRIST-HAND ORTHO W EXT CONTR COCK-UP OTS,18.1,13.58,0.22,16.29,119
CPT,L3908,Who cock-up nonmolde pre ots,,,66.05,190.77,27
CPT,L3912,Hfo flexion glove pre ots,,,104.55,301.96,27
CPT,L3913,HC CUS FIT & ADJ H/F ORTHOSIS W/O JOINTS,166.97,125.23,2.0,150.27,119
CPT,L3913,Hfo w/o joints cf,,,300.24,867.17,27
CPT,L3915,Who nontorsion jnts pre cst,,,589.29,1702.05,27
CPT,L3916,Who nontorsion jnts pre ots,,,589.29,1702.05,27
CPT,L3917,Metacarp fx orthosis pre cst,,,117.07,338.13,27
CPT,L3918,Metacarp fx orthosis pre ots,,,117.07,338.13,27
CPT,L3919,HC CUS FIT & ADJ HO W/O JOINTS,169.6,127.2,2.04,152.64,119
CPT,L3919,Ho w/o joints cf,,,300.24,867.17,27
CPT,L3921,HC CUS FIT & ADJ HFO W JOINT(S),712.08,534.06,8.54,640.87,119
CPT,L3921,Hfo w/joint(s) cf,,,356.04,1028.36,27
CPT,L3923,HC HFO WITHOUTH JOINTS PRE CST,116.95,87.71,1.4,105.26,119
CPT,L3923,Hfo without joints pre cst,,,95.9,276.96,27
CPT,L3924,HC PREFAB HFO WO JOINTS OTS,189.3,141.98,2.27,170.37,119
CPT,L3924,Hfo without joints pre ots,,,95.9,276.96,27
CPT,L3925,Fo pip dip jnt/sprng pre ots,,,54.42,157.19,27
CPT,L3925,HC FO PIP DIP JNT/SPRNG PRE OTS,82.9,62.18,0.99,74.61,119
CPT,L3927,Fo pip dip no jt spr pre ots,,,38.78,112.0,27
CPT,L3927,HC FO PIP DIP NO JT SPR PRE OTS,128.96,96.72,1.55,116.06,119
CPT,L3929,Hfo nontorsion jnts pre cst,,,86.18,248.92,27
CPT,L3930,Hfo nontorsion jnts pre ots,,,86.18,248.92,27
CPT,L3931,Whfo nontorsion joint prefab,,,212.89,614.88,27
CPT,L3933,Fo w/o joints cf,,,236.52,683.16,27
CPT,L3933,HC CUS FIT & ADJ FINGER ORTHOSIS W/O JNTS,90.68,68.01,1.09,81.61,119
CPT,L3935,Fo nontorsion joint cf,,,244.97,707.55,27
CPT,L3935,HC CUS FIT & ADJ FO NONTORSION JOINT,489.94,367.46,5.88,440.95,119
CPT,L3960,Sewho airplan desig abdu pos,,,810.2,2340.08,27
CPT,L3961,Sewho cap design w/o jnts cf,,,1862.51,5379.48,27
CPT,L3962,Sewho erbs palsey design abd,,,790.98,2284.58,27
CPT,L3967,Sewho airplane w/o jnts cf,,,2199.0,6351.33,27
CPT,L3971,Sewho cap design w/jnt(s) cf,,,2087.32,6028.76,27
CPT,L3973,Sewho airplane w/jnt(s) cf,,,2199.0,6351.33,27
CPT,L3975,Sewhfo cap design w/o jnt cf,,,1862.51,5379.48,27
CPT,L3976,Sewhfo airplane w/o jnts cf,,,1862.51,5379.48,27
CPT,L3977,Sewhfo cap desgn w/jnt(s) cf,,,2087.32,6028.76,27
CPT,L3978,Sewhfo airplane w/jnt(s) cf,,,2199.0,6351.33,27
CPT,L3980,HC PREFAB FIT & ADJ ORTHOSIS FX HUMERAL,559.8,419.85,6.72,503.82,119
CPT,L3980,Up ext fx orthos humeral nos,,,340.81,984.36,27
CPT,L3981,Ue fx orth shoul cap forearm,,,1118.11,3229.4,27
CPT,L3982,HC PREFAB FIT & ADJ UPPER EXTREM FX ORTHOSIS,22.8,17.1,0.27,20.52,119
CPT,L3982,Upper ext fx orthosis rad/ul,,,421.4,1217.11,27
CPT,L3984,"HC PREFAB FIT & ADJ UPPER EXT FRACTURE ORTHOSIS/BRACE, WRIST",427.95,320.96,5.14,385.16,119
CPT,L3984,Upper ext fx orthosis wrist,,,436.0,1259.29,27
CPT,L3995,Sock fracture or equal each,,,36.05,104.12,27
CPT,L4000,Repl girdle milwaukee orth,,,1629.09,4705.27,27
CPT,L4010,Replace trilateral socket br,,,819.58,2367.18,27
CPT,L4020,Replace quadlat socket brim,,,970.36,2802.69,27
CPT,L4030,Replace socket brim cust fit,,,568.8,1642.85,27
CPT,L4040,Replace molded thigh lacer,,,480.05,1386.53,27
CPT,L4045,Replace non-molded thigh lac,,,444.83,1284.78,27
CPT,L4050,Replace molded calf lacer,,,465.1,1343.34,27
CPT,L4055,Replace non-molded calf lace,,,301.17,869.87,27
CPT,L4060,Replace high roll cuff,,,477.38,1378.82,27
CPT,L4070,Replace prox & dist upright,,,317.05,915.73,27
CPT,L4080,Repl met band kafo-afo prox,,,113.95,329.12,27
CPT,L4090,Repl met band kafo-afo calf/,,,101.74,293.86,27
CPT,L4100,Repl leath cuff kafo prox th,,,117.51,339.41,27
CPT,L4110,Repl leath cuff kafo-afo cal,,,96.8,279.57,27
CPT,L4130,Replace pretibial shell,,,642.36,1855.3,27
CPT,L4205,Ortho dvc repair per 15 min,,,29.13,83.33,26
CPT,L4350,Ankle control ortho pre ots,,,100.7,290.86,27
CPT,L4350,HC PREFAB ANKLE AIRCAST; RIGID/STIRRUP OTS,243.6,182.7,2.92,219.24,119
CPT,L4360,HC PNEUMAT WALKING BOOT PRE CAST,161.55,121.16,1.94,145.4,119
CPT,L4360,Pneumat walking boot pre cst,,,336.62,972.26,27
CPT,L4361,HC PREFAB PNMTIC BOOT OTS,155.0,116.25,1.86,139.5,119
CPT,L4361,Pneuma/vac walk boot pre ots,,,336.62,972.26,27
CPT,L4370,Pneum full leg splnt pre ots,,,233.28,673.79,27
CPT,L4386,"HC NON-PNEUMATIC WALKING BOOT, PREFAB-CUSTOM FIT",138.5,103.88,1.66,124.65,119
CPT,L4386,Non-pneum walk boot pre cst,,,193.12,557.77,27
CPT,L4387,HC PREFAB NON-PNMTC BOOT OTS,266.0,199.5,3.19,239.4,119
CPT,L4387,Non-pneum walk boot pre ots,,,193.12,557.77,27
CPT,L4392,Replace afo soft interface,,,28.17,81.35,27
CPT,L4394,Replace foot drop spint,,,20.53,59.29,27
CPT,L4396,HC PREFAB CUS ANKLE CONTRACTURE BOOT,691.95,518.96,8.3,622.76,119
CPT,L4396,HC PREFAB CUS BOOT AFO PODOUS REG,456.75,342.56,5.48,411.08,119
CPT,L4396,Static or dynami afo pre cst,,,200.73,579.77,27
CPT,L4397,HC PREFAB ANKLE CONTR BOOT OTS,596.15,447.11,7.15,536.54,119
CPT,L4397,Static or dynami afo pre ots,,,200.73,579.77,27
CPT,L4398,Foot drop splint pre ots,,,92.45,267.0,27
CPT,L4631,Afo walk boot type cus fab,,,1676.52,4842.27,27
CPT,L5000,Sho insert w arch toe filler,,,606.43,1751.55,27
CPT,L5010,Mold socket ank hgt w/ toe f,,,1603.04,4630.04,27
CPT,L5020,Tibial tubercle hgt w/ toe f,,,2812.59,8123.57,27
CPT,L5050,Ank symes mold sckt sach ft,,,2988.14,8630.6,27
CPT,L5060,Symes met fr leath socket ar,,,4050.18,11698.06,27
CPT,L5100,Molded socket shin sach foot,,,2789.55,8057.0,27
CPT,L5105,Plast socket jts/thgh lacer,,,4574.04,13211.15,27
CPT,L5150,Mold sckt ext knee shin sach,,,4668.49,13483.92,27
CPT,L5160,Mold socket bent knee shin s,,,5141.23,14849.33,27
CPT,L5200,Kne sing axis fric shin sach,,,3964.97,11451.96,27
CPT,L5210,No knee/ankle joints w/ ft b,,,3139.28,9067.12,27
CPT,L5220,No knee joint with artic ali,,,3617.25,10447.64,27
CPT,L5230,Fem focal defic constant fri,,,6087.9,17583.59,27
CPT,L5250,Hip canad sing axi cons fric,,,7822.45,22593.46,27
CPT,L5270,Tilt table locking hip sing,,,7135.5,20609.36,27
CPT,L5280,Hemipelvect canad sing axis,,,8105.34,23410.53,27
CPT,L5301,Bk mold socket sach ft endo,,,2778.5,8025.1,27
CPT,L5312,Knee disart sach ft endo,,,4377.37,12643.09,27
CPT,L5321,Ak open end sach,,,3944.84,11393.82,27
CPT,L5331,Hip disart canadian sach ft,,,6724.11,19421.14,27
CPT,L5341,Hemipelvectomy canadian sach,,,7280.84,21029.15,27
CPT,L5400,Postop dress & 1 cast chg bk,,,1472.98,4254.4,27
CPT,L5410,Postop dsg bk ea add cast ch,,,501.48,1448.4,27
CPT,L5420,Postop dsg & 1 cast chg ak/d,,,2051.81,5926.2,27
CPT,L5430,Postop dsg ak ea add cast ch,,,603.98,1744.47,27
CPT,L5450,HC IPOP BK RIGID DRESS L5450,1332.45,999.34,15.99,1199.21,119
CPT,L5450,Postop app non-wgt bear dsg,,,588.07,1698.53,27
CPT,L5460,Postop app non-wgt bear dsg,,,688.77,1989.36,27
CPT,L5500,Init bk ptb plaster direct,,,2030.67,5865.17,27
CPT,L5505,Init ak ischal plstr direct,,,2363.76,6827.21,27
CPT,L5510,Prep bk ptb plaster molded,,,2023.28,5843.81,27
CPT,L5520,Perp bk ptb thermopls direct,,,1726.01,4985.2,27
CPT,L5530,Prep bk ptb thermopls molded,,,2271.47,6560.65,27
CPT,L5535,Prep bk ptb open end socket,,,2035.38,5878.77,27
CPT,L5540,Prep bk ptb laminated socket,,,2438.06,7041.8,27
CPT,L5560,Prep ak ischial plast molded,,,2850.32,8232.54,27
CPT,L5570,Prep ak ischial direct form,,,3084.54,8909.05,27
CPT,L5580,Prep ak ischial thermo mold,,,3464.71,10007.09,27
CPT,L5585,Prep ak ischial open end,,,3473.78,10033.24,27
CPT,L5590,Prep ak ischial laminated,,,3684.89,10643.02,27
CPT,L5595,Hip disartic sach thermopls,,,4832.77,13958.4,27
CPT,L5600,Hip disart sach laminat mold,,,5336.83,15414.29,27
CPT,L5610,Above knee hydracadence,,,3218.05,9294.64,27
CPT,L5611,Ak 4 bar link w/fric swing,,,2578.4,7447.15,27
CPT,L5613,Ak 4 bar ling w/hydraul swig,,,3687.53,10650.61,27
CPT,L5614,4-bar link above knee w/swng,,,2059.48,5948.34,27
CPT,L5615,Ak 4 bar link hydl swg/stanc,,,7782.7,9035.71,19
CPT,L5616,Ak univ multiplex sys frict,,,2140.48,6182.31,27
CPT,L5617,Ak/bk self-aligning unit ea,,,680.76,1966.21,27
CPT,L5618,Test socket symes,,,337.55,974.96,27
CPT,L5620,Test socket below knee,,,333.68,963.78,27
CPT,L5622,Test socket knee disarticula,,,435.12,1256.73,27
CPT,L5624,Test socket above knee,,,437.72,1264.26,27
CPT,L5626,Test socket hip disarticulat,,,572.26,1652.84,27
CPT,L5628,Test socket hemipelvectomy,,,579.49,1673.74,27
CPT,L5629,Below knee acrylic socket,,,381.43,1101.67,27
CPT,L5630,Syme typ expandabl wall sckt,,,588.27,1699.08,27
CPT,L5631,Ak/knee disartic acrylic soc,,,527.36,1523.17,27
CPT,L5632,Symes type ptb brim design s,,,327.61,946.22,27
CPT,L5634,Symes type poster opening so,,,486.8,1406.0,27
CPT,L5636,Symes type medial opening so,,,407.76,1177.72,27
CPT,L5637,Below knee total contact,,,346.74,1001.48,27
CPT,L5638,Below knee leather socket,,,778.81,2249.42,27
CPT,L5639,Below knee wood socket,,,1794.25,5182.29,27
CPT,L5640,Knee disarticulat leather so,,,1023.3,2955.57,27
CPT,L5642,Above knee leather socket,,,991.51,2863.75,27
CPT,L5643,Hip flex inner socket ext fr,,,2490.8,7194.16,27
CPT,L5644,Above knee wood socket,,,945.22,2730.05,27
CPT,L5645,Bk flex inner socket ext fra,,,1276.88,3688.01,27
CPT,L5646,Below knee cushion socket,,,851.79,2460.22,27
CPT,L5647,Below knee suction socket,,,1165.73,3366.96,27
CPT,L5648,Above knee cushion socket,,,1053.61,3043.12,27
CPT,L5649,Isch containmt/narrow m-l so,,,2544.5,7349.22,27
CPT,L5650,Tot contact ak/knee disart s,,,781.25,2256.48,27
CPT,L5651,Ak flex inner socket ext fra,,,1921.85,5550.86,27
CPT,L5652,Suction susp ak/knee disart,,,697.71,2015.18,27
CPT,L5653,Knee disart expand wall sock,,,931.39,2690.11,27
CPT,L5654,Socket insert symes,,,400.19,1155.87,27
CPT,L5655,Socket insert below knee,,,318.35,919.49,27
CPT,L5656,Socket insert knee articulat,,,459.44,1326.99,27
CPT,L5658,Socket insert above knee,,,500.21,1444.76,27
CPT,L5661,Multi-durometer symes,,,730.41,2109.62,27
CPT,L5665,Multi-durometer below knee,,,614.55,1775.0,27
CPT,L5666,Below knee cuff suspension,,,84.01,242.67,27
CPT,L5668,Bk molded distal cushion,,,121.21,350.06,27
CPT,L5670,Bk molded supracondylar susp,,,434.25,1254.25,27
CPT,L5671,Bk/ak locking mechanism,,,796.03,2299.15,27
CPT,L5672,Bk removable medial brim sus,,,477.2,1378.27,27
CPT,L5673,Socket insert w lock mech,,,909.4,2626.61,27
CPT,L5676,Bk knee joints single axis p,,,537.91,1553.63,27
CPT,L5677,Bk knee joints polycentric p,,,591.78,1709.24,27
CPT,L5678,Bk joint covers pair,,,62.01,179.13,27
CPT,L5679,Socket insert w/o lock mech,,,757.79,2188.73,27
CPT,L5680,Bk thigh lacer non-molded,,,446.0,1288.17,27
CPT,L5681,Intl custm cong/latyp insert,,,1608.6,4646.09,27
CPT,L5682,Bk thigh lacer glut/ischia m,,,750.62,2168.0,27
CPT,L5683,Initial custom socket insert,,,1608.6,4646.09,27
CPT,L5684,Bk fork strap,,,58.91,170.14,27
CPT,L5685,Below knee sus/seal sleeve,,,156.33,451.53,27
CPT,L5686,Bk back check,,,72.44,209.23,27
CPT,L5688,Bk waist belt webbing,,,73.32,211.77,27
CPT,L5690,Bk waist belt padded and lin,,,117.45,339.22,27
CPT,L5692,Ak pelvic control belt light,,,165.04,476.69,27
CPT,L5692,HC ADDITION TO LOWER EXTREMETY ABOVE KNEE PELVIC CONTROL BELT LIGHT,962.8,722.1,11.55,866.52,119
CPT,L5694,Ak pelvic control belt pad/l,,,242.74,701.1,27
CPT,L5695,Ak sleeve susp neoprene/equa,,,237.97,687.32,27
CPT,L5695,HC AK SLEEVE SUSP NEOPRENE OR EQUAL,884.85,663.64,10.62,796.36,119
CPT,L5696,Ak/knee disartic pelvic join,,,222.07,641.4,27
CPT,L5697,Ak/knee disartic pelvic band,,,104.99,303.24,27
CPT,L5698,Ak/knee disartic silesian ba,,,125.2,361.62,27
CPT,L5699,Shoulder harness,,,223.79,646.38,27
CPT,L5700,Replace socket below knee,,,3405.83,9837.03,27
CPT,L5701,Replace socket above knee,,,4545.81,13129.59,27
CPT,L5702,Replace socket hip,,,6265.41,18096.27,27
CPT,L5703,Symes ankle w/o (sach) foot,,,2715.61,7843.46,27
CPT,L5704,Custom shape cover bk,,,710.73,2052.78,27
CPT,L5705,Custom shape cover ak,,,1206.78,3485.55,27
CPT,L5706,Custom shape cvr knee disart,,,1190.75,3439.21,27
CPT,L5707,Custom shape cvr hip disart,,,1642.85,4745.01,27
CPT,L5710,Kne-shin exo sng axi mnl loc,,,509.38,1471.22,27
CPT,L5711,Knee-shin exo mnl lock ultra,,,626.72,1810.14,27
CPT,L5712,Knee-shin exo frict swg & st,,,517.18,1493.76,27
CPT,L5714,Knee-shin exo variable frict,,,609.18,1759.46,27
CPT,L5716,Knee-shin exo mech stance ph,,,1166.37,3368.81,27
CPT,L5718,Knee-shin exo frct swg & sta,,,1457.85,4210.67,27
CPT,L5722,Knee-shin pneum swg frct exo,,,1205.53,3481.94,27
CPT,L5724,Knee-shin exo fluid swing ph,,,1893.54,5469.08,27
CPT,L5726,Knee-shin ext jnts fld swg e,,,2087.9,6030.43,27
CPT,L5728,Knee-shin fluid swg & stance,,,3437.85,9929.49,27
CPT,L5780,Knee-shin pneum/hydra pneum,,,1379.47,3984.3,27
CPT,L5781,Lower limb pros vacuum pump,,,4883.25,14104.21,27
CPT,L5782,Hd low limb pros vacuum pump,,,5148.04,14868.99,27
CPT,L5783,Add low ext mec limb vol lam,,,3088.3,3585.52,19
CPT,L5785,Exoskeletal bk ultralt mater,,,623.59,1801.1,27
CPT,L5790,Exoskeletal ak ultra-light m,,,863.0,2492.6,27
CPT,L5795,Exoskel hip ultra-light mate,,,1288.69,3722.09,27
CPT,L5810,Endoskel knee-shin mnl lock,,,648.79,1873.86,27
CPT,L5811,Endo knee-shin mnl lck ultra,,,1133.85,3274.9,27
CPT,L5812,Endo knee-shin frct swg & st,,,834.62,2410.63,27
CPT,L5814,Endo knee-shin hydral swg ph,,,4532.61,13091.47,27
CPT,L5816,Endo knee-shin polyc mch sta,,,1360.99,3930.92,27
CPT,L5818,Endo knee-shin frct swg & st,,,1536.83,4438.78,27
CPT,L5822,Endo knee-shin pneum swg frc,,,2260.59,6529.25,27
CPT,L5824,Endo knee-shin fluid swing p,,,2454.19,7088.41,27
CPT,L5826,Miniature knee joint,,,3811.38,11008.35,27
CPT,L5827,Endo knee shin single axis,,,7311.26,8488.37,18
CPT,L5828,Endo knee-shin fluid swg/sta,,,3811.44,11008.53,27
CPT,L5830,Endo knee-shin pneum/swg pha,,,2277.5,6578.07,27
CPT,L5840,Multi-axial knee/shin system,,,4684.02,13528.77,27
CPT,L5841,Addition endoskletl knee-shi,,,3175.53,3686.79,19
CPT,L5845,Knee-shin sys stance flexion,,,2187.48,6318.07,27
CPT,L5848,Knee-shin sys hydraul stance,,,1312.34,3790.4,27
CPT,L5850,Endo ak/hip knee extens assi,,,204.71,591.28,27
CPT,L5855,Mech hip extension assist,,,491.41,1419.33,27
CPT,L5856,Elec knee-shin swing/stance,,,29277.32,84561.19,27
CPT,L5857,Elec knee-shin swing only,,,10375.38,29967.05,27
CPT,L5858,Stance phase only,,,22682.29,65512.88,27
CPT,L5859,Knee-shin pro flex/ext cont,,,17707.86,51145.31,27
CPT,L5910,Endo below knee alignable sy,,,579.6,1674.05,27
CPT,L5920,Endo ak/hip alignable system,,,843.27,2435.61,27
CPT,L5925,Above knee manual lock,,,537.72,1553.09,27
CPT,L5926,Endoskel posit rotat unit,,,723.97,840.53,19
CPT,L5930,High activity knee frame,,,4095.11,11827.84,27
CPT,L5940,Endo bk ultra-light material,,,802.74,2318.54,27
CPT,L5950,Endo ak ultra-light material,,,970.24,2802.33,27
CPT,L5960,Endo hip ultra-light materia,,,1157.08,3341.98,27
CPT,L5961,Endo poly hip pneu/hyd/rot,,,6154.17,17774.98,27
CPT,L5962,Below knee flex cover system,,,898.74,2595.83,27
CPT,L5964,Above knee flex cover system,,,1270.11,3668.44,27
CPT,L5966,Hip flexible cover system,,,1615.16,4665.02,27
CPT,L5968,Multiaxial ankle w dorsiflex,,,4435.02,12809.59,27
CPT,L5970,Foot external keel sach foot,,,272.52,787.12,27
CPT,L5971,Sach foot replacement,,,272.52,787.12,27
CPT,L5972,Flexible keel foot,,,528.4,1526.18,27
CPT,L5973,Ank-foot sys dors-plant flex,,,21285.87,61479.61,27
CPT,L5974,Foot single axis ankle/foot,,,283.6,819.11,27
CPT,L5975,Combo ankle/foot prosthesis,,,565.79,1634.17,27
CPT,L5976,Energy storing foot,,,725.74,2096.15,27
CPT,L5978,Ft prosth multiaxial ankl/ft,,,350.26,1011.68,27
CPT,L5979,Multi-axial ankle/ft prosth,,,3315.12,9575.0,27
CPT,L5980,Flex foot system,,,5933.53,17137.7,27
CPT,L5981,Flex-walk sys low ext prosth,,,3877.43,11199.1,27
CPT,L5982,Exoskeletal axial rotation u,,,925.17,2672.12,27
CPT,L5984,Endoskeletal axial rotation,,,723.97,2091.01,27
CPT,L5985,Lwr ext dynamic prosth pylon,,,343.52,992.19,27
CPT,L5986,Multi-axial rotation unit,,,1014.11,2929.02,27
CPT,L5987,Shank ft w vert load pylon,,,8779.6,25357.98,27
CPT,L5988,Vertical shock reducing pylo,,,2438.02,7041.71,27
CPT,L5990,User adjustable heel height,,,2214.13,6395.06,27
CPT,L5991,Low pros ext osseo connector,,,11524.55,33286.16,27
CPT,L6000,Part hand thumb rem,,,1594.75,4606.1,27
CPT,L6010,Part hand little/ring,,,1889.43,5457.22,27
CPT,L6020,Part hand no fingers,,,1682.06,4858.27,27
CPT,L6026,Part hand myo exclu term dev,,,5716.86,16511.9,27
CPT,L6050,Wrst mld sck flx hng tri pad,,,2453.64,7086.8,27
CPT,L6055,Wrst mold sock w/exp interfa,,,3396.97,9811.39,27
CPT,L6100,Elb mold sock flex hinge pad,,,2428.6,7014.49,27
CPT,L6110,Elbow mold sock suspension t,,,2506.42,7239.26,27
CPT,L6120,Elbow mold doub splt soc ste,,,3146.87,9089.05,27
CPT,L6130,Elbow stump activated lock h,,,3395.13,9806.11,27
CPT,L6200,Elbow mold outsid lock hinge,,,3659.84,10570.65,27
CPT,L6205,Elbow molded w/ expand inter,,,4482.45,12946.57,27
CPT,L6250,Elbow inter loc elbow forarm,,,3258.55,9411.62,27
CPT,L6300,Shlder disart int lock elbow,,,4778.05,13800.36,27
CPT,L6310,Shoulder passive restor comp,,,3642.26,10519.89,27
CPT,L6320,Shoulder passive restor cap,,,2186.7,6315.82,27
CPT,L6350,Thoracic intern lock elbow,,,5489.98,15856.63,27
CPT,L6360,Thoracic passive restor comp,,,3822.98,11041.87,27
CPT,L6370,Thoracic passive restor cap,,,2437.79,7041.01,27
CPT,L6380,Postop dsg cast chg wrst/elb,,,1397.64,4036.77,27
CPT,L6382,Postop dsg cast chg elb dis/,,,1899.59,5486.55,27
CPT,L6384,Postop dsg cast chg shlder/t,,,2634.2,7608.31,27
CPT,L6386,Postop ea cast chg & realign,,,482.0,1392.16,27
CPT,L6388,Postop applicat rigid dsg on,,,606.8,1752.61,27
CPT,L6400,Below elbow prosth tiss shap,,,3713.38,10725.32,27
CPT,L6450,Elb disart prosth tiss shap,,,4933.93,14250.59,27
CPT,L6500,Above elbow prosth tiss shap,,,4851.92,14013.72,27
CPT,L6550,Shldr disar prosth tiss shap,,,6068.83,17528.49,27
CPT,L6570,Scap thorac prosth tiss shap,,,6314.52,18238.1,27
CPT,L6580,Wrist/elbow bowden cable mol,,,2257.79,6521.14,27
CPT,L6582,Wrist/elbow bowden cbl dir f,,,2202.54,6361.55,27
CPT,L6584,Elbow fair lead cable molded,,,2456.67,7095.54,27
CPT,L6586,Elbow fair lead cable dir fo,,,2556.07,7382.63,27
CPT,L6588,Shdr fair lead cable molded,,,3392.51,9798.53,27
CPT,L6590,Shdr fair lead cable direct,,,3402.51,9827.41,27
CPT,L6600,Polycentric hinge pair,,,225.14,650.27,27
CPT,L6605,Single pivot hinge pair,,,222.3,642.08,27
CPT,L6610,Flexible metal hinge pair,,,203.44,587.6,27
CPT,L6611,Additional switch ext power,,,502.49,1451.31,27
CPT,L6615,Disconnect locking wrist uni,,,234.33,676.82,27
CPT,L6616,Disconnect insert locking wr,,,77.85,224.86,27
CPT,L6620,Flexion/extension wrist unit,,,408.31,1179.33,27
CPT,L6621,Flex/ext wrist w/wo friction,,,2791.55,8062.79,27
CPT,L6623,Spring-ass rot wrst w/ latch,,,769.91,2223.71,27
CPT,L6624,Flex/ext/rotation wrist unit,,,4596.36,13275.57,27
CPT,L6625,Rotation wrst w/ cable lock,,,638.35,1843.74,27
CPT,L6628,Quick disconn hook adapter o,,,766.63,2214.24,27
CPT,L6629,Lamination collar w/ couplin,,,220.0,635.43,27
CPT,L6630,Stainless steel any wrist,,,258.68,747.13,27
CPT,L6632,Latex suspension sleeve each,,,103.97,300.29,27
CPT,L6635,Lift assist for elbow,,,248.63,718.12,27
CPT,L6637,Nudge control elbow lock,,,440.72,1272.92,27
CPT,L6638,Elec lock on manual pw elbow,,,3052.03,8815.13,27
CPT,L6640,Shoulder abduction joint pai,,,352.05,1016.83,27
CPT,L6641,Excursion amplifier pulley t,,,193.74,559.59,27
CPT,L6642,Excursion amplifier lever ty,,,260.99,753.8,27
CPT,L6645,Shoulder flexion-abduction j,,,383.15,1106.65,27
CPT,L6646,Multipo locking shoulder jnt,,,3849.31,11117.89,27
CPT,L6647,Shoulder lock actuator,,,633.76,1830.5,27
CPT,L6648,Ext pwrd shlder lock/unlock,,,3970.01,11466.49,27
CPT,L6650,Shoulder universal joint,,,406.26,1173.41,27
CPT,L6655,Standard control cable extra,,,90.16,260.42,27
CPT,L6660,Heavy duty control cable,,,112.81,325.85,27
CPT,L6665,Teflon or equal cable lining,,,55.27,159.64,27
CPT,L6670,Hook to hand cable adapter,,,57.56,166.26,27
CPT,L6672,Harness chest/shlder saddle,,,242.72,701.03,27
CPT,L6675,Harness figure of 8 sing con,,,144.14,416.34,27
CPT,L6676,Harness figure of 8 dual con,,,169.94,490.83,27
CPT,L6677,Ue triple control harness,,,362.05,1045.68,27
CPT,L6680,Test sock wrist disart/bel e,,,294.91,851.78,27
CPT,L6682,Test sock elbw disart/above,,,321.5,928.56,27
CPT,L6684,Test socket shldr disart/tho,,,457.02,1320.01,27
CPT,L6686,Suction socket,,,708.58,2046.59,27
CPT,L6687,Frame typ socket bel elbow/w,,,923.09,2666.14,27
CPT,L6688,Frame typ sock above elb/dis,,,635.82,1836.42,27
CPT,L6689,Frame typ socket shoulder di,,,1078.3,3114.43,27
CPT,L6690,Frame typ sock interscap-tho,,,825.31,2383.72,27
CPT,L6691,Removable insert each,,,414.31,1196.62,27
CPT,L6692,Silicon gel insert w/wo lock,,,839.8,2425.59,27
CPT,L6693,Lockingelbow forearm cntrbal,,,3464.86,10007.48,27
CPT,L6694,Elbow socket ins use w/lock,,,909.4,2626.61,27
CPT,L6695,Elbow socket ins use w/o lck,,,757.79,2188.73,27
CPT,L6696,Cus elbo skt in for con/atyp,,,1608.6,4646.09,27
CPT,L6697,Cus elbo skt in not con/atyp,,,1608.6,4646.09,27
CPT,L6698,Add up-ex prosthes lock mech,,,796.03,2299.15,27
CPT,L6700,Ue add ext power myoel,,,28931.56,33589.54,18
CPT,L6703,Term dev passive hand mitt,,,443.91,1282.13,27
CPT,L6704,Term dev sport/rec/work att,,,864.1,2495.79,27
CPT,L6706,Term dev mech hook vol open,,,555.44,1604.25,27
CPT,L6707,Term dev mech hook vol close,,,1715.35,4954.43,27
CPT,L6708,Term dev mech hand vol open,,,1195.34,3452.47,27
CPT,L6709,Term dev mech hand vol close,,,1853.57,5353.65,27
CPT,L6711,Ped term dev hook vol open,,,820.57,2370.04,27
CPT,L6712,Ped term dev hook vol clos,,,1510.76,4363.49,27
CPT,L6713,Ped term dev hand vol open,,,1906.74,5507.2,27
CPT,L6714,Ped term dev hand vol clos,,,1614.97,4664.48,27
CPT,L6715,Term device multi art digit,,,3860.85,11151.21,27
CPT,L6721,Hook/hand hvy dty vol open,,,2870.46,8290.67,27
CPT,L6722,Hook/hand hvy dty vol clos,,,2474.58,7147.28,27
CPT,L6805,Term dev modifier wrist unit,,,427.42,1234.5,27
CPT,L6810,Term dev precision pinch dev,,,264.25,763.23,27
CPT,L6880,Elec hand ind art digits,,,29217.93,84389.66,27
CPT,L6881,Term dev auto grasp feature,,,4989.46,14410.97,27
CPT,L6882,Microprocessor control uplmb,,,3784.81,10931.6,27
CPT,L6883,Replc sockt below e/w disa,,,2057.04,5941.31,27
CPT,L6884,Replc sockt above elbow disa,,,2679.56,7739.31,27
CPT,L6885,Replc sockt shldr dis/interc,,,3822.98,11041.87,27
CPT,L6890,Prefab glove for term device,,,218.13,630.02,27
CPT,L6895,Custom glove for term device,,,684.99,1978.46,27
CPT,L6900,Hand restorat thumb/1 finger,,,1812.92,5236.25,27
CPT,L6905,Hand restoration multiple fi,,,1762.21,5089.77,27
CPT,L6910,Hand restoration no fingers,,,1716.75,4958.47,27
CPT,L6915,Hand restoration replacmnt g,,,751.38,2170.18,27
CPT,L6920,Wrist disarticul switch ctrl,,,9736.85,28122.78,27
CPT,L6925,Wrist disart myoelectronic c,,,10501.57,30331.53,27
CPT,L6930,Below elbow switch control,,,10230.5,29548.56,27
CPT,L6935,Below elbow myoelectronic ct,,,10983.7,31724.03,27
CPT,L6940,Elbow disarticulation switch,,,14040.8,40553.81,27
CPT,L6945,Elbow disart myoelectronic c,,,16334.84,47179.65,27
CPT,L6950,Above elbow switch control,,,15959.35,46095.12,27
CPT,L6955,Above elbow myoelectronic ct,,,19113.49,55205.17,27
CPT,L6960,Shldr disartic switch contro,,,19277.39,55678.58,27
CPT,L6965,Shldr disartic myoelectronic,,,20885.99,60324.64,27
CPT,L6970,Interscapular-thor switch ct,,,21143.84,61069.41,27
CPT,L6975,Interscap-thor myoelectronic,,,22653.52,65429.79,27
CPT,L7007,Adult electric hand,,,4130.11,11928.92,27
CPT,L7008,Pediatric electric hand,,,6950.26,20074.31,27
CPT,L7009,Adult electric hook,,,4324.66,12490.85,27
CPT,L7040,Prehensile actuator,,,3383.69,9773.06,27
CPT,L7045,Pediatric electric hook,,,1939.99,5603.23,27
CPT,L7170,Electronic elbow hosmer swit,,,7384.16,21327.53,27
CPT,L7180,Electronic elbow sequential,,,42853.91,123774.25,27
CPT,L7181,Electronic elbo simultaneous,,,48901.12,141240.29,27
CPT,L7185,Electron elbow adolescent sw,,,7660.93,22126.93,27
CPT,L7186,Electron elbow child switch,,,13884.71,40102.99,27
CPT,L7190,Elbow adolescent myoelectron,,,9692.58,27994.93,27
CPT,L7191,Elbow child myoelectronic ct,,,14225.9,41088.43,27
CPT,L7259,Electronic wrist rotator any,,,4628.37,13368.03,27
CPT,L7360,Six volt bat otto bock/eq ea,,,272.93,788.3,27
CPT,L7362,Battery chrgr six volt otto,,,400.96,1158.09,27
CPT,L7364,Twelve volt battery utah/equ,,,478.27,1381.39,27
CPT,L7366,Battery chrgr 12 volt utah/e,,,644.25,1860.76,27
CPT,L7367,Replacemnt lithium ionbatter,,,475.14,1372.32,27
CPT,L7368,Lithium ion battery charger,,,615.95,1779.04,27
CPT,L7400,Add ue prost be/wd ultlite,,,374.07,1080.41,27
CPT,L7401,Add ue prost a/e ultlite mat,,,418.78,1209.55,27
CPT,L7402,Add ue prost s/d ultlite mat,,,452.21,1306.11,27
CPT,L7403,Add ue prost b/e acrylic,,,449.44,1298.13,27
CPT,L7404,Add ue prost a/e acrylic,,,678.36,1959.29,27
CPT,L7405,Add ue prost s/d acrylic,,,887.15,2562.36,27
CPT,L7406,Add upp ext mec limb vol lam,,,3088.3,3585.52,18
CPT,L7520,Repair prosthesis per 15 min,,,61.67,176.4,26
CPT,L7700,Pros soc insert gasket/seal,,,143.5,414.49,27
CPT,L8000,Mastectomy bra,,,45.16,130.42,27
CPT,L8001,Breast prosthesis bra & form,,,153.08,442.12,27
CPT,L8002,Brst prsth bra & bilat form,,,201.36,581.6,27
CPT,L8015,Ext breastprosthesis garment,,,73.18,211.35,27
CPT,L8020,Mastectomy form,,,240.78,695.45,27
CPT,L8030,Breast prosthes w/o adhesive,,,427.28,1234.13,27
CPT,L8031,Breast prosthesis w adhesive,,,427.28,1234.13,27
CPT,L8032,Reusable nipple prosthesis,,,47.79,138.04,27
CPT,L8035,Custom breast prosthesis,,,4471.26,12914.25,27
CPT,L8040,Nasal prosthesis,,,2819.01,8142.11,27
CPT,L8041,Midfacial prosthesis,,,3397.99,9814.36,27
CPT,L8042,Orbital prosthesis,,,3817.97,11027.4,27
CPT,L8043,Upper facial prosthesis,,,4276.13,12350.69,27
CPT,L8044,Hemi-facial prosthesis,,,4734.26,13673.88,27
CPT,L8045,Auricular prosthesis,,,2964.34,8561.85,27
CPT,L8046,Partial facial prosthesis,,,3054.36,8821.84,27
CPT,L8047,Nasal septal prosthesis,,,1565.35,4521.16,27
CPT,L8300,Truss single w/ standard pad,,,115.52,333.65,27
CPT,L8310,Truss double w/ standard pad,,,186.32,538.14,27
CPT,L8320,Truss addition to std pad wa,,,64.15,185.28,27
CPT,L8330,Truss add to std pad scrotal,,,59.25,171.15,27
CPT,L8400,Sheath below knee,,,18.89,54.56,27
CPT,L8410,Sheath above knee,,,26.28,75.89,27
CPT,L8415,Sheath upper limb,,,28.41,82.06,27
CPT,L8417,Pros sheath/sock w gel cushn,,,91.76,265.03,27
CPT,L8420,Prosthetic sock multi ply bk,,,23.34,67.43,27
CPT,L8430,Prosthetic sock multi ply ak,,,29.48,85.14,27
CPT,L8435,Pros sock multi ply upper lm,,,25.24,72.89,27
CPT,L8440,HC ORTHOTIC SHRNKR BELW KNEE L8440,197.55,148.16,2.37,177.8,119
CPT,L8440,Shrinker below knee,,,50.19,144.96,27
CPT,L8460,Shrinker above knee,,,79.99,231.04,27
CPT,L8465,Shrinker upper limb,,,58.54,169.08,27
CPT,L8470,Pros sock single ply bk,,,10.68,30.83,27
CPT,L8480,Pros sock single ply ak,,,14.73,42.55,27
CPT,L8485,Pros sock single ply upper l,,,16.01,46.21,27
CPT,L8500,Artificial larynx,,,792.11,2287.83,27
CPT,L8501,HC KIT DILATOR PROVOX VEGA PUNC SET 17FR 10MM,1893.1,1419.82,22.72,1703.79,119
CPT,L8501,HC SET CATHETER KIT PROVOX VEGA PUNC 17F 12.5,1764.48,1323.36,21.17,1588.03,119
CPT,L8501,HC TRACHEOSTOMY SPEAKING VALVE,247.07500000000002,185.305,1.75,313.52,238
CPT,L8501,Tracheostomy speaking valve,,,144.99,418.76,27
CPT,L8507,Trach-esoph voice pros pt in,,,51.11,147.63,27
CPT,L8509,HC PROSTHESIS VOICE INDWELLING,1274.1,955.58,15.29,1146.69,119
CPT,L8509,HC VALVE SPEECH PROSTHESIS VOICE PROVOX2 8M,1260.1,945.08,15.12,1134.09,119
CPT,L8509,Trach-esoph voice pros md in,,,133.26,384.9,27
CPT,L8510,Voice amplifier,,,308.39,890.72,27
CPT,L8511,Indwelling trach insert,,,88.76,256.36,27
CPT,L8512,Gel cap for trach voice pros,,,2.66,7.68,27
CPT,L8513,Trach pros cleaning device,,,6.36,18.35,27
CPT,L8514,Repl trach puncture dilator,,,115.09,332.4,27
CPT,L8515,Gel cap app device for trach,,,77.06,222.55,27
CPT,L8600,Implant breast silicone/eq,,,2418.99,2886.29,8
CPT,L8603,Collagen imp urinary 2.5 ml,,,1272.23,1518.01,8
CPT,L8605,Inj bulking agent anal canal,,,2120.17,2529.74,8
CPT,L8606,Synthetic implnt urinary 1ml,,,641.14,765.0,8
CPT,L8607,Inj vocal cord bulking agent,,,127.01,151.55,8
CPT,L8609,Artificial cornea,,,19286.94,23012.83,8
CPT,L8610,Ocular implant,,,2267.42,2705.44,8
CPT,L8612,Aqueous shunt prosthesis,,,1954.3,2331.83,8
CPT,L8613,Ossicular implant,,,747.07,891.39,8
CPT,L8614,Cochlear device,,,56406.93,67303.72,8
CPT,L8615,Coch implant headset replace,,,551.57,1593.08,27
CPT,L8616,Coch implant microphone repl,,,128.43,370.93,27
CPT,L8617,Coch implant trans coil repl,,,112.19,324.02,27
CPT,L8618,Coch implant tran cable repl,,,32.06,92.61,27
CPT,L8619,Coch imp ext proc/contr rplc,,,10003.53,28893.02,27
CPT,L8621,Repl zinc air battery,,,0.77,2.22,27
CPT,L8622,Repl alkaline battery,,,0.39,1.12,27
CPT,L8623,Lith ion batt cidnon-earlvl,,,79.12,228.53,27
CPT,L8624,Lith ion batt cid ear level,,,197.17,569.49,27
CPT,L8625,Charger coch impl/aoi battry,,,230.96,667.08,27
CPT,L8627,Cid ext speech process repl,,,8474.28,24476.13,27
CPT,L8628,Cid ext controller repl,,,1529.25,4416.93,27
CPT,L8629,Cid transmit coil and cable,,,218.95,632.39,27
CPT,L8630,Metacarpophalangeal implant,,,1286.75,1535.33,8
CPT,L8631,Mcp joint repl 2 pc or more,,,6413.44,7652.4,8
CPT,L8641,Metatarsal joint implant,,,1356.04,1618.0,8
CPT,L8642,Hallux implant,,,887.6,1059.07,8
CPT,L8658,Interphalangeal joint spacer,,,1182.31,1410.71,8
CPT,L8659,Interphalangeal joint repl,,,5712.26,6815.76,8
CPT,L8670,Vascular graft synthetic,,,1617.33,1929.76,8
CPT,L8678,Ext sply implt neurostim,,,47.05,56.14,8
CPT,L8679,Imp neurosti pls gn any type,,,24968.1,29791.48,8
CPT,L8681,Pt prgrm for implt neurostim,,,1294.82,3739.81,27
CPT,L8682,Implt neurostim radiofq rec,,,17839.32,21285.56,8
CPT,L8683,Radiofq trsmtr for implt neu,,,6486.97,18736.22,27
CPT,L8684,Radiof trsmtr implt scrl neu,,,959.12,2770.19,27
CPT,L8689,External recharg sys intern,,,2109.42,6092.6,27
CPT,L8690,Aud osseo dev int/ext comp,,,14082.21,16802.64,8
CPT,L8691,Aoi snd proc repl excl actua,,,2106.02,6082.78,27
CPT,L8693,Aud osseo dev abutment,,,1854.31,5355.77,27
CPT,L8694,Aoi transducer/actuator repl,,,1154.91,3335.7,27
CPT,L8695,External recharg sys extern,,,20.38,58.87,27
CPT,L8696,Ext antenna phren nerve stim,,,265.07,765.61,27
CPT,L8701,Ewh s/d uprt micro sensor,,,34284.44,39804.23,19
CPT,L8702,Ewhf s/d uprt micro sensor,,,67452.66,78312.54,19
CPT,M0201,Pne flu hepb cov home admin,,,35.33,107.45,27
CPT,M0220,"HCD COVID INJ TIXAGEVIMAB AND CILGAVIMAB, INCL POST ADMIN MONITOR",295.06,221.3,3.54,265.55,119
CPT,M0220,Tixagev and cilgav inj,,,367.82,438.88,8
CPT,M0221,Tixagev and cilgav inj hm,,,612.22,730.5,8
CPT,M0222,Bebtelovimab injection,,,856.63,1022.11,8
CPT,M0222,"HCD COVID INJ BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMIN MONITOR",583.0,437.25,7.0,524.7,119
CPT,M0223,Bebtelovimab injection home,,,1345.43,1605.35,8
CPT,M0224,Pemivibart infusion,,,431.88,501.41,18
CPT,M0235,Intrav inf mon anti fir do,,,431.88,501.41,18
CPT,M0236,Intrav inf mon anti sec do,,,431.88,501.41,18
CPT,M0237,Intrav inf toci first dose,,,431.88,501.41,18
CPT,M0238,Intrav inf toci second dos,,,431.88,501.41,18
CPT,M0240,Casiri and imdev repeat,,,1202.56,1434.87,8
CPT,M0241,Casiri and imdev repeat hm,,,2004.26,2391.45,8
CPT,M0243,Casirivi and imdevi inj,,,1202.56,1434.87,8
CPT,M0243,"HCD IV INFUSION, COVID-19, CASIRIVIMAB AND IMDEVIMAB",927.07,695.3,11.12,834.36,119
CPT,M0244,Casirivi and imdevi inj hm,,,2004.26,2391.45,8
CPT,M0245,Bamlan and etesev infusion,,,1202.56,1434.87,8
CPT,M0246,Bamlan and etesev infus home,,,2004.26,2391.45,8
CPT,M0247,"HCD COVID INTRAVENOUS INFUS, SOTROVIMAB INCL POST ADMIN MONITOR",1991.31,1493.48,23.9,1792.18,119
CPT,M0247,Sotrovimab infusion,,,1202.56,1434.87,8
CPT,M0248,Sotrovimab inf  home admin,,,2004.26,2391.45,8
CPT,M0249,Adm tocilizu covid-19 1st,,,431.88,1434.87,26
CPT,M0250,Adm tocilizu covid-19 2nd,,,431.88,1434.87,26
CPT,P2028,Cephalin floculation test,,,4.77,7.43,58
CPT,P2029,Congo red blood test,,,4.77,7.43,58
CPT,P2031,Hair analysis,,,4.95,7.43,39
CPT,P2033,Blood thymol turbidity,,,4.77,7.43,58
CPT,P2038,Blood mucoprotein,,,4.41,7.43,58
CPT,P3000,Screen pap by tech w md supv,,,15.82,22.73,58
CPT,P3001,Screening pap smear by phys,,,21.97,70.4,47
CPT,P7001,Culture bacterial urine,,,28.26,28.26,3
CPT,P9010,HC WHOLE BLOOD FOR TRANSFUSION PER UNIT,1688.31,1266.23,20.26,1519.48,119
CPT,P9010,Whole blood for transfusion,,,189.84,261.36,19
CPT,P9011,Blood split unit,,,141.8,164.63,19
CPT,P9011,"HC BLOOD, SPLIT UNIT - FFP",341.95,256.46,4.1,307.76,119
CPT,P9011,HC PROCESS LEUKO PED PLT ALIQUOT,1312.05,984.04,15.74,1180.84,119
CPT,P9011,HC PROCESS LEUKO PED RBC ALIQUOT,497.4,373.05,5.97,447.66,119
CPT,P9012,Cryoprecipitate each unit,,,63.57,73.8,19
CPT,P9012,HC PROCESS CRYOPRECIPATE,451.7,338.78,5.42,406.53,119
CPT,P9016,"HC PROCESS, LEUKOREDUCED RED CELLS",1651.19,1238.39,19.81,1486.07,119
CPT,P9016,Rbc leukocytes reduced,,,182.0,211.3,19
CPT,P9017,HC ONE DONOR FRESH FROZN PLASMA,457.87,343.4,5.49,412.08,119
CPT,P9017,Plasma 1 donor frz w/in 8 hr,,,84.29,97.86,19
CPT,P9019,Platelets each unit,,,53.17,88.19,19
CPT,P9020,Plaelet rich plasma unit,,,557.32,647.05,19
CPT,P9021,HC PROCESS AUTOLOGOUS RBC-OUTSIDE,1421.22,1065.92,17.05,1279.1,119
CPT,P9021,Red blood cells unit,,,144.32,167.56,19
CPT,P9022,HC WASHED RED BLOOD CELLS EA UNIT,2642.07,1981.55,31.7,2377.86,119
CPT,P9022,Washed red blood cells unit,,,368.58,460.77,19
CPT,P9023,Frozen plasma pooled sd,,,55.96,72.34,19
CPT,P9025,Plasma cryo redu path each,,,133.76,156.91,19
CPT,P9026,Cryo fib comp path redu each,,,313.77,549.28,19
CPT,P9027,Rbc o2 co2 reduced,,,487.1,565.52,19
CPT,P9031,Platelets leukocytes reduced,,,125.77,146.02,19
CPT,P9032,Platelets irradiated,,,135.78,392.97,19
CPT,P9033,Platelets leukoreduced irrad,,,189.59,238.46,19
CPT,P9034,Platelets pheresis,,,308.96,461.07,19
CPT,P9035,"HC PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT",4128.42,3096.32,49.54,3715.58,119
CPT,P9035,Platelet pheres leukoreduced,,,487.1,565.52,19
CPT,P9036,Platelet pheresis irradiated,,,587.65,949.13,19
CPT,P9037,HC PLATELETS PHERESIS LR IRRAD EA UNIT,4500.62,3375.46,54.01,4050.56,119
CPT,P9037,Plate pheres leukoredu irrad,,,675.66,784.44,19
CPT,P9038,HC RBC IRRADIATED EACH UNIT,4069.65,3052.24,48.84,3662.68,119
CPT,P9038,Rbc irradiated,,,145.22,173.24,19
CPT,P9039,HC RBC DEGLYCEROLIZED EACH UNIT WASHED,4241.75,3181.31,50.9,3817.58,119
CPT,P9039,Rbc deglycerolized,,,313.0,758.99,19
CPT,P9040,HC RBCS LEUKOREDUCED IRRAD,2522.86,1892.14,30.27,2270.57,119
CPT,P9040,Rbc leukoreduced irradiated,,,255.8,296.98,19
CPT,P9041,Albumin (human)5% 50ml,,,10.55,12.42,53
CPT,P9043,Plasma protein fract5%50ml,,,8.07,9.37,19
CPT,P9044,Cryoprecipitatereducedplasma,,,132.05,171.02,19
CPT,P9044,HC CRYOPRECIPITATE REDUCED PLASMA,509.2,381.9,6.11,458.28,119
CPT,P9045,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",540.0,405.0,2.36,972.0,476
CPT,P9045,Albumin (human) 5% 250 ml,,,52.77,62.09,63
CPT,P9046,Albumin (human) 25% 20 ml,,,21.1,24.84,63
CPT,P9047,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",810.0,607.5,6.48,972.0,357
CPT,P9047,Albumin (human) 25% 50ml,,,52.77,62.09,53
CPT,P9048,Plasmaprotein fract5%250ml,,,35.32,85.59,19
CPT,P9050,Granulocytes pheresis unit,,,1836.58,1836.58,1
CPT,P9051,Blood l/r cmv-neg,,,151.58,199.92,19
CPT,P9051,HC RBCS LEUKOREDUCED CMV NEG,1792.37,1344.28,21.51,1613.13,119
CPT,P9052,HC PLATELETS HLA MATCHED LEUKOREDUCED,5600.67,4200.5,67.21,5040.6,119
CPT,P9052,Platelets hla-m l/r unit,,,708.06,902.67,19
CPT,P9053,HC PLATELETS APHER IRRAD CMV NEG,4141.47,3106.1,49.7,3727.32,119
CPT,P9053,Plt pher l/r cmv-neg irr,,,459.23,533.17,19
CPT,P9054,Blood l/r froz/degly/wash,,,242.44,281.47,19
CPT,P9055,HC PLATELETS APHER CMV NEG,3835.96,2876.97,46.03,3452.36,119
CPT,P9055,Plt aph/pher l/r cmv-neg,,,227.25,263.84,19
CPT,P9056,Blood l/r irradiated,,,84.17,97.72,19
CPT,P9057,Rbc frz/deg/wsh l/r irrad,,,422.69,563.51,19
CPT,P9058,HC RBCS LEUKOREDUCED IRRAD.CMV NEG,2097.91,1573.43,25.17,1888.12,119
CPT,P9058,Rbc l/r cmv-neg irrad,,,222.86,258.74,19
CPT,P9059,"HC PROCESS FFP,8-24 HRS COLLECT,EA UNIT",459.54,344.66,5.51,413.59,119
CPT,P9059,Plasma frz between 8-24hour,,,71.09,82.54,19
CPT,P9060,Fr frz plasma donor retested,,,48.93,56.81,19
CPT,P9070,Pathogen reduced plasma pool,,,55.78,65.14,19
CPT,P9071,Pathogen reduced plasma sing,,,292.53,339.63,19
CPT,P9073,"HC PLATELETS, PHERESIS, PATHOGEN REDUCED EA UNIT",3442.63,2581.97,41.31,3098.37,119
CPT,P9073,Platelets pheresis path redu,,,587.28,681.83,19
CPT,P9099,Blood component/product noc,,,35.32,56.81,19
CPT,P9100,HC PATHOGEN(S) TEST FOR PLATELETS,806.48,604.86,9.68,725.83,119
CPT,P9100,Pathogen test for platelets,,,37.63,66.11,22
CPT,P9603,One-way allow prorated miles,,,2.82,3.37,8
CPT,P9604,One-way allow prorated trip,,,28.23,33.68,8
CPT,P9612,Catheterize for urine spec,,,4.5,10.55,58
CPT,P9612,HC CATH FOR SPECIMEN COLLECTION POC,24.62,18.46,0.3,22.16,119
CPT,P9615,Urine specimen collect mult,,,4.5,8.57,39
CPT,Q0035,Cardiokymography,,,7.94,61.54,99
CPT,Q0091,Obtaining screen pap smear,,,17.83,125.14,66
CPT,Q0092,Set up port xray equipment,,,23.2,73.25,44
CPT,Q0111,Wet mounts/ w preparations,,,15.82,22.73,58
CPT,Q0112,Potassium hydroxide preps,,,5.19,8.75,58
CPT,Q0113,Pinworm examinations,,,3.8,6.41,58
CPT,Q0114,Fern test,,,8.68,14.61,58
CPT,Q0115,Post-coital mucous exam,,,22.27,37.5,58
CPT,Q0138,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,3637.56,2728.17,43.65,3273.8,119
CPT,Q0138,Ferumoxytol non-esrd,,,0.32,0.55,63
CPT,Q0139,Ferumoxytol esrd use,,,0.32,0.55,63
CPT,Q0144,Azithromycin dihydrate oral,,,26.22,26.22,8
CPT,Q0161,CHLORPROMAZINE 10 MG TABLET,0.82,0.61,0.01,0.74,119
CPT,Q0161,CHLORPROMAZINE 25 MG TABLET,23.41,17.56,0.28,21.07,119
CPT,Q0161,Chlorpromazine hcl 5mg oral,,,1.94,1.94,8
CPT,Q0162,Ondansetron oral,,,0.01,0.01,44
CPT,Q0163,Diphenhydramine hcl 50mg,,,0.04,0.04,8
CPT,Q0164,PROCHLORPERAZINE MALEATE 10 MG TABLET,3.12,2.34,0.04,2.81,119
CPT,Q0164,PROCHLORPERAZINE MALEATE 5 MG TABLET,6.64,4.98,0.08,5.98,119
CPT,Q0164,Prochlorperazine maleate 5mg,,,0.54,0.54,8
CPT,Q0166,Granisetron hcl 1 mg oral,,,53.14,53.14,8
CPT,Q0167,DRONABINOL 2.5 MG CAPSULE,26.82,20.11,0.13,38.21,357
CPT,Q0167,Dronabinol 2.5mg oral,,,0.78,2.83,44
CPT,Q0169,PROMETHAZINE 12.5 MG TABLET,0.48,0.36,0.01,0.43,119
CPT,Q0169,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,232.72,174.54,2.79,209.45,119
CPT,Q0169,Promethazine hcl 12.5mg oral,,,0.23,0.23,8
CPT,Q0173,Trimethobenzamide hcl 250mg,,,,,0
CPT,Q0174,Thiethylperazine maleate10mg,,,,,0
CPT,Q0175,PERPHENAZINE 8 MG TABLET,4.52,3.39,0.05,4.07,119
CPT,Q0175,Perphenazine 4mg oral,,,2.15,2.15,8
CPT,Q0177,Hydroxyzine pamoate 25mg,,,0.2,0.2,8
CPT,Q0180,Dolasetron mesylate oral,,,63.86,63.86,8
CPT,Q0181,Unspecified oral anti-emetic,,,,,0
CPT,Q0220,Tixagev and cilgav- 300mg,,,,,0
CPT,Q0221,Tixagev and cilgav- 600mg,,,0.01,0.01,8
CPT,Q0222,Bebtelovimab 175 mg,,,2268.0,2394.0,44
CPT,Q0224,Inj pemivibart 4500 mg,,,7701.45,7701.45,8
CPT,Q0235,Inj monoclon antibody 1 mg,,,,,0
CPT,Q0237,Inj tocilizumab-anoh hospi,,,,,0
CPT,Q0240,Casirivi and imdevi 600 mg,,,,,0
CPT,Q0243,Casirivimab and imdevimab,,,,,0
CPT,Q0244,Casirivi and imdevi 1200 mg,,,0.01,0.01,8
CPT,Q0245,Bamlanivimab and etesevima,,,0.03,0.03,8
CPT,Q0247,Sotrovimab,,,2268.0,2268.0,8
CPT,Q0249,Tocilizumab for covid-19,,,8.85,8.85,8
CPT,Q0477,HC KIT LVAD HEARTMATE 3 MODULAR CABLE REPLACEMENT,18160.35,13620.26,217.92,16344.31,119
CPT,Q0477,Pwr module pt cable lvad rpl,,,948.78,2740.33,27
CPT,Q0478,HC ADAPTER ASSIST DC FOR HEARTWARE CONTROLLER,6390.0,4792.5,76.68,5751.0,119
CPT,Q0478,Power adapter combo vad,,,224.72,649.05,27
CPT,Q0479,HC POWER UNIT MOBILE HEARTMATE II REPLACEMENT,29350.1,22012.58,352.2,26415.09,119
CPT,Q0479,Power module combo vad rep,,,14650.25,42314.07,27
CPT,Q0480,Driver pneumatic vad rep,,,99999.93,303449.79,27
CPT,Q0481,HC CONTROLLER HEARTMATE 3 LVAD,20178.2,15133.65,242.14,18160.38,119
CPT,Q0481,HC KIT CONTROLLER HEARTWARE,21740.8,16305.6,260.89,19566.72,119
CPT,Q0481,Microprcsr cu elec vad rep,,,17769.7,51323.93,27
CPT,Q0482,Microprcsr cu combo vad rep,,,5565.8,16075.59,27
CPT,Q0483,Monitor elec vad rep,,,22928.6,66224.29,27
CPT,Q0484,Monitor elec or comb vad rep,,,4452.6,12860.36,27
CPT,Q0485,Monitor cable elec vad rep,,,429.93,1241.75,27
CPT,Q0486,Mon cable elec/pneum vad rep,,,357.78,1033.37,27
CPT,Q0487,Leads any type vad rep only,,,417.41,1205.61,27
CPT,Q0489,Pwr pck base combo vad rep,,,19877.86,57412.89,27
CPT,Q0490,Emr pwr source elec vad rep,,,859.8,2483.34,27
CPT,Q0491,Emr pwr source combo vad rep,,,1351.76,3904.28,27
CPT,Q0492,Emr pwr cbl elec vad rep,,,108.89,314.53,27
CPT,Q0493,Emr pwr cbl combo vad rep,,,310.1,895.66,27
CPT,Q0494,Emr hd pmp elec/combo rep,,,262.4,757.9,27
CPT,Q0495,Charger elec/combo vad rep,,,5108.11,14753.68,27
CPT,Q0496,Battery elec/combo vad rep,,,1833.37,5295.3,27
CPT,Q0497,Bat clps elec/comb vad rep,,,572.52,1653.59,27
CPT,Q0497,HC CLIP BATTERY 14V LI-ION REPLACEMENT,2563.1,1922.32,30.76,2306.79,119
CPT,Q0498,HC VEST HOLSTER LVAD ALL REPLACEMENT,1866.8,1400.1,22.4,1680.12,119
CPT,Q0498,Holster elec/combo vad rep,,,628.14,1814.26,27
CPT,Q0499,Belt/vest elec/combo vad rep,,,204.08,589.45,27
CPT,Q0499,HC BAG CONSOLIDATED RIGHT REPLACEMENT,1638.1,1228.58,19.66,1474.29,119
CPT,Q0499,HC PACK WAIST FOR CONTROLLER 2050 REPLACEMENT,1866.8,1400.1,22.4,1680.12,119
CPT,Q0500,Filters elec/combo vad rep,,,37.32,107.81,27
CPT,Q0501,HC BAG SHOWER HEARTMATE II/3 LVAD REPLACEMENT,2097.1,1572.82,25.17,1887.39,119
CPT,Q0501,HC CASE TRAVEL 1260 REPLACEMENT,746.7,560.02,8.96,672.03,119
CPT,Q0501,Shwr cov elec/combo vad rep,,,624.54,1803.83,27
CPT,Q0502,Mobility cart pneum vad rep,,,795.08,2296.42,27
CPT,Q0503,Battery pneum vad replacemnt,,,1590.22,4593.02,27
CPT,Q0504,Pwr adpt pneum vad rep veh,,,839.12,2423.6,27
CPT,Q0506,HC BATTERY 14V LI-ION 4 BATT/SET REPLACEMENT,9585.0,7188.75,115.02,8626.5,119
CPT,Q0506,HC BATTERY LITHIUM ION 11V FOR HE REPLACEMENT,2157.5,1618.12,25.89,1941.75,119
CPT,Q0506,Lith-ion batt elec/pneum vad,,,1044.49,3016.78,27
CPT,Q0508,HC ADAPTER AC HEARTWARE CONTROLLER,4315.0,3236.25,51.78,3883.5,119
CPT,Q0508,HC BAG CONSOLIDATED,1638.1,1228.58,19.66,1474.29,119
CPT,Q0508,HC BAG SHOWER HEARTMATE II/3 LVAD,2097.1,1572.82,25.17,1887.39,119
CPT,Q0508,HC BATTERY 14V LI-ION 4 BATT/SET,9585.0,7188.75,115.02,8626.5,119
CPT,Q0508,HC BATTERY LITHIUM ION 11V FOR HE,2157.5,1618.12,25.89,1941.75,119
CPT,Q0508,HC CHARGER BATTERY HEARTWARE,20721.7,15541.28,248.66,18649.53,119
CPT,Q0508,HC CLIP BATTERY 14V LI-ION,2563.1,1922.32,30.76,2306.79,119
CPT,Q0508,HC KIT LVAD HEARTMATE 3 MODULAR CABLE,18160.35,13620.26,217.92,16344.31,119
CPT,Q0508,HC KIT VENTRICULAR ASSIST DEVICE DLES,527.85,395.89,6.33,475.07,119
CPT,Q0508,HC PACK PROCEDURE PATIENT FOR CONTROLLER AND BATTERY,1866.8,1400.1,22.4,1680.12,119
CPT,Q0508,HC PACK WAIST FOR CONTROLLER 2050,1866.8,1400.1,22.4,1680.12,119
CPT,Q0508,HC POWER UNIT MOBILE HEARTMATE II,29350.1,22012.58,352.2,26415.09,119
CPT,Q0510,Dispens fee immunosupressive,,,127.16,151.73,8
CPT,Q0511,Sup fee antiemanticaimmuno,,,61.04,72.83,8
CPT,Q0512,Px sup fee anti-can sub pres,,,40.69,48.55,8
CPT,Q0513,Disp fee inhal drugs/30 days,,,83.93,100.14,8
CPT,Q0514,Disp fee inhal drugs/90 days,,,167.85,200.28,8
CPT,Q0515,Sermorelin acetate injection,,,2.24,2.24,1
CPT,Q2009,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,105.85,79.38499999999999,1.07,110.61,238
CPT,Q2009,FOSPHENYTOIN 25 MG PE/ML IN NS INJECTION NEO/PED CMPD,44.4,33.3,0.53,39.96,119
CPT,Q2009,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,491.58,368.68,5.9,442.42,238
CPT,Q2009,Fosphenytoin inj pe,,,1.34,5.16,17
CPT,Q2017,Teniposide  50 mg,,,,,0
CPT,Q2026,Radiesse injection,,,333.42,387.1,18
CPT,Q2028,Inj sculptra 0.5mg,,,1.0,2.16,18
CPT,Q2034,Agriflu vaccine,,,,,0
CPT,Q2035,Afluria vacc 3 yrs & > im,,,21.42,21.42,8
CPT,Q2036,Flulaval vacc 3 yrs & > im,,,,,0
CPT,Q2037,Fluvirin vacc 3 yrs & > im,,,,,0
CPT,Q2038,Fluzone vacc 3 yrs & > im,,,20.71,20.71,8
CPT,Q2039,Influenza virus vaccine nos,,,,,0
CPT,Q2041,Axicabtagene ciloleucel car+,,,489517.15,619080.23,27
CPT,Q2042,Tisagenlecleucel car-pos t,,,565623.84,686994.12,27
CPT,Q2043,Sipuleucel-t auto cd54+,,,53981.46,64357.43,63
CPT,Q2049,Imported lipodox inj,,,298.74,614.01,18
CPT,Q2050,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1048.52,786.39,12.58,943.67,119
CPT,Q2050,Doxorubicin inj 10mg,,,102.23,155.68,63
CPT,Q2053,Brexucabtagene car pos t,,,488051.51,568082.65,27
CPT,Q2054,Lisocabtagene mara car pos t,,,516485.97,653106.84,27
CPT,Q2055,Idecabtagene vicleucel car,,,528312.43,647046.12,27
CPT,Q2056,Ciltacabtagene car-pos t,,,551318.34,656973.85,27
CPT,Q2057,Afamitresgene autoleucel,,,770620.0,894689.82,18
CPT,Q2058,Obecbtge autol up to 400 mil,,,278250.0,323048.25,18
CPT,Q3014,HC TELEHEALTH FACILITY FEE,107.49,80.62,1.29,96.74,119
CPT,Q3014,Telehealth facility fee,,,29.96,86.91,9
CPT,Q3027,Inj beta interferon im 1 mcg,,,54.41,68.38,54
CPT,Q3028,Inj beta interferon sq 1 mcg,,,43.23,43.23,8
CPT,Q3031,Collagen skin test,,,0.5,0.5,3
CPT,Q4001,Cast sup body cast plaster,,,148.02,176.61,8
CPT,Q4002,Cast sup body cast fiberglas,,,559.22,667.25,8
CPT,Q4003,Cast sup shoulder cast plstr,,,106.25,126.78,8
CPT,Q4004,Cast sup shoulder cast fbrgl,,,367.93,439.01,8
CPT,Q4005,Cast sup long arm adult plst,,,39.19,46.76,8
CPT,Q4006,Cast sup long arm adult fbrg,,,88.3,105.36,8
CPT,Q4007,Cast sup long arm ped plster,,,19.58,23.36,8
CPT,Q4008,Cast sup long arm ped fbrgls,,,44.12,52.65,8
CPT,Q4009,Cast sup sht arm adult plstr,,,26.17,31.23,8
CPT,Q4010,Cast sup sht arm adult fbrgl,,,58.85,70.21,8
CPT,Q4011,Cast sup sht arm ped plaster,,,13.05,15.57,8
CPT,Q4012,Cast sup sht arm ped fbrglas,,,29.5,35.2,8
CPT,Q4013,Cast sup gauntlet plaster,,,47.63,56.84,8
CPT,Q4014,Cast sup gauntlet fiberglass,,,80.32,95.83,8
CPT,Q4015,Cast sup gauntlet ped plster,,,23.86,28.47,8
CPT,Q4016,Cast sup gauntlet ped fbrgls,,,40.13,47.88,8
CPT,Q4017,Cast sup lng arm splint plst,,,27.52,32.83,8
CPT,Q4018,Cast sup lng arm splint fbrg,,,43.87,52.34,8
CPT,Q4019,Cast sup lng arm splnt ped p,,,13.78,16.44,8
CPT,Q4020,Cast sup lng arm splnt ped f,,,22.03,26.28,8
CPT,Q4021,Cast sup sht arm splint plst,,,20.37,24.31,8
CPT,Q4022,Cast sup sht arm splint fbrg,,,36.78,43.88,8
CPT,Q4023,Cast sup sht arm splnt ped p,,,10.25,12.23,8
CPT,Q4024,Cast sup sht arm splnt ped f,,,18.41,21.97,8
CPT,Q4025,Cast sup hip spica plaster,,,114.19,136.25,8
CPT,Q4026,Cast sup hip spica fiberglas,,,356.73,425.65,8
CPT,Q4027,Cast sup hip spica ped plstr,,,57.17,68.22,8
CPT,Q4028,Cast sup hip spica ped fbrgl,,,178.48,212.96,8
CPT,Q4029,Cast sup long leg plaster,,,87.38,104.27,8
CPT,Q4030,Cast sup long leg fiberglass,,,230.01,274.44,8
CPT,Q4031,Cast sup lng leg ped plaster,,,43.64,52.07,8
CPT,Q4032,Cast sup lng leg ped fbrgls,,,115.01,137.22,8
CPT,Q4033,Cast sup lng leg cylinder pl,,,81.53,97.28,8
CPT,Q4034,Cast sup lng leg cylinder fb,,,202.66,241.82,8
CPT,Q4035,Cast sup lngleg cylndr ped p,,,40.74,48.62,8
CPT,Q4036,Cast sup lngleg cylndr ped f,,,101.39,120.98,8
CPT,Q4037,Cast sup shrt leg plaster,,,49.64,59.23,8
CPT,Q4038,Cast sup shrt leg fiberglass,,,124.54,148.6,8
CPT,Q4039,Cast sup shrt leg ped plster,,,24.92,29.74,8
CPT,Q4040,Cast sup shrt leg ped fbrgls,,,62.26,74.29,8
CPT,Q4041,Cast sup lng leg splnt plstr,,,60.46,72.14,8
CPT,Q4042,Cast sup lng leg splnt fbrgl,,,103.21,123.14,8
CPT,Q4043,Cast sup lng leg splnt ped p,,,30.24,36.08,8
CPT,Q4044,Cast sup lng leg splnt ped f,,,51.67,61.66,8
CPT,Q4045,Cast sup sht leg splnt plstr,,,35.09,41.87,8
CPT,Q4046,Cast sup sht leg splnt fbrgl,,,56.43,67.34,8
CPT,Q4047,Cast sup sht leg splnt ped p,,,17.47,20.84,8
CPT,Q4048,Cast sup sht leg splnt ped f,,,28.26,33.72,8
CPT,Q4049,Finger splint static,,,6.36,7.59,8
CPT,Q4074,Iloprost non-comp unit dose,,,139.5,173.52,44
CPT,Q4081,Epoetin alfa 100 units esrd,,,0.82,0.88,44
CPT,Q4082,Drug/bio noc part b drug cap,,,,,0
CPT,Q4101,Apligraf,,,30.36,126.0,53
CPT,Q4101,HC GRAFT APLIGRAF PER 1 SQ CM,4526.25,3394.69,54.32,4073.62,119
CPT,Q4102,Oasis wound matrix,,,12.72,126.0,53
CPT,Q4103,HC OASIS 5X7CM TRI-LAYER,41.35,31.01,0.5,37.22,119
CPT,Q4103,Oasis burn matrix,,,12.86,126.0,53
CPT,Q4104,Integra bmwd,,,47.4,126.0,53
CPT,Q4105,Integra drt or omnigraft,,,21.35,126.0,53
CPT,Q4106,Dermagraft,,,16.25,84.42,44
CPT,Q4107,Graftjacket,,,126.0,126.0,9
CPT,Q4108,Integra matrix,,,46.91,126.0,53
CPT,Q4110,HC MATRIX PRIMATRIX PER 1SQ CM,310.9,233.18,3.73,279.81,119
CPT,Q4110,Primatrix,,,42.88,126.0,53
CPT,Q4111,Gammagraft,,,7.06,126.0,53
CPT,Q4114,HC INTEGRA FLOWABLE WOUND MATRIX 1 CC,6198.8,4649.1,74.39,5578.92,119
CPT,Q4114,Integra flowable wound matri,,,1576.51,1852.71,44
CPT,Q4115,Alloskin,,,9.79,126.0,53
CPT,Q4116,Alloderm,,,126.0,126.0,9
CPT,Q4116,HC ALLODERM PER 1 SQ CM,266.25,199.69,3.2,239.62,119
CPT,Q4117,HC HYALOMATRIX PER 1 SQ CM,111.05,83.29,1.33,99.94,119
CPT,Q4117,Hyalomatrix,,,8.71,126.0,53
CPT,Q4118,Matristem micromatrix,,,2.5,2.99,44
CPT,Q4121,Theraskin,,,44.3,126.0,53
CPT,Q4122,Dermacell awm porous sq cm,,,126.0,126.0,9
CPT,Q4123,Alloskin,,,23.4,126.0,53
CPT,Q4124,HC OASIS TRI-LAYER WND MATRIX PER 1 SQ CM,12.5,9.38,0.15,11.25,119
CPT,Q4124,Oasis tri-layer wound matrix,,,9.1,126.0,53
CPT,Q4125,Arthroflex,,,126.0,126.0,9
CPT,Q4126,Memoderm/derma/tranz/integup,,,88.18,126.0,53
CPT,Q4127,Talymed,,,77.3,126.0,53
CPT,Q4128,Flexhd/allopatchhd/sq cm,,,30.67,126.0,53
CPT,Q4130,Strattice tm,,,126.0,126.0,9
CPT,Q4132,Grafix core grafixpl core,,,126.0,373.33,53
CPT,Q4133,Grafix stravix prime pl sqcm,,,126.0,160.22,53
CPT,Q4133,HC GRAFIX PRIME PER 1SQ CM Q4133 (HIGH),1054.75,791.06,12.66,949.28,119
CPT,Q4134,Hmatrix,,,126.0,126.0,9
CPT,Q4135,Mediskin,,,126.0,126.0,9
CPT,Q4136,Ezderm,,,126.0,126.0,9
CPT,Q4137,Amnioexcel biodexcel 1sq cm,,,99.9,126.0,53
CPT,Q4137,HC AMNIOEXCEL 2X3CM PER SQ CM,654.4,490.8,7.85,588.96,119
CPT,Q4137,HC AMNIOEXCEL 4X4CM PER SQ CM,111.05,83.29,1.33,99.94,119
CPT,Q4137,HC AMNIOEXCEL 4X8CM PER SQ CM,111.05,83.29,1.33,99.94,119
CPT,Q4137,HC AMNIOEXCEL 5X5CM PER SQ CM,111.05,83.29,1.33,99.94,119
CPT,Q4138,Biodfence dryflex 1cm,,,126.0,126.0,9
CPT,Q4140,Biodfence 1cm,,,126.0,126.0,9
CPT,Q4141,Alloskin ac 1 cm,,,126.0,225.19,17
CPT,Q4142,Xcm biologic tiss matrix 1cm,,,126.0,126.0,9
CPT,Q4143,Repriza 1cm,,,39.68,126.0,17
CPT,Q4145,Epifix inj 1mg,,,49.54,59.12,8
CPT,Q4146,Tensix 1cm,,,126.0,126.0,9
CPT,Q4147,Architect ecm px fx 1 sq cm,,,126.0,172.22,17
CPT,Q4148,Neox neox rt or clarix cord,,,126.0,151.59,17
CPT,Q4150,Allowrap ds or dry 1 sq cm,,,74.3,126.0,53
CPT,Q4151,Amnioband guardian 1 sq cm,,,120.83,163.76,53
CPT,Q4152,Dermapure 1 square cm,,,44.44,126.0,53
CPT,Q4153,Dermavest plurivest sq cm,,,126.0,180.83,53
CPT,Q4154,Biovance 1 square cm,,,126.0,176.79,53
CPT,Q4155,Neoxflo or clarixflo 1 mg,,,30.8,30.8,8
CPT,Q4156,Neox 100 or clarix 100,,,77.44,126.0,17
CPT,Q4157,Revitalon 1 square cm,,,126.0,126.0,9
CPT,Q4158,HC GRAFTS FISH SKIN PER SQ CM LVL 01 (HIGH),236.65,177.49,2.84,212.98,119
CPT,Q4158,HC GRAFTS FISH SKIN PER SQ CM LVL 02 (HIGH),359.7,269.77,4.32,323.73,119
CPT,Q4158,HC GRAFTS FISH SKIN PER SQ CM LVL 03 (HIGH),805.85,604.39,9.67,725.26,119
CPT,Q4158,Kerecis omega3 per sq cm,,,3.45,126.0,17
CPT,Q4159,Affinity1 square cm,,,126.0,460.5,53
CPT,Q4159,HC AFFINITY 1.5X1.5CM 2.25CM PER SQ CM,513.35,385.01,6.16,462.02,119
CPT,Q4159,HC AFFINITY 2.5X2.5CM 6.25CM PER SQ CM,858.75,644.06,10.3,772.88,119
CPT,Q4160,Nushield 1 square cm,,,94.06,126.0,53
CPT,Q4161,Bio-connekt per square cm,,,126.0,2171.05,53
CPT,Q4163,"HC WOUNDEX, BIOSKIN, PER SQ CM",494.7,371.02,5.94,445.23,119
CPT,Q4163,Woundex bioskin per sq cm,,,104.78,210.61,53
CPT,Q4164,Helicoll per square cm,,,126.0,1912.72,17
CPT,Q4165,Keramatrix kerasorb sq cm,,,126.0,126.0,9
CPT,Q4166,Cytal per square centimeter,,,23.13,126.0,17
CPT,Q4167,Truskin per sq centimeter,,,126.0,126.0,9
CPT,Q4168,Amnioband 1 mg,,,43.89,52.37,8
CPT,Q4169,Artacent wound per sq cm,,,126.0,588.21,17
CPT,Q4170,Cygnus per sq cm,,,81.1,154.34,53
CPT,Q4171,Interfyl 1 mg,,,13.89,13.89,8
CPT,Q4173,Palingen or palingen xplus,,,126.0,401.84,17
CPT,Q4175,Miroderm,,,63.37,126.0,53
CPT,Q4176,Neopatch or therion 1 sq cm,,,126.0,129.61,45
CPT,Q4178,Floweramniopatch per sq cm,,,118.16,126.0,17
CPT,Q4179,Flowerderm per sq cm,,,126.0,126.0,9
CPT,Q4180,Revita per sq cm,,,126.0,298.29,53
CPT,Q4181,Amnio wound per square cm,,,126.0,126.0,9
CPT,Q4182,Transcyte per sq centimeter,,,126.0,126.0,9
CPT,Q4183,Surgigraft 1 sq cm,,,126.0,126.0,9
CPT,Q4184,Cellesta or duo per sq cm,,,126.0,730.36,17
CPT,Q4186,Epifix 1 sq cm,,,126.0,185.4,53
CPT,Q4186,HC EPIFIX 2X3CM SQ CM,930.3,697.72,11.16,837.27,119
CPT,Q4186,HC EPIFIX 3X3CM SQ CM,1034.5,775.88,12.41,931.05,119
CPT,Q4186,HC EPIFIX 3X4CM SQ CM,921.65,691.24,11.06,829.48,119
CPT,Q4186,HC EPIFIX 4X4CM SQ CM,874.15,655.61,10.49,786.74,119
CPT,Q4186,HC EPIFIX 5X6CM SQ CM,884.9,663.68,10.62,796.41,119
CPT,Q4186,HC EPIFIX 7X7CM SQ CM,948.65,711.49,11.38,853.78,119
CPT,Q4186,HC EPIFIX DISK 14MM SQ CM,795.7,596.78,9.55,716.13,119
CPT,Q4186,HC EPIFIX DISK 16MM SQ CM,805.05,603.79,9.66,724.54,119
CPT,Q4186,HC EPIFIX DISK 18MM SQ CM,1067.2,800.4,12.81,960.48,119
CPT,Q4186,HC EPIFIX DISK 24MM SQ CM,723.4,542.55,8.68,651.06,119
CPT,Q4186,HC EPIFIX FEN 6X16CM SQ CM,391.6,293.7,4.7,352.44,119
CPT,Q4186,HC EPIFIX NON FEN 6X16CM SQ CM,391.6,293.7,4.7,352.44,119
CPT,Q4186,HC EPIFIX PER SQ CM (HIGH),5144.85,3858.64,61.74,4630.37,119
CPT,Q4186,HC EPIFIX SHEET 2.0X3.0 SQ CM,1257.0,942.75,15.08,1131.3,119
CPT,Q4186,HC EPIFIX SHEET 2.0X3.0CM SQ CM,796.1,597.08,9.55,716.49,119
CPT,Q4186,HC EPIFIX SHEET 3.5X3.5CMSQ CM,728.65,546.49,8.74,655.78,119
CPT,Q4186,HC EPIFIX SHEET 4.0X4.5CM SQ CM,585.05,438.79,7.02,526.54,119
CPT,Q4187,Epicord 1 sq cm,,,126.0,286.48,53
CPT,Q4187,HC EPICORD 1X2CM SQ CM,1954.7,1466.02,23.46,1759.23,119
CPT,Q4187,HC EPICORD 2X3CM SQ CM,1005.3,753.98,12.06,904.77,119
CPT,Q4187,HC EPICORD 3X5CM SQ CM,1005.0,753.75,12.06,904.5,119
CPT,Q4188,Amnioarmor 1 sq cm,,,126.0,845.38,17
CPT,Q4190,Artacent ac 1 sq cm,,,126.0,278.15,17
CPT,Q4191,Restorigin 1 sq cm,,,126.0,1477.44,17
CPT,Q4193,Coll-e-derm 1 sq cm,,,126.0,2418.0,17
CPT,Q4194,Novachor 1 sq cm,,,126.0,1007.17,17
CPT,Q4195,Puraply 1 sq cm,,,71.23,253.08,53
CPT,Q4196,HC PURAPLY AM PER 1 SQ CM (HIGH),449.65,337.24,5.4,404.68,119
CPT,Q4196,HC PURAPLY AM PER 1 SQ CM (HIGH) WITH JW MOD,449.65,337.24,5.4,404.68,119
CPT,Q4196,HC PURAPLY DISC PER 1 SQ CM,1050.1,787.58,12.6,945.09,119
CPT,Q4196,Puraply am 1 sq cm,,,109.76,126.0,53
CPT,Q4197,Puraply xt 1 sq cm,,,111.63,178.34,53
CPT,Q4198,Genesis amnio membrane 1sqcm,,,126.0,126.0,9
CPT,Q4199,Cygnus matrix per sq cm,,,126.0,401.14,53
CPT,Q4200,Skin te 1 sq cm,,,126.0,126.0,9
CPT,Q4201,Matrion 1 sq cm,,,112.63,170.26,53
CPT,Q4203,Derma-gide 1 sq cm,,,126.0,878.21,53
CPT,Q4204,Xwrap 1 sq cm,,,126.0,3496.8,17
CPT,Q4205,Membrane graft or wrap sq cm,,,126.0,1532.97,17
CPT,Q4208,Novafix per sq cm,,,126.0,126.0,9
CPT,Q4209,Surgraft per sq cm,,,126.0,126.0,9
CPT,Q4210,Axolotl graf dualgraf sq cm,,,2156.63,2573.26,8
CPT,Q4211,Amnion bio or axobio sq cm,,,126.0,126.0,9
CPT,Q4214,Cellesta cord per sq cm,,,126.0,126.0,9
CPT,Q4216,Artacent cord per sq cm,,,126.0,126.0,9
CPT,Q4217,Woundfix biowound plus xplus,,,126.0,435.85,17
CPT,Q4218,Surgicord per sq cm,,,126.0,126.0,9
CPT,Q4219,Surgigraft dual per sq cm,,,126.0,126.0,9
CPT,Q4220,Bellacell hd surederm sq cm,,,126.0,126.0,9
CPT,Q4221,Amniowrap2 per sq cm,,,126.0,2356.0,17
CPT,Q4222,Progenamatrix per sq cm,,,126.0,172.41,17
CPT,Q4225,Amnio or derma tl per sq cm,,,126.0,1798.0,17
CPT,Q4226,Myown harv prep proc sq cm,,,628.09,749.43,8
CPT,Q4227,Amniocore per sq cm,,,126.0,1215.2,53
CPT,Q4229,Cogenex amnio memb per sq cm,,,126.0,1095.46,53
CPT,Q4231,Corplex p- per cc,,,677.32,677.32,36
CPT,Q4232,Corplex per sq cm,,,126.0,380.64,53
CPT,Q4234,Xcellerate per sq cm,,,126.0,639.67,17
CPT,Q4235,Amniorepair or altiply sq cm,,,126.0,159.51,53
CPT,Q4236,Carepatch per sq cm,,,126.0,566.67,17
CPT,Q4237,Cryo-cord per sq cm,,,126.0,126.0,9
CPT,Q4238,Derm-maxx per sq cm,,,126.0,1087.0,17
CPT,Q4239,Amnio-maxx or lite per sq cm,,,126.0,2883.23,17
CPT,Q4246,Coretext or protext per cc,,,2968.0,9006.4,44
CPT,Q4247,Amniotext patch per sq cm,,,126.0,1608.29,53
CPT,Q4248,Dermacyte amn mem allo sq cm,,,126.0,1295.8,53
CPT,Q4249,Amniply per sq cm,,,126.0,126.0,9
CPT,Q4250,Amnioamp-mp per sq cm,,,126.0,126.0,9
CPT,Q4251,Vim per square centimeter,,,126.0,126.0,9
CPT,Q4252,Vendaje per square centimet,,,126.0,1042.39,53
CPT,Q4253,Zenith amniotic membrane psc,,,126.0,169.57,17
CPT,Q4254,Novafix dl per sq cm,,,126.0,126.0,9
CPT,Q4255,Reguard topical use per sq,,,126.0,126.0,9
CPT,Q4256,Mlg complet per sq cm,,,126.0,1130.23,17
CPT,Q4257,Relese per sq cm,,,126.0,657.3,17
CPT,Q4258,Enverse per sq cm,,,61.23,126.0,53
CPT,Q4259,Celera per sq cm,,,126.0,1509.17,17
CPT,Q4260,Signature apatch per sq cm,,,126.0,126.0,9
CPT,Q4261,Tag per square centimeter,,,126.0,126.0,9
CPT,Q4262,Dual layer impax per sq cm,,,126.0,367.37,17
CPT,Q4263,Surgraft tl per sq cm,,,126.0,622.08,17
CPT,Q4264,Cocoon membrane per sq cm,,,126.0,126.0,9
CPT,Q4265,Neostim tl per sq cm,,,126.0,2473.8,17
CPT,Q4266,Neostim per sq cm,,,126.0,1804.61,17
CPT,Q4267,Neostim dl per sq cm,,,126.0,445.03,17
CPT,Q4268,Surgraft ft per sq cm,,,126.0,1075.22,17
CPT,Q4269,Surgraft xt per sq cm,,,126.0,126.0,9
CPT,Q4270,Complete sl per sq cm,,,126.0,126.0,9
CPT,Q4271,Complete ft per sq cm,,,126.0,1861.64,17
CPT,Q4272,Esano a per sq cm,,,126.0,126.0,9
CPT,Q4273,Esano aaa per sq cm,,,126.0,126.0,9
CPT,Q4274,Esano ac per sq cm,,,126.0,158.72,17
CPT,Q4275,Esano aca per sq cm,,,126.0,213.76,17
CPT,Q4276,Orion per sq cm,,,126.0,1034.9,17
CPT,Q4278,Epieffect per sq cm,,,126.0,365.9,17
CPT,Q4279,Vendaje ac per sq cm,,,126.0,126.0,9
CPT,Q4280,Xcell amnio matrix per sq cm,,,126.0,3720.0,17
CPT,Q4281,Barrera slor dl per sq cm,,,126.0,970.53,17
CPT,Q4282,Cygnus dual per sq cm,,,126.0,759.23,17
CPT,Q4283,Biovance tri or 3l sq cm,,,126.0,935.85,17
CPT,Q4284,Dermabind sl per sq cm,,,126.0,126.0,9
CPT,Q4285,Nudyn dl or dl mesh pr sq cm,,,126.0,126.0,9
CPT,Q4286,Nudyn sl or slw per sq cm,,,126.0,126.0,9
CPT,Q4287,Dermabind dl per sq cm,,,126.0,126.0,9
CPT,Q4288,Dermabind ch per sq cm,,,126.0,126.0,9
CPT,Q4289,Revoshield+ amnio per sq cm,,,126.0,126.0,9
CPT,Q4290,Membrane wrap hydr per sq cm,,,126.0,2294.0,17
CPT,Q4291,Lamellas xt per sq cm,,,126.0,126.0,9
CPT,Q4292,Lamellas per sq cm,,,126.0,126.0,9
CPT,Q4293,Acesso dl per sq cm,,,126.0,1853.8,17
CPT,Q4294,Amnio quad-core per sq cm,,,126.0,2666.0,17
CPT,Q4295,Amnio tri-core per sq cm,,,126.0,2418.0,17
CPT,Q4296,Rebound matrix per sq cm,,,126.0,2666.0,17
CPT,Q4297,Emerge matrix per sq cm,,,126.0,2666.0,17
CPT,Q4298,Amnicore pro per sq cm,,,126.0,126.0,9
CPT,Q4299,Amnicore pro+ per sq cm,,,126.0,2914.0,17
CPT,Q4300,Acesso tl per sq cm,,,126.0,2473.8,17
CPT,Q4301,Activate matrix per sq cm,,,126.0,2790.0,17
CPT,Q4302,Complete aca per sq cm,,,126.0,2349.8,17
CPT,Q4303,Complete aa per sq cm,,,126.0,4048.58,17
CPT,Q4304,Grafix plus per sq cm,,,126.0,1362.53,17
CPT,Q4305,Amer am ac tri-lay per sq cm,,,126.0,126.0,9
CPT,Q4306,Americ amnion ac per sq cm,,,126.0,126.0,9
CPT,Q4307,American amnion per sq cm,,,126.0,126.0,9
CPT,Q4308,Sanopellis per sq cm,,,126.0,126.0,9
CPT,Q4309,Via matrix per sq cm,,,126.0,126.0,9
CPT,Q4310,Procenta per 100 mg,,,2852.38,2852.38,8
CPT,Q4311,Acesso per sq cm,,,126.0,126.0,9
CPT,Q4312,Acesso ac per sq cm,,,126.0,126.0,9
CPT,Q4313,Dermabind fm per sq cm,,,126.0,126.0,9
CPT,Q4314,Reeva per sq cm,,,126.0,126.0,9
CPT,Q4315,Regenelink amniotic mem allo,,,126.0,126.0,9
CPT,Q4316,Amchoplast per sq cm,,,126.0,126.0,9
CPT,Q4317,Vitograft per sq cm,,,126.0,126.0,9
CPT,Q4318,E-graft per sq cm,,,126.0,126.0,9
CPT,Q4319,Sanograft per sq cm,,,126.0,126.0,9
CPT,Q4320,Pellograft per sq cm,,,126.0,126.0,9
CPT,Q4321,Renograft per sq cm,,,126.0,126.0,9
CPT,Q4322,Caregraft per sq cm,,,126.0,126.0,9
CPT,Q4323,Alloply per sq cm,,,126.0,126.0,9
CPT,Q4324,Amniotx per sq cm,,,126.0,126.0,9
CPT,Q4325,Acapatch per sq cm,,,126.0,126.0,9
CPT,Q4326,Woundplus per sq cm,,,126.0,126.0,9
CPT,Q4327,Duoamnion per sq cm,,,126.0,126.0,9
CPT,Q4328,Most per sq cm,,,126.0,126.0,9
CPT,Q4329,Singlay per sq cm,,,126.0,126.0,9
CPT,Q4330,Total per sq cm,,,126.0,126.0,9
CPT,Q4331,Axolotl graft per sq cm,,,126.0,126.0,9
CPT,Q4332,Axolotl dualgraft per sq cm,,,126.0,2015.0,17
CPT,Q4333,Ardeograft per sq cm,,,126.0,126.0,9
CPT,Q4334,Amnioplast 1 per sq cm,,,126.0,126.0,9
CPT,Q4335,Amnioplast 2 per sq cm,,,126.0,126.0,9
CPT,Q4336,Artecent c per sq cm,,,126.0,126.0,9
CPT,Q4337,Artecent trident per sq cm,,,126.0,126.0,9
CPT,Q4338,Artacent velos per sq cm,,,126.0,126.0,9
CPT,Q4339,Artacent vericlen per sq cm,,,126.0,126.0,9
CPT,Q4340,Simpligraft per sq cm,,,126.0,126.0,9
CPT,Q4341,Simplimax per sq cm,,,126.0,126.0,9
CPT,Q4342,Theramend per sq cm,,,126.0,126.0,9
CPT,Q4343,Dermacyte ac matrx per sq cm,,,126.0,126.0,9
CPT,Q4344,Tri membrane wrap per sq cm,,,126.0,126.0,9
CPT,Q4345,Matrix hd allogrft per sq cm,,,126.0,126.0,9
CPT,Q4346,Shelter dm matrix per sq cm,,,126.0,126.0,9
CPT,Q4347,Rampart dl matrix per sq cm,,,126.0,126.0,9
CPT,Q4348,Sentry sl matrix per sq cm,,,126.0,126.0,9
CPT,Q4349,Mantle dl matrix per sq cm,,,126.0,126.0,9
CPT,Q4350,Palisade dm matrix per sq cm,,,126.0,126.0,9
CPT,Q4351,Enclose tl matrix per sq cm,,,126.0,126.0,9
CPT,Q4352,Overlay sl matrix per sq cm,,,126.0,126.0,9
CPT,Q4353,Xceed tl matrix per sq cm,,,126.0,126.0,9
CPT,Q4354,Palingen dl-palingen dl-x,,,126.0,126.0,9
CPT,Q4355,Abio xpl abio xpl hy p sq cm,,,126.0,126.0,9
CPT,Q4356,Abio mem abio hyd per sq cm,,,126.0,126.0,9
CPT,Q4357,Xwrap plus per sq cm,,,126.0,126.0,9
CPT,Q4358,Xwrap dual per sq cm,,,126.0,126.0,9
CPT,Q4359,Choriply per sq cm,,,126.0,126.0,9
CPT,Q4360,Amchoplast fd per sq cm,,,126.0,126.0,9
CPT,Q4361,Epixpress per sq cm,,,126.0,126.0,9
CPT,Q4362,Cygnus disk per sq cm,,,126.0,126.0,9
CPT,Q4363,Am bur mem hydro per sq cm,,,126.0,126.0,9
CPT,Q4364,Am bur xp mem xpl hy p sq cm,,,126.0,126.0,9
CPT,Q4365,Amnio bur dl mem per sq cm,,,126.0,126.0,9
CPT,Q4366,Dl amnio bur x-mem per sq cm,,,126.0,126.0,9
CPT,Q4367,Amniocore sl per sq cm,,,126.0,126.0,9
CPT,Q4368,Amchothick per sq cm,,,126.0,126.0,9
CPT,Q4369,Amnioplast 3 per sq cm,,,126.0,126.0,9
CPT,Q4370,Aeroguard per sq cm,,,126.0,126.0,9
CPT,Q4371,Neoguard per sq cm,,,126.0,126.0,9
CPT,Q4372,Amchoplast excl per sq cm,,,126.0,126.0,9
CPT,Q4373,Membrane wrp lt per sq cm,,,126.0,126.0,9
CPT,Q4375,Duograft ac per sq cm,,,126.0,126.0,9
CPT,Q4376,Duograft aa per sq cm,,,126.0,126.0,9
CPT,Q4377,Trigraft ft per sq cm,,,126.0,126.0,9
CPT,Q4378,Renew ft matrix per sq cm,,,126.0,126.0,9
CPT,Q4379,Amniodefend ft per sq cm,,,126.0,126.0,9
CPT,Q4380,Advograft one per sq cm,,,126.0,126.0,9
CPT,Q4382,Advograft dual per sq cm,,,126.0,126.0,9
CPT,Q4383,Axolotl graft ult per sq cm,,,126.0,126.0,9
CPT,Q4384,Axolotl dual ult per sq cm,,,126.0,126.0,9
CPT,Q4385,Apollo ft per sq cm,,,126.0,126.0,9
CPT,Q4386,Acesso trifaca per sq cm,,,126.0,126.0,9
CPT,Q4387,Neothelium ft per sq cm,,,126.0,126.0,9
CPT,Q4388,Neothelium 4l per sq cm,,,126.0,126.0,9
CPT,Q4389,Neothelium 4l+ per sq cm,,,126.0,126.0,9
CPT,Q4390,Ascendion per sq cm,,,126.0,126.0,9
CPT,Q4391,Amnioplast double per sq cm,,,126.0,126.0,9
CPT,Q4392,Grafix duo per sq cm,,,126.0,126.0,9
CPT,Q4393,Surgraft ac per sq cm,,,126.0,126.0,9
CPT,Q4394,Surgraft aca per sq cm,,,126.0,126.0,9
CPT,Q4395,Acelagraft per sq cm,,,126.0,126.0,9
CPT,Q4396,Natalin per sq cm,,,126.0,126.0,9
CPT,Q4397,Summit aaa per sq cm,,,126.0,126.0,9
CPT,Q4398,Summit ac per sq cm,,,126.0,126.0,9
CPT,Q4399,Summit fx per sq cm,,,126.0,126.0,9
CPT,Q4400,Polygon3 per sq cm,,,126.0,126.0,9
CPT,Q4401,Absolv3 per sq cm,,,126.0,126.0,9
CPT,Q4402,Xwrap 2.0 per sq cm,,,126.0,126.0,9
CPT,Q4403,Xwrap dual plus per sq cm,,,126.0,126.0,9
CPT,Q4404,Xwrap hydro plus per sq cm,,,126.0,126.0,9
CPT,Q4405,Xwrap fenestra plus sq cm,,,126.0,126.0,9
CPT,Q4406,Xwrap fenestra per sq cm,,,126.0,126.0,9
CPT,Q4407,Xwrap tribus per sq cm,,,126.0,126.0,9
CPT,Q4408,Xwrap hydro per sq cm,,,126.0,126.0,9
CPT,Q4409,Amniomatrixf3x per sq cm,,,126.0,126.0,9
CPT,Q4410,Amchomatrixdl per sq cm,,,126.0,126.0,9
CPT,Q4411,Amniomatrixf4x per sq cm,,,126.0,126.0,9
CPT,Q4412,Choriofix per sq cm,,,126.0,126.0,9
CPT,Q4413,Cygnus solo per sq cm,,,126.0,126.0,9
CPT,Q4414,Simplichor per sq cm,,,126.0,126.0,9
CPT,Q4415,Alexiguard st-l per sq cm,,,126.0,126.0,9
CPT,Q4416,Alexiguard tl-t per sq cm,,,126.0,126.0,9
CPT,Q4417,Alexiguard dl-t per sq cm,,,126.0,126.0,9
CPT,Q4420,Nuform per sq cm,,,126.0,126.0,9
CPT,Q4431,Pma skin substitute nos,,,126.0,126.0,9
CPT,Q4432,510(k) skin subs nos,,,126.0,126.0,9
CPT,Q4433,361 hct/p skin subs nos,,,126.0,126.0,9
CPT,Q5005,HC HOSPICE ROOM/BOARD,1202.25,901.69,14.43,1082.03,119
CPT,Q5080,HC ADAPTER AC HEARTWARE CONTROLLER 1430US,4315.0,3236.25,51.78,3883.5,119
CPT,Q5099,Inj ustekinumab-stba 1 mg,,,12.64,14.68,9
CPT,Q5100,Inj ustekinumab-kfce 1 mg,,,24.68,29.0,18
CPT,Q5101,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,780.83,585.62,9.37,702.75,119
CPT,Q5101,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1249.34,937.0,14.99,1124.41,119
CPT,Q5101,Injection zarxio,,,0.23,0.53,63
CPT,Q5103,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2693.11,2019.83,32.32,2423.8,119
CPT,Q5103,Injection inflectra,,,11.55,24.8,63
CPT,Q5104,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,2144.15,1608.11,25.73,1929.74,119
CPT,Q5104,Injection renflexis,,,26.26,45.47,63
CPT,Q5105,Inj retacrit esrd on dialysi,,,0.75,0.92,54
CPT,Q5106,Inj retacrit non-esrd use,,,7.47,9.11,63
CPT,Q5107,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,5315.8,3986.845,25.52,7654.73,238
CPT,Q5107,Inj mvasi 10 mg,,,23.84,32.35,63
CPT,Q5108,Injection fulphila,,,98.87,158.55,63
CPT,Q5108,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,5737.5,4303.12,68.85,5163.75,119
CPT,Q5109,Injection  ixifi  10 mg,,,,,0
CPT,Q5110,Nivestym,,,0.28,0.35,63
CPT,Q5111,Injection udenyca 0.5 mg,,,106.33,167.72,63
CPT,Q5111,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,10742.28,8056.71,128.91,9668.05,119
CPT,Q5112,Inj ontruzant 10 mg,,,19.0,58.34,63
CPT,Q5113,Inj herzuma 10 mg,,,36.39,80.54,63
CPT,Q5114,Inj ogivri 10 mg,,,37.71,62.18,63
CPT,Q5114,TRASTUZUMAB-DKST 150 MG INTRAVENOUS SOLUTION,2676.69,2007.52,32.12,2409.02,119
CPT,Q5114,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,7214.95,5411.21,86.58,6493.46,119
CPT,Q5115,Inj truxima 10 mg,,,29.38,48.82,63
CPT,Q5115,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,7730.44,5797.83,30.92,11595.66,238
CPT,Q5116,Inj. trazimera 10 mg,,,8.21,33.19,63
CPT,Q5117,Inj. kanjinti 10 mg,,,27.94,55.21,63
CPT,Q5117,TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION,10466.78,7850.09,125.6,9420.1,119
CPT,Q5118,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,4673.345,3505.005,22.43,6729.62,238
CPT,Q5118,Inj. zirabev 10 mg,,,23.0,33.69,63
CPT,Q5119,Inj ruxience 10 mg,,,13.27,32.68,63
CPT,Q5119,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,6553.344999999999,4915.01,26.21,9830.02,238
CPT,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,24.71,353.3,63
CPT,Q5121,Inj. avsola 10 mg,,,19.83,33.5,63
CPT,Q5122,Inj nyvepria,,,112.94,152.28,63
CPT,Q5123,Inj. riabni 10 mg,,,20.9,49.75,63
CPT,Q5124,Inj. byooviz 0.1 mg,,,60.22,235.95,63
CPT,Q5125,Inj releuko 1 mcg,,,0.34,0.55,27
CPT,Q5126,Inj alymsys 10 mg,,,33.01,65.28,27
CPT,Q5127,Inj stimufend 0.5 mg,,,147.24,357.56,27
CPT,Q5128,Inj cimerli 0.1 mg,,,83.34,235.14,27
CPT,Q5129,Inj vegzelma 10 mg,,,38.16,65.24,27
CPT,Q5130,Inj fylnetra 0.5 mg,,,127.23,217.8,27
CPT,Q5130,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6871.25,5153.44,82.46,6184.12,119
CPT,Q5131,Inj- idacio- 20 mg,,,242.73,242.73,8
CPT,Q5132,Inj- abrilada- 10 mg,,,140.13,140.13,8
CPT,Q5133,Inj tofidence 1 mg,,,5.54,6.43,27
CPT,Q5134,Inj tyruko 1 mg,,,24.39,24.39,9
CPT,Q5135,Inj tyenne 1 mg,,,4.11,5.29,27
CPT,Q5135,TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,2984.11,2238.08,35.81,2685.7,119
CPT,Q5135,TOCILIZUMAB-AAZG 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,5968.22,4476.17,71.62,5371.4,119
CPT,Q5135,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1193.64,895.23,14.32,1074.28,119
CPT,Q5136,DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE,4408.95,3306.71,52.91,3968.06,119
CPT,Q5136,Inj. denosumab-bbdz 1 mg,,,27.54,31.97,18
CPT,Q5137,Inj wezlana sub cu 1 mg,,,,,0
CPT,Q5138,Inj wezlana iv 1 mg,,,11.64,13.53,18
CPT,Q5140,Inj adalimumab-fkjp 1 mg,,,13.18,87.14,10
CPT,Q5141,Inj adalimumab-aaty 1 mg,,,13.75,43.57,10
CPT,Q5142,Inj adalimumab-ryvk 1 mg,,,10.47,12.16,10
CPT,Q5143,Inj adalimumab-adbm 1 mg,,,10.43,12.11,10
CPT,Q5144,Inj idacio 1 mg,,,7.69,15.02,10
CPT,Q5145,Inj abrilada 1 mg,,,19.47,128.07,10
CPT,Q5146,Inj hercessi 10 mg,,,37.15,46.47,18
CPT,Q5147,Inj aflibercept-ayyh 1 mg,,,859.36,997.72,18
CPT,Q5148,Inj nyposi 1 mcg,,,0.55,1.0,18
CPT,Q5151,Inj eculizumab-aagh 2 mg,,,31.35,36.4,18
CPT,Q5152,Inj eculizumab-aeeb 2 mg,,,40.31,46.8,18
CPT,Q5157,Inj denosumab-bmwo 1 mg,,,28.13,32.66,18
CPT,Q5158,Inj denosumab-bnht 1 mg,,,28.72,33.34,18
CPT,Q5160,Inj jobevne 10 mg,,,84.38,84.38,9
CPT,Q9950,Inj sulf hexa lipid microsph,,,18.37,21.82,44
CPT,Q9956,Inj octafluoropropane micml,,,30.52,47.87,44
CPT,Q9957,Inj perflutren lip microsml,,,45.78,47.87,44
CPT,Q9957,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,755.1949999999999,566.395,8.89,692.38,238
CPT,Q9958,DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,194.4,145.8,2.33,174.96,119
CPT,Q9958,DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLUTION,258.0,193.5,2.22,298.08,238
CPT,Q9958,Hocm <149 mg/ml iodine 1ml,,,0.07,0.09,44
CPT,Q9961,Hocm 250-299mg/ml iodine1ml,,,0.14,0.85,44
CPT,Q9962,Hocm 300-349mg/ml iodine1ml,,,0.46,0.55,8
CPT,Q9963,DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,268.65,201.49,1.66,358.99,238
CPT,Q9963,Hocm 350-399mg/ml iodine1ml,,,0.2,0.25,44
CPT,Q9965,IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,268.44,201.33,3.22,241.6,119
CPT,Q9965,Locm 100-199mg/ml iodine1ml,,,1.49,1.82,44
CPT,Q9966,IOHEXOL 240 MG IODINE/ML INTRAVENOUS SOLUTION,248.22,186.16500000000002,2.82,235.12,238
CPT,Q9966,IOPAMIDOL 200 MG IODINE/ML (41 %) INJECTION SOLUTION,131.4,98.55,1.58,118.26,119
CPT,Q9966,IOPAMIDOL 200 MG IODINE/ML (41 %) INTRATHECAL SOLUTION,459.48,344.61,4.65,478.12,238
CPT,Q9966,IOPAMIDOL 250 MG IODINE/ML (51 %) INTRAVENOUS SOLUTION,187.65,140.74,1.62,216.0,238
CPT,Q9966,Locm 200-299mg/ml iodine1ml,,,0.44,0.47,44
CPT,Q9967,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,259.92,194.94,2.89,250.29,476
CPT,Q9967,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,720.3,540.225,7.26,751.68,238
CPT,Q9967,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRATHECAL SOLUTION,515.25,386.44,6.18,463.72,119
CPT,Q9967,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,337.65,253.24,1.59,1317.6,714
CPT,Q9967,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,422.1,316.58,1.84,1371.6,1071
CPT,Q9967,Locm 300-399mg/ml iodine1ml,,,0.16,0.17,44
CPT,Q9968,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,4662.49,3496.87,55.95,4196.24,119
CPT,Q9968,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,476
CPT,Q9968,Visualization adjunct,,,8.73,10.14,19
CPT,Q9969,HCD NON-HEU TC99M ADD ON PER STUDY DOSE,10.83,8.12,0.13,9.75,119
CPT,Q9969,Non-heu tc-99m add-on/dose,,,10.0,11.61,10
CPT,Q9982,FLUTEMETAMOL F-18 5 MCI (185 MBQ) INTRAVENOUS SOLUTION,180576.0,135432.0,1083.46,243777.6,238
CPT,Q9982,Flutemetamol f18 diagnostic,,,1866.58,12016.62,26
CPT,Q9983,Florbetaben f18 diagnostic,,,1273.76,10195.92,26
CPT,Q9991,Buprenorph xr 100 mg or less,,,1825.83,2341.06,63
CPT,Q9992,Buprenorphine xr over 100 mg,,,1825.83,2341.06,63
CPT,Q9997,Ustekinumab-ttwe iv inj 1 mg,,,8.27,10.79,18
CPT,Q9998,Inj ustekinumab-aekn 1 mg,,,40.35,46.85,18
CPT,Q9999,Inj ustekinumab-aauz 1 mg,,,32.96,38.42,18
CPT,R0070,Transport portable x-ray,,,534.99,638.34,8
CPT,R0075,Transport port x-ray multipl,,,534.99,638.34,8
CPT,S0012,Butorphanol tartrate - nasal,,,86.69,86.69,8
CPT,S0013,Esketamine - nasal spray,,,14.9,14.9,8
CPT,S0014,Tacrine hydrochloride - 10 mg,,,,,0
CPT,S0017,Injection - aminocaproic acid,,,9.01,9.01,8
CPT,S0021,Injection - cefoperazone sod,,,,,0
CPT,S0023,Injection - cimetidine hydroc,,,,,0
CPT,S0028,Injection - famotidine - 20 mg,,,0.97,0.97,8
CPT,S0032,Injection - nafcillin sodium,,,19.51,19.51,8
CPT,S0034,Injection - ofloxacin - 400 mg,,,,,0
CPT,S0039,Injection - sulfamethoxazole,,,13.55,13.55,8
CPT,S0040,Injection - ticarcillin disod,,,,,0
CPT,S0074,Injection - cefotetan disodiu,,,13.08,13.08,8
CPT,S0078,Injection - fosphenytoin sodi,,,51.57,51.57,8
CPT,S0080,Injection - pentamidine iseth,,,105.52,105.52,8
CPT,S0081,Injection - piperacillin sodi,,,,,0
CPT,S0088,Imatinib 100 mg,,,90.96,90.96,8
CPT,S0090,Sildenafil citrate - 25 mg,,,59.81,59.81,8
CPT,S0091,Granisetron 1mg,,,53.12,53.12,8
CPT,S0092,Hydromorphone 250 mg,,,61.02,61.02,8
CPT,S0093,Morphine 500 mg,,,10.18,10.18,8
CPT,S0104,Zidovudine - oral - 100 mg,,,1.82,1.82,8
CPT,S0106,Bupropion hcl sr 60 tablets,,,104.4,104.4,8
CPT,S0108,Mercaptopurine 50 mg,,,6.46,6.46,8
CPT,S0109,Methadone oral 5mg,,,0.29,0.29,8
CPT,S0117,Tretinoin topical 5 g,,,4.05,4.05,8
CPT,S0119,ONDANSETRON 4 MG DISINTEGRATING TABLET,3.5149999999999997,2.635,0.04,3.3,238
CPT,S0119,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,81.99,61.49,0.51,381.78,476
CPT,S0119,Ondansetron 4 mg,,,21.27,21.27,8
CPT,S0122,Inj menotropins 75 iu,,,262.17,262.17,8
CPT,S0126,Inj follitropin alfa 75 iu,,,260.83,260.83,8
CPT,S0128,Inj follitropin beta 75 iu,,,234.9,234.9,8
CPT,S0132,Inj ganirelix acetat 250 mcg,,,198.72,198.72,8
CPT,S0136,Clozapine - 25 mg,,,1.19,1.19,8
CPT,S0137,Didanosine - 25 mg,,,,,0
CPT,S0138,Finasteride - 5 mg,,,2.82,2.82,8
CPT,S0139,Minoxidil - 10 mg,,,1.16,1.16,8
CPT,S0140,Saquinavir - 200 mg,,,4.33,4.33,8
CPT,S0142,Colistimethate inh sol mg,,,,,0
CPT,S0145,Peg interferon alfa-2a/180,,,1202.49,1202.49,8
CPT,S0148,Peg interferon alfa-2b/10,,,,,0
CPT,S0155,Epoprostenol dilutant,,,15.66,15.66,8
CPT,S0156,Exemestane - 25 mg,,,18.21,18.21,8
CPT,S0157,Becaplermin gel 1% - 0.5 gm,,,48.95,48.95,8
CPT,S0160,Dextroamphetamine,,,2.61,2.61,8
CPT,S0169,Calcitrol,,,0.91,0.91,8
CPT,S0170,Anastrozole 1 mg,,,11.97,11.97,8
CPT,S0172,Chlorambucil 2 mg,,,599.46,599.46,8
CPT,S0174,Dolasetron 50 mg,,,31.92,31.92,8
CPT,S0175,Flutamide 125 mg,,,32.35,32.35,8
CPT,S0176,Hydroxyurea 500 mg,,,0.97,0.97,8
CPT,S0177,Levamisole 50 mg,,,,,0
CPT,S0178,Lomustine 10 mg,,,121.49,121.49,8
CPT,S0179,Megestrol 20 mg,,,0.78,0.78,8
CPT,S0182,Procarbazine - oral,,,139.61,139.61,8
CPT,S0183,Prochlorperazine 5 mg,,,0.54,0.54,8
CPT,S0187,Tamoxifen 10 mg,,,1.7,1.7,8
CPT,S0189,Testosterone pellet 75 mg,,,116.84,116.84,8
CPT,S0190,MIFEPRISTONE 200 MG TABLET,193.5,145.12,2.32,174.15,119
CPT,S0190,Mifepristone - oral - 200 mg,,,38.7,38.7,8
CPT,S0191,Misoprostol - oral - 200 mcg,,,1.08,1.08,8
CPT,S0194,Vitamin suppl 100 caps,,,60.51,60.51,8
CPT,S0197,Prenatal vitamins 30 day,,,0.79,0.79,8
CPT,S2083,Adjustment gastric band,,,57.23,57.23,1
CPT,S2118,Total hip resurfacing,,,12954.18,12954.18,1
CPT,S2152,HC HEART ACQUISITION,627.05,470.29,7.52,564.34,119
CPT,S2152,HC KIDNEY CADAVERIC ACQUISITION,190366.81,142775.11,2284.4,171330.13,119
CPT,S2152,HC LIVER CADAVERIC ACQUISITION,302887.69,227165.77,3634.65,272598.92,119
CPT,S2152,HC LIVING KIDNEY ACQUISITION,284863.57,213647.68,3418.36,256377.21,119
CPT,S2152,HC LIVING LIVER ACQUISITION,453535.81,340151.86,5442.43,408182.23,119
CPT,S2152,HC PANCREAS ACQUISITION,154512.43,115884.32,1854.15,139061.19,119
CPT,S2235,Implant auditory brain imp,,,12954.18,12954.18,1
CPT,S2325,Hip core decompression,,,12954.18,12954.18,1
CPT,S2400,Fetal surg congen hernia,,,12954.18,12954.18,1
CPT,S2401,Fetal surg urin trac obstr,,,12954.18,12954.18,1
CPT,S2402,Fetal surg cong cyst malf,,,12954.18,12954.18,1
CPT,S2403,Fetal surg pulmon sequest,,,12954.18,12954.18,1
CPT,S2404,Fetal surg myelomeningo,,,12954.18,12954.18,1
CPT,S2405,Fetal surg sacrococ teratoma,,,12954.18,12954.18,1
CPT,S2411,Fetoscop laser ther ttts,,,12954.18,12954.18,1
CPT,S3620,HC METABOLIC SCREENING TEST KIT,625.36,469.02,7.5,562.82,119
CPT,S3620,Newborn metabolic screening,,,133.65,133.65,1
CPT,S4989,Contracept iud,,,,,0
CPT,S4990,Nicotine patch legend,,,,,0
CPT,S4991,Nicotine patch nonlegend,,,1.65,1.65,8
CPT,S4993,Contraceptive pills for bc,,,1.26,1.26,8
CPT,S4995,Smoking cessation gum,,,0.34,0.34,8
CPT,S5000,Prescription drug - generic,,,,,0
CPT,S5001,Prescription drug -brand name,,,,,0
CPT,S5550,Insulin rapid 5 u,,,0.46,0.46,8
CPT,S5551,Insulin most rapid 5 u,,,0.39,0.39,8
CPT,S5552,Insulin intermed 5 u,,,0.24,0.24,8
CPT,S5553,Insulin long acting 5 u,,,0.34,0.34,8
CPT,S5570,Insulin dispos pen 1.5 ml,,,61.71,61.71,8
CPT,S5571,Insulin dispos pen 3 ml,,,19.87,19.87,8
CPT,S8940,Hippotherapy per session,,,141.7,141.7,1
CPT,S9122,Home health aide or certifie,,,43.95,43.95,1
CPT,S9123,Nursing care in home rn,,,169.51,169.51,1
CPT,S9124,Nursing care - in the home - b,,,145.3,145.3,1
CPT,S9441,HC ASTHMA EDUCATION,59.03,44.27,0.71,53.13,119
CPT,S9441,HC COM CON ASTHMA EDUCATION,82.78,62.08,0.99,74.5,119
CPT,S9443,HC LACTATION EDUCATION; NON PHYSICIAN PROVIDER PER SESSION,290.1,217.58,3.48,261.09,238
CPT,S9449,HC RDN WTH FULL PROGRAM S9449,800.0,600.0,9.6,720.0,119
CPT,S9449,HC RDN WTH PARTIAL PROGRAM S9449,917.45,688.09,11.01,825.7,119
CPT,S9470,HC DIETITIAN MEDICAID CONSULT 30 MIN,92.53,69.39500000000001,1.03,89.24,238
CPT,S9480,HC INTENSIVE OUTPATIENT PSYCHIA,554.28,415.71,6.65,498.85,119
CPT,S9480,Intensive outpatient psychia,,,206.56,206.56,1
CPT,S9900,Christian sci pract visit,,,192.64,192.64,1
CPT,U0001,2019-ncov diagnostic p,,,32.0,53.88,58
CPT,U0002,Covid-19 lab test non-cdc,,,13.96,76.97,66
CPT,U0002,HC SARS-COVID-19 PCR NON-CDC/ NON HIGH TP,213.23,159.92,2.56,191.91,119
CPT,U0003,Cov-19 amp prb hgh thruput,,,75.0,75.0,36
CPT,U0004,Cov-19 test non-cdc hgh thru,,,75.0,75.0,36
CPT,U0005,Infec agen detec ampli probe,,,25.0,25.0,36
CPT,V2020,Vision svcs frames purchases,,,88.18,254.69,27
CPT,V2100,Lens spher single plano 4.00,,,62.69,181.07,27
CPT,V2101,Single visn sphere 4.12-7.00,,,66.06,190.77,27
CPT,V2102,Singl visn sphere 7.12-20.00,,,92.91,268.37,27
CPT,V2103,Spherocylindr 4.00d/12-2.00d,,,50.52,145.93,27
CPT,V2104,Spherocylindr 4.00d/2.12-4d,,,57.61,166.38,27
CPT,V2105,Spherocylinder 4.00d/4.25-6d,,,49.23,142.17,27
CPT,V2106,Spherocylinder 4.00d/>6.00d,,,54.62,157.76,27
CPT,V2107,Spherocylinder 4.25d/12-2d,,,56.03,161.83,27
CPT,V2108,Spherocylinder 4.25d/2.12-4d,,,68.18,196.91,27
CPT,V2109,Spherocylinder 4.25d/4.25-6d,,,59.51,171.87,27
CPT,V2110,Spherocylinder 4.25d/over 6d,,,58.72,169.6,27
CPT,V2111,Spherocylindr 7.25d/.25-2.25,,,61.21,176.79,27
CPT,V2112,Spherocylindr 7.25d/2.25-4d,,,66.83,193.02,27
CPT,V2113,Spherocylindr 7.25d/4.25-6d,,,76.34,220.49,27
CPT,V2114,Spherocylinder over 12.00d,,,100.17,289.31,27
CPT,V2115,Lens lenticular bifocal,,,105.84,305.7,27
CPT,V2118,Lens aniseikonic single,,,88.02,254.23,27
CPT,V2121,Lenticular lens single,,,93.9,271.23,27
CPT,V2200,Lens spher bifoc plano 4.00d,,,65.94,190.45,27
CPT,V2201,Lens sphere bifocal 4.12-7.0,,,77.34,223.4,27
CPT,V2202,Lens sphere bifocal 7.12-20.,,,102.28,295.41,27
CPT,V2203,Lens sphcyl bifocal 4.00d/.1,,,65.82,190.11,27
CPT,V2204,Lens sphcy bifocal 4.00d/2.1,,,68.4,197.58,27
CPT,V2205,Lens sphcy bifocal 4.00d/4.2,,,79.71,230.22,27
CPT,V2206,Lens sphcy bifocal 4.00d/ove,,,75.39,217.73,27
CPT,V2207,Lens sphcy bifocal 4.25-7d/.,,,76.82,221.89,27
CPT,V2208,Lens sphcy bifocal 4.25-7/2.,,,82.65,238.7,27
CPT,V2209,Lens sphcy bifocal 4.25-7/4.,,,83.73,241.85,27
CPT,V2210,Lens sphcy bifocal 4.25-7/ov,,,89.28,257.87,27
CPT,V2211,Lens sphcy bifo 7.25-12/.25-,,,118.19,341.36,27
CPT,V2212,Lens sphcyl bifo 7.25-12/2.2,,,122.04,352.49,27
CPT,V2213,Lens sphcyl bifo 7.25-12/4.2,,,123.28,356.07,27
CPT,V2214,Lens sphcyl bifocal over 12.,,,117.18,338.44,27
CPT,V2215,Lens lenticular bifocal,,,104.37,301.44,27
CPT,V2218,Lens aniseikonic bifocal,,,121.41,350.67,27
CPT,V2219,Lens bifocal seg width over,,,71.25,205.8,27
CPT,V2220,Lens bifocal add over 3.25d,,,44.82,129.45,27
CPT,V2221,Lenticular lens bifocal,,,109.35,315.83,27
CPT,V2300,Lens sphere trifocal 4.00d,,,86.75,250.56,27
CPT,V2301,Lens sphere trifocal 4.12-7.,,,92.34,266.7,27
CPT,V2302,Lens sphere trifocal 7.12-20,,,98.42,284.28,27
CPT,V2303,Lens sphcy trifocal 4.0/.12-,,,82.59,238.54,27
CPT,V2304,Lens sphcy trifocal 4.0/2.25,,,88.56,255.78,27
CPT,V2305,Lens sphcy trifocal 4.0/4.25,,,98.95,285.79,27
CPT,V2306,Lens sphcyl trifocal 4.00/>6,,,111.32,321.53,27
CPT,V2307,Lens sphcy trifocal 4.25-7/.,,,94.3,272.38,27
CPT,V2308,Lens sphc trifocal 4.25-7/2.,,,98.19,283.61,27
CPT,V2309,Lens sphc trifocal 4.25-7/4.,,,104.01,300.42,27
CPT,V2310,Lens sphc trifocal 4.25-7/>6,,,102.78,296.87,27
CPT,V2311,Lens sphc trifo 7.25-12/.25-,,,106.94,308.85,27
CPT,V2312,Lens sphc trifo 7.25-12/2.25,,,107.55,310.64,27
CPT,V2313,Lens sphc trifo 7.25-12/4.25,,,120.12,346.93,27
CPT,V2314,Lens sphcyl trifocal over 12,,,129.0,372.57,27
CPT,V2315,Lens lenticular trifocal,,,143.21,413.64,27
CPT,V2318,Lens aniseikonic trifocal,,,176.06,508.53,27
CPT,V2319,Lens trifocal seg width > 28,,,59.61,172.18,27
CPT,V2320,Lens trifocal add over 3.25d,,,62.88,181.62,27
CPT,V2321,Lenticular lens trifocal,,,141.16,407.72,27
CPT,V2410,Lens variab asphericity sing,,,143.49,414.46,27
CPT,V2430,Lens variable asphericity bi,,,147.57,426.23,27
CPT,V2500,Contact lens pmma spherical,,,103.19,298.05,27
CPT,V2501,Cntct lens pmma-toric/prism,,,181.59,524.49,27
CPT,V2502,Contact lens pmma bifocal,,,205.03,592.18,27
CPT,V2503,Cntct lens pmma color vision,,,168.6,486.95,27
CPT,V2510,Cntct gas permeable sphericl,,,148.67,429.41,27
CPT,V2511,Cntct toric prism ballast,,,191.34,552.68,27
CPT,V2512,Cntct lens gas permbl bifocl,,,226.1,653.03,27
CPT,V2513,Contact lens extended wear,,,189.82,548.28,27
CPT,V2520,Contact lens hydrophilic,,,125.17,361.53,27
CPT,V2521,Cntct lens hydrophilic toric,,,242.38,700.06,27
CPT,V2522,Cntct lens hydrophil bifocl,,,212.08,612.57,27
CPT,V2523,Cntct lens hydrophil extend,,,180.74,522.03,27
CPT,V2524,Cntct lens hydrophil photoch,,,144.86,418.39,27
CPT,V2530,Contact lens gas impermeable,,,291.33,841.44,27
CPT,V2531,Contact lens gas permeable,,,658.74,1902.63,27
CPT,V2623,Plastic eye prosth custom,,,1139.97,3292.56,27
CPT,V2624,Polishing artifical eye,,,92.92,268.37,27
CPT,V2625,Enlargemnt of eye prosthesis,,,585.75,1691.79,27
CPT,V2626,Reduction of eye prosthesis,,,239.46,691.62,27
CPT,V2627,Scleral cover shell,,,2009.6,5804.31,27
CPT,V2628,Fabrication & fitting,,,486.9,1406.28,27
CPT,V2630,Anter chamber intraocul lens,,,345.82,412.63,8
CPT,V2631,Iris support intraoclr lens,,,345.82,412.63,8
CPT,V2632,Post chmbr intraocular lens,,,345.82,412.63,8
CPT,V2700,Balance lens,,,61.99,179.07,27
CPT,V2710,Glass/plastic slab off prism,,,92.79,268.0,27
CPT,V2715,Prism lens/es,,,13.95,40.3,27
CPT,V2718,Fresnell prism press-on lens,,,34.27,98.98,27
CPT,V2730,Special base curve,,,25.31,73.1,27
CPT,V2744,Tint photochromatic lens/es,,,19.69,56.87,27
CPT,V2745,Tint any color/solid/grad,,,12.61,36.41,27
CPT,V2750,Anti-reflective coating,,,22.91,66.15,27
CPT,V2755,Uv lens/es,,,21.07,60.87,27
CPT,V2760,Scratch resistant coating,,,62.06,74.05,8
CPT,V2762,Polarization any lens,,,176.09,210.11,8
CPT,V2770,Occluder lens/es,,,23.97,69.25,27
CPT,V2780,Oversize lens/es,,,15.04,43.43,27
CPT,V2782,Lens 1.54-1.65 p/1.60-1.79g,,,78.55,226.89,27
CPT,V2783,Lens > 1.66 p/>1.80 g,,,88.6,255.9,27
CPT,V2784,Lens polycarb or equal,,,57.64,166.48,27
CPT,V2785,Corneal tissue processing,,,,,0
CPT,V5010,Assessment for hearing aid,,,385.4,385.4,1
CPT,V5011,HC HEARING AID FIT & COUNSEL,241.54,181.16,2.9,217.39,119
CPT,V5011,Hearing aid fitting/checking,,,592.6,592.6,1
CPT,V5014,Hearing aid repair/modifying,,,192.7,192.7,1
CPT,V5020,Conformity evaluation,,,385.4,385.4,1
CPT,V5240,"HC DISPENSING FEE, CONTRALATERAL BINAURAL",722.11,541.58,8.67,649.9,119
CPT,ZQ4196,HC PURAPLY DISC PER 1 SQ CM WITH JW MOD,1050.1,787.58,12.6,945.09,119
LOCAL,Other,All Other,,,,,0
MS-DRG,MS-001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,187486.32,495000.0,180
MS-DRG,MS-001,Heart Transplant Or Implant Of Heart Assist System With Mcc,,,189523.66,189523.66,4
MS-DRG,MS-002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,75812.34,495000.0,180
MS-DRG,MS-002,Heart Transplant Or Implant Of Heart Assist System Without Mcc,,,158369.67,158369.67,4
MS-DRG,MS-003,ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE- MOUTH AND NECK WITH MAJOR O.R. PROCEDURES,,,142001.46,384397.52,280
MS-DRG,MS-003,"Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck With Major O.R. Procedures",,,237876.58,237876.58,4
MS-DRG,MS-004,TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE- MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES,,,92669.04,220982.88,280
MS-DRG,MS-004,"Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Neck Without Major O.R. Procedures",,,139439.13,139439.13,4
MS-DRG,MS-005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,68979.61,470000.0,150
MS-DRG,MS-005,Liver Transplant With Mcc Or Intestinal Transplant,,,224031.78,224031.78,4
MS-DRG,MS-006,LIVER TRANSPLANT WITHOUT MCC,,,31022.59,470000.0,150
MS-DRG,MS-006,Liver Transplant Without Mcc,,,56530.5,56530.5,4
MS-DRG,MS-007,LUNG TRANSPLANT,,,86639.81,103943.75,120
MS-DRG,MS-007,Lung Transplant,,,143490.78,143490.78,4
MS-DRG,MS-008,SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT,,,37496.06,470000.0,92
MS-DRG,MS-008,Simultaneous Pancreas And Kidney Transplant,,,65720.14,65720.14,4
MS-DRG,MS-010,PANCREAS TRANSPLANT,,,48007.08,470000.0,92
MS-DRG,MS-010,Pancreas Transplant,,,48742.88,48742.88,4
MS-DRG,MS-011,TRACHEOSTOMY FOR FACE- MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC,,,36489.18,134867.36,280
MS-DRG,MS-011,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc",,,60714.47,60714.47,4
MS-DRG,MS-012,TRACHEOSTOMY FOR FACE- MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC,,,28206.01,119955.12,280
MS-DRG,MS-012,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc",,,45953.96,45953.96,4
MS-DRG,MS-013,TRACHEOSTOMY FOR FACE- MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC,,,19279.9,68413.93,280
MS-DRG,MS-013,"Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc",,,33245.39,33245.39,4
MS-DRG,MS-014,ALLOGENEIC BONE MARROW TRANSPLANT,,,80402.51,102797.21,120
MS-DRG,MS-014,Allogeneic Bone Marrow Transplant,,,131567.94,131567.94,4
MS-DRG,MS-016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,39671.05,46058.09,120
MS-DRG,MS-016,Autologous Bone Marrow Transplant With Cc/Mcc,,,71518.49,71518.49,4
MS-DRG,MS-017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,36343.33,58637.99,120
MS-DRG,MS-017,Autologous Bone Marrow Transplant Without Cc/Mcc,,,51368.16,51368.16,4
MS-DRG,MS-018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY,,,288902.84,335416.19,120
MS-DRG,MS-018,Chimeric Antigen Receptor (Car) T-Cell And Other Immunotherapies,,,424867.81,424867.81,4
MS-DRG,MS-019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,47732.11,77013.23,120
MS-DRG,MS-019,Simultaneous Pancreas And Kidney Transplant With Hemodialysis,,,83863.8,83863.8,4
MS-DRG,MS-020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,52644.08,295196.88,280
MS-DRG,MS-020,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc,,,109355.21,109355.21,4
MS-DRG,MS-021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,35416.74,225707.28,280
MS-DRG,MS-021,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc,,,79804.02,79804.02,4
MS-DRG,MS-022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,21257.53,87553.92,280
MS-DRG,MS-022,Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/Mcc,,,51232.37,51232.37,4
MS-DRG,MS-023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,38337.02,173957.12,280
MS-DRG,MS-023,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis With Mcc Or Chemotherapy Implant Or Epilepsy With Neurostimulator,,,53059.15,53059.15,4
MS-DRG,MS-024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,26171.51,122358.24,280
MS-DRG,MS-024,Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Without Mcc,,,46415.88,46415.88,4
MS-DRG,MS-025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,30418.47,137937.6,280
MS-DRG,MS-025,Craniotomy And Endovascular Intracranial Procedures With Mcc,,,56532.83,56532.83,4
MS-DRG,MS-026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,20801.26,94103.6,280
MS-DRG,MS-026,Craniotomy And Endovascular Intracranial Procedures With Cc,,,32459.66,32459.66,4
MS-DRG,MS-027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,16878.78,74853.84,280
MS-DRG,MS-027,Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc,,,20539.14,20539.14,4
MS-DRG,MS-028,SPINAL PROCEDURES WITH MCC,,,38907.03,90453.04,280
MS-DRG,MS-028,Spinal Procedures With Mcc,,,69087.04,69087.04,4
MS-DRG,MS-029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,22824.39,54974.16,280
MS-DRG,MS-029,Spinal Procedures With Cc Or Spinal Neurostimulators,,,28189.81,28189.81,4
MS-DRG,MS-030,SPINAL PROCEDURES WITHOUT CC/MCC,,,13083.57,29231.76,280
MS-DRG,MS-030,Spinal Procedures Without Cc/Mcc,,,27520.15,27520.15,4
MS-DRG,MS-031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,21645.94,119337.6,280
MS-DRG,MS-031,Ventricular Shunt Procedures With Mcc,,,48439.96,48439.96,4
MS-DRG,MS-032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,14256.88,59800.24,280
MS-DRG,MS-032,Ventricular Shunt Procedures With Cc,,,13158.88,13158.88,4
MS-DRG,MS-033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,11125.18,46400.8,280
MS-DRG,MS-033,Ventricular Shunt Procedures Without Cc/Mcc,,,9694.49,9694.49,4
MS-DRG,MS-034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,25895.87,96794.4,280
MS-DRG,MS-034,Carotid Artery Stent Procedures With Mcc,,,47011.26,47011.26,4
MS-DRG,MS-035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,15992.99,56774.64,280
MS-DRG,MS-035,Carotid Artery Stent Procedures With Cc,,,26844.68,26844.68,4
MS-DRG,MS-036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,12997.78,56452.24,280
MS-DRG,MS-036,Carotid Artery Stent Procedures Without Cc/Mcc,,,22107.11,22107.11,4
MS-DRG,MS-037,EXTRACRANIAL PROCEDURES WITH MCC,,,22024.9,104564.24,280
MS-DRG,MS-037,Extracranial Procedures With Mcc,,,39647.26,39647.26,4
MS-DRG,MS-038,EXTRACRANIAL PROCEDURES WITH CC,,,10855.57,45698.96,280
MS-DRG,MS-038,Extracranial Procedures With Cc,,,19224.18,19224.18,4
MS-DRG,MS-039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,7864.36,30861.12,280
MS-DRG,MS-039,Extracranial Procedures Without Cc/Mcc,,,13548.84,13548.84,4
MS-DRG,MS-040,PERIPHERAL- CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC,,,25832.31,127038.0,280
MS-DRG,MS-040,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc",,,44531.06,44531.06,4
MS-DRG,MS-041,PERIPHERAL- CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR,,,14709.81,53575.44,280
MS-DRG,MS-041,"Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Peripheral Neurostimulator",,,24222.88,24222.88,4
MS-DRG,MS-042,PERIPHERAL- CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC,,,11558.71,56092.64,280
MS-DRG,MS-042,"Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc",,,21742.68,21742.68,4
MS-DRG,MS-052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,12118.01,52516.48,280
MS-DRG,MS-052,Spinal Disorders And Injuries With Cc/Mcc,,,20926.78,20926.78,4
MS-DRG,MS-053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,6551.07,27585.04,280
MS-DRG,MS-053,Spinal Disorders And Injuries Without Cc/Mcc,,,12022.66,12022.66,4
MS-DRG,MS-054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,10215.31,39913.12,280
MS-DRG,MS-054,Nervous System Neoplasms With Mcc,,,16302.95,16302.95,4
MS-DRG,MS-055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,6821.36,31788.64,280
MS-DRG,MS-055,Nervous System Neoplasms Without Mcc,,,11852.05,11852.05,4
MS-DRG,MS-056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,15542.07,64284.08,256
MS-DRG,MS-056,Degenerative Nervous System Disorders With Mcc,,,31484.76,31484.76,4
MS-DRG,MS-057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,8667.86,39035.2,256
MS-DRG,MS-057,Degenerative Nervous System Disorders Without Mcc,,,15387.23,15387.23,4
MS-DRG,MS-058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,11436.95,63019.28,280
MS-DRG,MS-058,Multiple Sclerosis And Cerebellar Ataxia With Mcc,,,20280.32,20280.32,4
MS-DRG,MS-059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,8301.91,35158.96,280
MS-DRG,MS-059,Multiple Sclerosis And Cerebellar Ataxia With Cc,,,13440.91,13440.91,4
MS-DRG,MS-060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,6153.67,28425.76,280
MS-DRG,MS-060,Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc,,,8452.65,8452.65,4
MS-DRG,MS-061,ISCHEMIC STROKE- PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC,,,18445.63,90063.68,280
MS-DRG,MS-061,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Mcc",,,26438.47,26438.47,4
MS-DRG,MS-062,ISCHEMIC STROKE- PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC,,,11756.07,64842.08,280
MS-DRG,MS-062,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent With Cc",,,20926.78,20926.78,4
MS-DRG,MS-063,ISCHEMIC STROKE- PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC,,,9391.74,52861.2,280
MS-DRG,MS-063,"Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic Agent Without Cc/Mcc",,,18583.53,18583.53,4
MS-DRG,MS-064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,13454.05,49652.08,280
MS-DRG,MS-064,Intracranial Hemorrhage Or Cerebral Infarction With Mcc,,,21521.01,21521.01,4
MS-DRG,MS-065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,6759.14,33132.8,280
MS-DRG,MS-065,Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours,,,12656.34,12656.34,4
MS-DRG,MS-066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,4578.79,23116.08,280
MS-DRG,MS-066,Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc,,,8210.08,8210.08,4
MS-DRG,MS-067,Nonspecific Cva And Precerebral Occlusion Without Infarction With Mcc,,,16622.11,16622.11,4
MS-DRG,MS-067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,9825.94,35962.48,280
MS-DRG,MS-068,Nonspecific Cva And Precerebral Occlusion Without Infarction Without Mcc,,,10622.97,10622.97,4
MS-DRG,MS-068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,5783.03,29125.12,280
MS-DRG,MS-069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,5344.16,23041.68,280
MS-DRG,MS-069,Transient Ischemia Without Thrombolytic,,,9135.08,9135.08,4
MS-DRG,MS-070,Nonspecific Cerebrovascular Disorders With Mcc,,,17717.72,17717.72,4
MS-DRG,MS-070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,11137.89,53935.04,280
MS-DRG,MS-071,Nonspecific Cerebrovascular Disorders With Cc,,,12324.41,12324.41,4
MS-DRG,MS-071,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,6864.18,31716.72,280
MS-DRG,MS-072,Nonspecific Cerebrovascular Disorders Without Cc/Mcc,,,9074.73,9074.73,4
MS-DRG,MS-072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,5059.15,23039.2,280
MS-DRG,MS-073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,10733.13,45639.44,280
MS-DRG,MS-073,Cranial And Peripheral Nerve Disorders With Mcc,,,17623.71,17623.71,4
MS-DRG,MS-074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,6896.29,26129.28,280
MS-DRG,MS-074,Cranial And Peripheral Nerve Disorders Without Mcc,,,11925.17,11925.17,4
MS-DRG,MS-075,VIRAL MENINGITIS WITH CC/MCC,,,9740.32,33100.56,280
MS-DRG,MS-075,Viral Meningitis With Cc/Mcc,,,21451.37,21451.37,4
MS-DRG,MS-076,VIRAL MENINGITIS WITHOUT CC/MCC,,,3755.57,21112.24,280
MS-DRG,MS-076,Viral Meningitis Without Cc/Mcc,,,11604.84,11604.84,4
MS-DRG,MS-077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,,,15022.28,38276.32,168
MS-DRG,MS-078,HYPERTENSIVE ENCEPHALOPATHY WITH CC,,,9694.81,24688.4,168
MS-DRG,MS-079,HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,,,6476.63,16534.16,168
MS-DRG,MS-080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,12109.32,52275.92,256
MS-DRG,MS-080,Nontraumatic Stupor And Coma With Mcc,,,23976.84,23976.84,4
MS-DRG,MS-081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,5991.77,23981.6,256
MS-DRG,MS-081,Nontraumatic Stupor And Coma Without Mcc,,,10561.46,10561.46,4
MS-DRG,MS-082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,15291.19,72597.04,280
MS-DRG,MS-082,Traumatic Stupor And Coma >1 Hour With Mcc,,,23159.77,23159.77,4
MS-DRG,MS-083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,9338.22,42256.72,280
MS-DRG,MS-083,Traumatic Stupor And Coma >1 Hour With Cc,,,14235.92,14235.92,4
MS-DRG,MS-084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,6394.52,28929.2,280
MS-DRG,MS-084,Traumatic Stupor And Coma >1 Hour Without Cc/Mcc,,,10785.46,10785.46,4
MS-DRG,MS-085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,15199.53,71629.84,280
MS-DRG,MS-085,Traumatic Stupor And Coma <1 Hour With Mcc,,,27455.15,27455.15,4
MS-DRG,MS-086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,8715.36,39905.68,280
MS-DRG,MS-086,Traumatic Stupor And Coma <1 Hour With Cc,,,12368.51,12368.51,4
MS-DRG,MS-087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,6119.55,27056.8,280
MS-DRG,MS-087,Traumatic Stupor And Coma <1 Hour Without Cc/Mcc,,,7419.72,7419.72,4
MS-DRG,MS-088,CONCUSSION WITH MCC,,,9043.85,42693.2,280
MS-DRG,MS-088,Concussion With Mcc,,,18528.98,18528.98,4
MS-DRG,MS-089,CONCUSSION WITH CC,,,7349.89,31798.56,280
MS-DRG,MS-089,Concussion With Cc,,,13725.26,13725.26,4
MS-DRG,MS-090,CONCUSSION WITHOUT CC/MCC,,,5507.4,27349.44,280
MS-DRG,MS-090,Concussion Without Cc/Mcc,,,9674.76,9674.76,4
MS-DRG,MS-091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,11749.38,50458.08,280
MS-DRG,MS-091,Other Disorders Of Nervous System With Mcc,,,20304.7,20304.7,4
MS-DRG,MS-092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,6844.1,31146.32,280
MS-DRG,MS-092,Other Disorders Of Nervous System With Cc,,,11687.24,11687.24,4
MS-DRG,MS-093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,5327.43,24542.08,280
MS-DRG,MS-093,Other Disorders Of Nervous System Without Cc/Mcc,,,8990.01,8990.01,4
MS-DRG,MS-094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,23545.59,97793.84,280
MS-DRG,MS-094,Bacterial And Tuberculous Infections Of Nervous System With Mcc,,,42004.44,42004.44,4
MS-DRG,MS-095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,17255.44,65665.44,280
MS-DRG,MS-095,Bacterial And Tuberculous Infections Of Nervous System With Cc,,,30053.74,30053.74,4
MS-DRG,MS-096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,17046.66,61709.84,280
MS-DRG,MS-096,Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc,,,26850.48,26850.48,4
MS-DRG,MS-097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,23059.42,78725.12,280
MS-DRG,MS-097,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Mcc,,,45703.27,45703.27,4
MS-DRG,MS-098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,12918.25,60864.16,280
MS-DRG,MS-098,Non-Bacterial Infection Of Nervous System Except Viral Meningitis With Cc,,,24499.11,24499.11,4
MS-DRG,MS-099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,9114.77,32728.56,280
MS-DRG,MS-099,Non-Bacterial Infection Of Nervous System Except Viral Meningitis Without Cc/Mcc,,,16438.74,16438.74,4
MS-DRG,MS-100,SEIZURES WITH MCC,,,12957.64,51482.32,280
MS-DRG,MS-100,Seizures With Mcc,,,14687.39,14687.39,4
MS-DRG,MS-101,SEIZURES WITHOUT MCC,,,5837.72,28465.44,280
MS-DRG,MS-101,Seizures Without Mcc,,,8340.07,8340.07,4
MS-DRG,MS-102,HEADACHES WITH MCC,,,7499.08,26446.72,280
MS-DRG,MS-102,Headaches With Mcc,,,13516.35,13516.35,4
MS-DRG,MS-103,HEADACHES WITHOUT MCC,,,5595.04,23904.72,280
MS-DRG,MS-103,Headaches Without Mcc,,,7881.63,7881.63,4
MS-DRG,MS-104,CRANIOTOMY- VENTRICULAR SHUNT AND ENDOVASCULAR INTRACRANIAL PROCEDURES AGE 0-17,,,25799.73,25799.73,1
MS-DRG,MS-105,TRAUMATIC STUPOR AND COMA <1 HOUR AGE 0-17,,,3741.57,3741.57,1
MS-DRG,MS-106,CONCUSSION AGE 0-17,,,3420.36,3420.36,1
MS-DRG,MS-107,SEIZURES AND HEADACHES AGE 0-17,,,4776.95,4776.95,1
MS-DRG,MS-108,EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17,,,9272.96,9272.96,1
MS-DRG,MS-109,OTHER DISORDERS OF THE EYE AGE 0-17,,,7181.18,7181.18,1
MS-DRG,MS-111,SINUS AND MASTOID PROCEDURES AGE 0-17,,,20577.3,20577.3,1
MS-DRG,MS-112,OTITIS MEDIA AND URI AGE 0-17,,,2751.69,2751.69,1
MS-DRG,MS-113,ORBITAL PROCEDURES WITH CC/MCC,,,13744.45,45086.4,280
MS-DRG,MS-113,Orbital Procedures With Cc/Mcc,,,26392.04,26392.04,4
MS-DRG,MS-114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,9051.88,33643.68,280
MS-DRG,MS-114,Orbital Procedures Without Cc/Mcc,,,15314.12,15314.12,4
MS-DRG,MS-115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,10268.83,40538.08,280
MS-DRG,MS-115,Extraocular Procedures Except Orbit,,,17855.83,17855.83,4
MS-DRG,MS-116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,12096.6,42924.29,280
MS-DRG,MS-116,Intraocular Procedures With Cc/Mcc,,,13988.71,13988.71,4
MS-DRG,MS-117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,7258.23,26749.28,280
MS-DRG,MS-117,Intraocular Procedures Without Cc/Mcc,,,11669.83,11669.83,4
MS-DRG,MS-118,OTHER EAR- NOSE- MOUTH AND THROAT DIAGNOSES AGE 0-17,,,4966.87,4966.87,1
MS-DRG,MS-119,DENTAL AND ORAL DISEASES AGE 0-17,,,6297.21,6297.21,1
MS-DRG,MS-120,RESPIRATORY INFECTIONS AND INFLAMMATIONS AGE 0-17,,,7761.45,7761.45,1
MS-DRG,MS-121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,4225.56,28609.28,280
MS-DRG,MS-121,Acute Major Eye Infections With Cc/Mcc,,,6833.61,6833.61,4
MS-DRG,MS-122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,2709.68,18654.89,280
MS-DRG,MS-122,Acute Major Eye Infections Without Cc/Mcc,,,6833.61,6833.61,4
MS-DRG,MS-123,NEUROLOGICAL EYE DISORDERS,,,5342.82,25172.0,280
MS-DRG,MS-123,Neurological Eye Disorders,,,9331.22,9331.22,4
MS-DRG,MS-124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,8851.84,32180.48,280
MS-DRG,MS-124,Other Disorders Of The Eye With Mcc Or Thrombolytic Agent,,,16464.27,16464.27,4
MS-DRG,MS-125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,5136.76,21533.84,280
MS-DRG,MS-125,Other Disorders Of The Eye Without Mcc,,,5555.79,5555.79,4
MS-DRG,MS-135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,14517.8,59195.12,280
MS-DRG,MS-135,Sinus And Mastoid Procedures With Cc/Mcc,,,28807.25,28807.25,4
MS-DRG,MS-136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,6792.59,38365.6,280
MS-DRG,MS-136,Sinus And Mastoid Procedures Without Cc/Mcc,,,13638.21,13638.21,4
MS-DRG,MS-137,MOUTH PROCEDURES WITH CC/MCC,,,9686.06,32428.48,280
MS-DRG,MS-137,Mouth Procedures With Cc/Mcc,,,17627.19,17627.19,4
MS-DRG,MS-138,MOUTH PROCEDURES WITHOUT CC/MCC,,,5928.88,27771.04,280
MS-DRG,MS-138,Mouth Procedures Without Cc/Mcc,,,10394.33,10394.33,4
MS-DRG,MS-139,SALIVARY GLAND PROCEDURES,,,8267.12,34065.28,280
MS-DRG,MS-139,Salivary Gland Procedures,,,14781.4,14781.4,4
MS-DRG,MS-140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,4562.52,105335.52,280
MS-DRG,MS-140,Major Head And Neck Procedures With Mcc,,,48855.46,48855.46,4
MS-DRG,MS-141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,3483.38,53374.56,280
MS-DRG,MS-141,Major Head And Neck Procedures With Cc,,,19455.14,19455.14,4
MS-DRG,MS-142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,10680.28,39201.36,280
MS-DRG,MS-142,Major Head And Neck Procedures Without Cc/Mcc,,,19455.14,19455.14,4
MS-DRG,MS-143,OTHER EAR- NOSE- MOUTH AND THROAT O.R. PROCEDURES WITH MCC,,,22136.06,88944.28,280
MS-DRG,MS-143,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Mcc",,,37292.4,37292.4,4
MS-DRG,MS-144,OTHER EAR- NOSE- MOUTH AND THROAT O.R. PROCEDURES WITH CC,,,8508.01,43546.32,280
MS-DRG,MS-144,"Other Ear, Nose, Mouth And Throat O.R. Procedures With Cc",,,21266.83,21266.83,4
MS-DRG,MS-145,OTHER EAR- NOSE- MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC,,,4338.47,29467.36,280
MS-DRG,MS-145,"Other Ear, Nose, Mouth And Throat O.R. Procedures Without Cc/Mcc",,,9342.83,9342.83,4
MS-DRG,MS-146,EAR- NOSE- MOUTH AND THROAT MALIGNANCY WITH MCC,,,12475.39,52613.2,280
MS-DRG,MS-146,"Ear, Nose, Mouth And Throat Malignancy With Mcc",,,23676.24,23676.24,4
MS-DRG,MS-147,EAR- NOSE- MOUTH AND THROAT MALIGNANCY WITH CC,,,8506.63,30590.8,280
MS-DRG,MS-147,"Ear, Nose, Mouth And Throat Malignancy With Cc",,,14235.92,14235.92,4
MS-DRG,MS-148,EAR- NOSE- MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC,,,5332.78,19857.36,280
MS-DRG,MS-148,"Ear, Nose, Mouth And Throat Malignancy Without Cc/Mcc",,,9610.93,9610.93,4
MS-DRG,MS-149,DYSEQUILIBRIUM,,,5028.38,20653.44,280
MS-DRG,MS-149,Dysequilibrium,,,8875.11,8875.11,4
MS-DRG,MS-150,EPISTAXIS WITH MCC,,,8908.04,34241.36,280
MS-DRG,MS-150,Epistaxis With Mcc,,,16212.42,16212.42,4
MS-DRG,MS-151,EPISTAXIS WITHOUT MCC,,,4358.6,18758.72,280
MS-DRG,MS-151,Epistaxis Without Mcc,,,9063.13,9063.13,4
MS-DRG,MS-152,OTITIS MEDIA AND URI WITH MCC,,,7909.19,22992.08,280
MS-DRG,MS-152,Otitis Media And Uri With Mcc,,,14078.08,14078.08,4
MS-DRG,MS-153,OTITIS MEDIA AND URI WITHOUT MCC,,,4173.92,14029.36,280
MS-DRG,MS-153,Otitis Media And Uri Without Mcc,,,5134.49,5134.49,4
MS-DRG,MS-154,OTHER EAR- NOSE- MOUTH AND THROAT DIAGNOSES WITH MCC,,,10460.17,40106.56,280
MS-DRG,MS-154,"Other Ear, Nose, Mouth And Throat Diagnoses With Mcc",,,17665.49,17665.49,4
MS-DRG,MS-155,OTHER EAR- NOSE- MOUTH AND THROAT DIAGNOSES WITH CC,,,6131.6,22984.64,280
MS-DRG,MS-155,"Other Ear, Nose, Mouth And Throat Diagnoses With Cc",,,10806.35,10806.35,4
MS-DRG,MS-156,OTHER EAR- NOSE- MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC,,,3932.36,16556.48,280
MS-DRG,MS-156,"Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc",,,8012.78,8012.78,4
MS-DRG,MS-157,DENTAL AND ORAL DISEASES WITH MCC,,,11485.79,42636.16,280
MS-DRG,MS-157,Dental And Oral Diseases With Mcc,,,19651.28,19651.28,4
MS-DRG,MS-158,DENTAL AND ORAL DISEASES WITH CC,,,6086.77,23641.84,280
MS-DRG,MS-158,Dental And Oral Diseases With Cc,,,9029.47,9029.47,4
MS-DRG,MS-159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,4740.03,18356.96,280
MS-DRG,MS-159,Dental And Oral Diseases Without Cc/Mcc,,,7075.02,7075.02,4
MS-DRG,MS-160,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17,,,7855.1,7855.1,1
MS-DRG,MS-161,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17,,,16963.51,16963.51,1
MS-DRG,MS-162,LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP- FOOT AND FEMUR AGE 0-17,,,10493.01,10493.01,1
MS-DRG,MS-163,MAJOR CHEST PROCEDURES WITH MCC,,,29984.27,151468.48,280
MS-DRG,MS-163,Major Chest Procedures With Mcc,,,56935.55,56935.55,4
MS-DRG,MS-164,MAJOR CHEST PROCEDURES WITH CC,,,16886.14,81619.28,280
MS-DRG,MS-164,Major Chest Procedures With Cc,,,22573.67,22573.67,4
MS-DRG,MS-165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,12806.44,59619.2,280
MS-DRG,MS-165,Major Chest Procedures Without Cc/Mcc,,,22573.67,22573.67,4
MS-DRG,MS-166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,25006.07,112190.24,280
MS-DRG,MS-166,Other Respiratory System O.R. Procedures With Mcc,,,43089.6,43089.6,4
MS-DRG,MS-167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,12065.16,61719.76,280
MS-DRG,MS-167,Other Respiratory System O.R. Procedures With Cc,,,22346.19,22346.19,4
MS-DRG,MS-168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,9141.53,42641.12,280
MS-DRG,MS-168,Other Respiratory System O.R. Procedures Without Cc/Mcc,,,16662.73,16662.73,4
MS-DRG,MS-169,FRACTURE- SPRAIN- STRAIN AND DISLOCATION EXCEPT FEMUR- HIP- PELVIS AND THIGH AGE 0-17,,,4005.01,4005.01,1
MS-DRG,MS-170,CELLULITIS AGE 0-17,,,3086.9,3086.9,1
MS-DRG,MS-171,TRAUMA TO THE SKIN- SUBCUTANEOUS TISSUE AND BREAST AGE 0-17,,,4786.58,4786.58,1
MS-DRG,MS-172,MISCELLANEOUS DISORDERS OF NUTRITION- METABOLISM- FLUIDS AND ELECTROLYTES AGE 0-17,,,5120.91,5120.91,1
MS-DRG,MS-173,URETHRAL PROCEDURES AGE 0-17,,,19912.8,76584.88,280
MS-DRG,MS-173,Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary Embolism,,,30610.83,30610.83,4
MS-DRG,MS-174,KIDNEY AND URINARY TRACT INFECTIONS AGE 0-17,,,3685.55,3685.55,1
MS-DRG,MS-175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,9189.7,39360.08,280
MS-DRG,MS-175,Pulmonary Embolism With Mcc Or Acute Cor Pulmonale,,,11126.67,11126.67,4
MS-DRG,MS-176,PULMONARY EMBOLISM WITHOUT MCC,,,5385.63,23612.08,280
MS-DRG,MS-176,Pulmonary Embolism Without Mcc,,,7618.18,7618.18,4
MS-DRG,MS-177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,10454.82,53153.84,280
MS-DRG,MS-177,Respiratory Infections And Inflammations With Mcc,,,14083.88,14083.88,4
MS-DRG,MS-178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,6529.66,30146.88,280
MS-DRG,MS-178,Respiratory Infections And Inflammations With Cc,,,12777.05,12777.05,4
MS-DRG,MS-179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,5051.12,21303.2,280
MS-DRG,MS-179,Respiratory Infections And Inflammations Without Cc/Mcc,,,9231.41,9231.41,4
MS-DRG,MS-180,RESPIRATORY NEOPLASMS WITH MCC,,,11814.95,30456.88,280
MS-DRG,MS-180,Respiratory Neoplasms With Mcc,,,19911.25,19911.25,4
MS-DRG,MS-181,RESPIRATORY NEOPLASMS WITH CC,,,7165.24,28715.92,280
MS-DRG,MS-181,Respiratory Neoplasms With Cc,,,13326.01,13326.01,4
MS-DRG,MS-182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,5043.09,12474.4,280
MS-DRG,MS-182,Respiratory Neoplasms Without Cc/Mcc,,,10432.63,10432.63,4
MS-DRG,MS-183,MAJOR CHEST TRAUMA WITH MCC,,,10235.38,48657.6,280
MS-DRG,MS-183,Major Chest Trauma With Mcc,,,17657.37,17657.37,4
MS-DRG,MS-184,MAJOR CHEST TRAUMA WITH CC,,,7119.07,32827.76,280
MS-DRG,MS-184,Major Chest Trauma With Cc,,,12353.43,12353.43,4
MS-DRG,MS-185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,5261.87,23664.16,280
MS-DRG,MS-185,Major Chest Trauma Without Cc/Mcc,,,8875.11,8875.11,4
MS-DRG,MS-186,PLEURAL EFFUSION WITH MCC,,,10391.49,41331.68,280
MS-DRG,MS-186,Pleural Effusion With Mcc,,,17946.36,17946.36,4
MS-DRG,MS-187,PLEURAL EFFUSION WITH CC,,,6617.31,31044.64,280
MS-DRG,MS-187,Pleural Effusion With Cc,,,12294.24,12294.24,4
MS-DRG,MS-188,PLEURAL EFFUSION WITHOUT CC/MCC,,,4798.23,25886.24,280
MS-DRG,MS-188,Pleural Effusion Without Cc/Mcc,,,8510.68,8510.68,4
MS-DRG,MS-189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,6846.85,28847.36,280
MS-DRG,MS-189,Pulmonary Edema And Respiratory Failure,,,11883.38,11883.38,4
MS-DRG,MS-190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,7410.77,35374.72,280
MS-DRG,MS-190,Chronic Obstructive Pulmonary Disease With Mcc,,,10911.96,10911.96,4
MS-DRG,MS-191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,5639.86,25452.24,280
MS-DRG,MS-191,Chronic Obstructive Pulmonary Disease With Cc,,,10158.73,10158.73,4
MS-DRG,MS-192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,4295.13,18939.76,280
MS-DRG,MS-192,Chronic Obstructive Pulmonary Disease Without Cc/Mcc,,,7664.6,7664.6,4
MS-DRG,MS-193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,8616.54,32483.04,280
MS-DRG,MS-193,Simple Pneumonia And Pleurisy With Mcc,,,10611.37,10611.37,4
MS-DRG,MS-194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,5391.66,22692.0,280
MS-DRG,MS-194,Simple Pneumonia And Pleurisy With Cc,,,6049.05,6049.05,4
MS-DRG,MS-195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,4204.81,15490.08,280
MS-DRG,MS-195,Simple Pneumonia And Pleurisy Without Cc/Mcc,,,4136.38,4136.38,4
MS-DRG,MS-196,INTERSTITIAL LUNG DISEASE WITH MCC,,,12625.8,41140.72,280
MS-DRG,MS-196,Interstitial Lung Disease With Mcc,,,20425.4,20425.4,4
MS-DRG,MS-197,INTERSTITIAL LUNG DISEASE WITH CC,,,6349.7,32934.4,280
MS-DRG,MS-197,Interstitial Lung Disease With Cc,,,11561.9,11561.9,4
MS-DRG,MS-198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,4791.54,24341.2,280
MS-DRG,MS-198,Interstitial Lung Disease Without Cc/Mcc,,,8356.32,8356.32,4
MS-DRG,MS-199,PNEUMOTHORAX WITH MCC,,,7318.59,54929.52,280
MS-DRG,MS-199,Pneumothorax With Mcc,,,20671.45,20671.45,4
MS-DRG,MS-200,PNEUMOTHORAX WITH CC,,,6917.74,34692.72,280
MS-DRG,MS-200,Pneumothorax With Cc,,,9201.24,9201.24,4
MS-DRG,MS-201,PNEUMOTHORAX WITHOUT CC/MCC,,,3896.48,23148.32,280
MS-DRG,MS-201,Pneumothorax Without Cc/Mcc,,,8555.94,8555.94,4
MS-DRG,MS-202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,6402.23,22915.2,280
MS-DRG,MS-202,Bronchitis And Asthma With Cc/Mcc,,,7405.79,7405.79,4
MS-DRG,MS-203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,4138.04,15475.2,280
MS-DRG,MS-203,Bronchitis And Asthma Without Cc/Mcc,,,4310.47,4310.47,4
MS-DRG,MS-204,RESPIRATORY SIGNS AND SYMPTOMS,,,5005.38,19229.92,280
MS-DRG,MS-204,Respiratory Signs And Symptoms,,,9514.6,9514.6,4
MS-DRG,MS-205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,10907.87,28259.6,280
MS-DRG,MS-205,Other Respiratory System Diagnoses With Mcc,,,10386.21,10386.21,4
MS-DRG,MS-206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,5748.44,22979.68,280
MS-DRG,MS-206,Other Respiratory System Diagnoses Without Mcc,,,10386.21,10386.21,4
MS-DRG,MS-207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,43049.62,156468.16,280
MS-DRG,MS-207,Respiratory System Diagnosis With Ventilator Support >96 Hours,,,77941.25,77941.25,4
MS-DRG,MS-208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,18389.43,74516.56,280
MS-DRG,MS-208,Respiratory System Diagnosis With Ventilator Support <=96 Hours,,,23618.21,23618.21,4
MS-DRG,MS-209,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS AGE 0-17,,,4656.17,268708.31,30
MS-DRG,MS-210,URETHRAL STRICTURE AGE 0-17,,,13901.12,13901.12,1
MS-DRG,MS-211,OTHER KIDNEY AND URINARY TRACT DIAGNOSES AGE 0-17,,,5455.25,5455.25,1
MS-DRG,MS-212,Concomitant Aortic And Mitral Valve?Procedures,,,98459.5,98459.5,4
MS-DRG,MS-212,TESTES PROCEDURES AGE 0-17,,,72750.22,273380.32,280
MS-DRG,MS-213,SPLENIC PROCEDURES AGE 0-17,,,16143.43,135481.81,30
MS-DRG,MS-214,RED BLOOD CELL DISORDERS AGE 0-17,,,5311.71,5311.71,1
MS-DRG,MS-215,OTHER HEART ASSIST SYSTEM IMPLANT,,,66614.61,351532.56,280
MS-DRG,MS-215,Other Heart Assist System Implant,,,121108.61,121108.61,4
MS-DRG,MS-216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,65449.18,259385.68,280
MS-DRG,MS-216,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Mcc,,,114510.6,114510.6,4
MS-DRG,MS-217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,43990.27,200210.4,280
MS-DRG,MS-217,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization With Cc,,,74626.58,74626.58,4
MS-DRG,MS-218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,43990.27,174140.64,280
MS-DRG,MS-218,Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheterization Without Cc/Mcc,,,69806.61,69806.61,4
MS-DRG,MS-219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,51369.59,252764.08,280
MS-DRG,MS-219,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Mcc,,,97528.7,97528.7,4
MS-DRG,MS-220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,35677.66,171062.96,280
MS-DRG,MS-220,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization With Cc,,,62719.98,62719.98,4
MS-DRG,MS-221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,33720.09,148182.48,280
MS-DRG,MS-221,Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheterization Without Cc/Mcc,,,55617.11,55617.11,4
MS-DRG,MS-228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,33099.24,171489.52,280
MS-DRG,MS-228,Other Cardiothoracic Procedures With Mcc,,,57929.03,57929.03,4
MS-DRG,MS-229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,21070.88,111981.92,280
MS-DRG,MS-229,Other Cardiothoracic Procedures Without Mcc,,,38800.02,38800.02,4
MS-DRG,MS-231,CORONARY BYPASS WITH PTCA WITH MCC,,,51850.66,235577.68,280
MS-DRG,MS-231,Coronary Bypass With Ptca With Mcc,,,98657.96,98657.96,4
MS-DRG,MS-232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,40560.18,193006.0,280
MS-DRG,MS-232,Coronary Bypass With Ptca Without Mcc,,,68854.92,68854.92,4
MS-DRG,MS-233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,,,51148.14,232842.24,280
MS-DRG,MS-233,Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc,,,88055.88,88055.88,4
MS-DRG,MS-234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,36546.72,158933.28,280
MS-DRG,MS-234,Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc,,,67340.33,67340.33,4
MS-DRG,MS-235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,39262.28,189720.0,280
MS-DRG,MS-235,Coronary Bypass Without Cardiac Catheterization With Mcc,,,70408.96,70408.96,4
MS-DRG,MS-236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,28024.03,129426.24,280
MS-DRG,MS-236,Coronary Bypass Without Cardiac Catheterization Without Mcc,,,49929.01,49929.01,4
MS-DRG,MS-239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,32927.3,127390.16,280
MS-DRG,MS-239,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc,,,54659.62,54659.62,4
MS-DRG,MS-240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,18239.58,75292.8,280
MS-DRG,MS-240,Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc,,,31903.73,31903.73,4
MS-DRG,MS-241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,9261.95,37785.28,280
MS-DRG,MS-241,Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc/Mcc,,,18206.33,18206.33,4
MS-DRG,MS-242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,21360.56,81227.44,280
MS-DRG,MS-242,Permanent Cardiac Pacemaker Implant With Mcc,,,40828.75,40828.75,4
MS-DRG,MS-243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,14256.21,78127.44,280
MS-DRG,MS-243,Permanent Cardiac Pacemaker Implant With Cc,,,27552.64,27552.64,4
MS-DRG,MS-244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,12092.59,62458.8,280
MS-DRG,MS-244,Permanent Cardiac Pacemaker Implant Without Cc/Mcc,,,22346.19,22346.19,4
MS-DRG,MS-245,AICD GENERATOR PROCEDURES,,,30523.5,142069.28,280
MS-DRG,MS-245,Aicd Generator Procedures,,,57315.07,57315.07,4
MS-DRG,MS-250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,14601.43,57414.48,280
MS-DRG,MS-250,Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc,,,28442.82,28442.82,4
MS-DRG,MS-251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,9998.55,45912.24,280
MS-DRG,MS-251,Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc,,,18872.52,18872.52,4
MS-DRG,MS-252,OTHER VASCULAR PROCEDURES WITH MCC,,,23337.53,105759.6,280
MS-DRG,MS-252,Other Vascular Procedures With Mcc,,,39299.08,39299.08,4
MS-DRG,MS-253,OTHER VASCULAR PROCEDURES WITH CC,,,17365.16,84037.28,280
MS-DRG,MS-253,Other Vascular Procedures With Cc,,,31431.37,31431.37,4
MS-DRG,MS-254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,11919.98,58679.28,280
MS-DRG,MS-254,Other Vascular Procedures Without Cc/Mcc,,,21493.15,21493.15,4
MS-DRG,MS-255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,18046.22,64415.52,280
MS-DRG,MS-255,Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc,,,30157.03,30157.03,4
MS-DRG,MS-256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,11359.34,41502.8,280
MS-DRG,MS-256,Upper Limb And Toe Amputation For Circulatory System Disorders With Cc,,,19185.88,19185.88,4
MS-DRG,MS-257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,7307.07,36572.56,280
MS-DRG,MS-257,Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/Mcc,,,12326.73,12326.73,4
MS-DRG,MS-258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,21021.37,74593.45,280
MS-DRG,MS-258,Cardiac Pacemaker Device Replacement With Mcc,,,33515.81,33515.81,4
MS-DRG,MS-259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,13528.31,56814.32,280
MS-DRG,MS-259,Cardiac Pacemaker Device Replacement Without Mcc,,,23439.48,23439.48,4
MS-DRG,MS-260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,21761.98,100926.08,280
MS-DRG,MS-260,Cardiac Pacemaker Revision Except Device Replacement With Mcc,,,41124.7,41124.7,4
MS-DRG,MS-261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,12647.88,53156.32,280
MS-DRG,MS-261,Cardiac Pacemaker Revision Except Device Replacement With Cc,,,22459.93,22459.93,4
MS-DRG,MS-262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,10904.4,38693.83,280
MS-DRG,MS-262,Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc,,,19710.47,19710.47,4
MS-DRG,MS-263,VEIN LIGATION AND STRIPPING,,,20454.71,72582.68,280
MS-DRG,MS-263,Vein Ligation And Stripping,,,32747.49,32747.49,4
MS-DRG,MS-264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,20114.31,88607.92,280
MS-DRG,MS-264,Other Circulatory System O.R. Procedures,,,38903.31,38903.31,4
MS-DRG,MS-265,AICD LEAD PROCEDURES,,,24206.59,87601.04,280
MS-DRG,MS-265,Aicd Lead Procedures,,,39755.19,39755.19,4
MS-DRG,MS-266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,36763.61,200996.56,280
MS-DRG,MS-266,Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc,,,77587.27,77587.27,4
MS-DRG,MS-267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,3542.02,154831.36,280
MS-DRG,MS-267,Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc,,,42669.46,42669.46,4
MS-DRG,MS-268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,13206.19,185030.32,280
MS-DRG,MS-268,Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc,,,81349.94,81349.94,4
MS-DRG,MS-269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,6003.13,116386.4,280
MS-DRG,MS-269,Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc,,,50265.59,50265.59,4
MS-DRG,MS-270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,3196.3,139405.76,280
MS-DRG,MS-270,Other Major Cardiovascular Procedures With Mcc,,,60095.87,60095.87,4
MS-DRG,MS-271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,4008.51,85716.24,280
MS-DRG,MS-271,Other Major Cardiovascular Procedures With Cc,,,40950.61,40950.61,4
MS-DRG,MS-272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,17080.16,70962.72,280
MS-DRG,MS-272,Other Major Cardiovascular Procedures Without Cc/Mcc,,,30519.14,30519.14,4
MS-DRG,MS-273,PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC,,,27600.54,101216.24,280
MS-DRG,MS-273,Percutaneous And Other Intracardiac Procedures With Mcc,,,47849.22,47849.22,4
MS-DRG,MS-274,PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC,,,22022.23,86199.84,280
MS-DRG,MS-274,Percutaneous And Other Intracardiac Procedures Without Mcc,,,39489.42,39489.42,4
MS-DRG,MS-275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,47704.01,177161.28,280
MS-DRG,MS-275,Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc,,,84666.93,84666.93,4
MS-DRG,MS-276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,32973.91,155099.2,280
MS-DRG,MS-276,Cardiac Defibrillator Implant With Mcc,,,67365.87,67365.87,4
MS-DRG,MS-277,Cardiac Defibrillator Implant Without Mcc,,,48791.62,48791.62,4
MS-DRG,MS-277,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,30898.82,117254.4,280
MS-DRG,MS-278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,28561.05,132141.59,280
MS-DRG,MS-278,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures With Mcc,,,46034.04,46034.04,4
MS-DRG,MS-279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,24127.64,85615.94,280
MS-DRG,MS-279,Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures Without Mcc,,,31668.13,31668.13,4
MS-DRG,MS-280,ACUTE MYOCARDIAL INFARCTION- DISCHARGED ALIVE WITH MCC,,,10731.8,51430.24,280
MS-DRG,MS-280,"Acute Myocardial Infarction, Discharged Alive With Mcc",,,16629.08,16629.08,4
MS-DRG,MS-281,ACUTE MYOCARDIAL INFARCTION- DISCHARGED ALIVE WITH CC,,,6148.99,31230.64,280
MS-DRG,MS-281,"Acute Myocardial Infarction, Discharged Alive With Cc",,,12069.08,12069.08,4
MS-DRG,MS-282,ACUTE MYOCARDIAL INFARCTION- DISCHARGED ALIVE WITHOUT CC/MCC,,,4837.7,23790.64,280
MS-DRG,MS-282,"Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc",,,8424.8,8424.8,4
MS-DRG,MS-283,ACUTE MYOCARDIAL INFARCTION- EXPIRED WITH MCC,,,13252.01,51712.96,280
MS-DRG,MS-283,"Acute Myocardial Infarction, Expired With Mcc",,,22551.62,22551.62,4
MS-DRG,MS-284,ACUTE MYOCARDIAL INFARCTION- EXPIRED WITH CC,,,4630.98,18391.68,280
MS-DRG,MS-284,"Acute Myocardial Infarction, Expired With Cc",,,8644.15,8644.15,4
MS-DRG,MS-285,ACUTE MYOCARDIAL INFARCTION- EXPIRED WITHOUT CC/MCC,,,4006.78,14217.89,280
MS-DRG,MS-285,"Acute Myocardial Infarction, Expired Without Cc/Mcc",,,6368.21,6368.21,4
MS-DRG,MS-286,CIRCULATORY DISORDERS EXCEPT AMI- WITH CARDIAC CATHETERIZATION WITH MCC,,,14804.14,64581.68,280
MS-DRG,MS-286,"Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc",,,24326.18,24326.18,4
MS-DRG,MS-287,CIRCULATORY DISORDERS EXCEPT AMI- WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,7159.21,34881.2,280
MS-DRG,MS-287,"Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc",,,14232.44,14232.44,4
MS-DRG,MS-288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,18105.1,72492.88,280
MS-DRG,MS-288,Acute And Subacute Endocarditis With Mcc,,,31695.99,31695.99,4
MS-DRG,MS-289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,6740.07,40521.81,280
MS-DRG,MS-289,Acute And Subacute Endocarditis With Cc,,,18891.09,18891.09,4
MS-DRG,MS-290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,6219.91,27297.36,280
MS-DRG,MS-290,Acute And Subacute Endocarditis Without Cc/Mcc,,,14172.09,14172.09,4
MS-DRG,MS-291,HEART FAILURE AND SHOCK WITH MCC,,,8588.92,41373.84,280
MS-DRG,MS-291,Heart Failure And Shock With Mcc,,,13082.28,13082.28,4
MS-DRG,MS-292,HEART FAILURE AND SHOCK WITH CC,,,5680.0,31483.6,280
MS-DRG,MS-292,Heart Failure And Shock With Cc,,,8822.88,8822.88,4
MS-DRG,MS-293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,3786.67,22421.68,280
MS-DRG,MS-293,Heart Failure And Shock Without Cc/Mcc,,,6586.41,6586.41,4
MS-DRG,MS-294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,,,11930.12,30429.6,168
MS-DRG,MS-295,DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,,,7045.17,15740.56,168
MS-DRG,MS-296,CARDIAC ARREST- UNEXPLAINED WITH MCC,,,10449.47,40565.36,280
MS-DRG,MS-296,"Cardiac Arrest, Unexplained With Mcc",,,19257.84,19257.84,4
MS-DRG,MS-297,CARDIAC ARREST- UNEXPLAINED WITH CC,,,4241.61,19723.44,280
MS-DRG,MS-297,"Cardiac Arrest, Unexplained With Cc",,,7478.91,7478.91,4
MS-DRG,MS-298,CARDIAC ARREST- UNEXPLAINED WITHOUT CC/MCC,,,3044.72,10941.76,280
MS-DRG,MS-298,"Cardiac Arrest, Unexplained Without Cc/Mcc",,,5741.49,5741.49,4
MS-DRG,MS-299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,8304.96,26974.96,280
MS-DRG,MS-299,Peripheral Vascular Disorders With Mcc,,,18078.67,18078.67,4
MS-DRG,MS-300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,7141.82,26297.92,280
MS-DRG,MS-300,Peripheral Vascular Disorders With Cc,,,10444.24,10444.24,4
MS-DRG,MS-301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,4814.96,23329.36,280
MS-DRG,MS-301,Peripheral Vascular Disorders Without Cc/Mcc,,,8418.99,8418.99,4
MS-DRG,MS-302,ATHEROSCLEROSIS WITH MCC,,,8005.53,28604.32,280
MS-DRG,MS-302,Atherosclerosis With Mcc,,,14173.25,14173.25,4
MS-DRG,MS-303,ATHEROSCLEROSIS WITHOUT MCC,,,4503.86,18433.84,280
MS-DRG,MS-303,Atherosclerosis Without Mcc,,,7946.63,7946.63,4
MS-DRG,MS-304,HYPERTENSION WITH MCC,,,7961.37,29058.16,280
MS-DRG,MS-304,Hypertension With Mcc,,,12914.0,12914.0,4
MS-DRG,MS-305,HYPERTENSION WITHOUT MCC,,,5051.79,18538.0,280
MS-DRG,MS-305,Hypertension Without Mcc,,,9393.9,9393.9,4
MS-DRG,MS-306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,10542.46,38588.8,280
MS-DRG,MS-306,Cardiac Congenital And Valvular Disorders With Mcc,,,17347.49,17347.49,4
MS-DRG,MS-307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,6109.52,28443.12,280
MS-DRG,MS-307,Cardiac Congenital And Valvular Disorders Without Mcc,,,10713.5,10713.5,4
MS-DRG,MS-308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,8055.04,29013.52,280
MS-DRG,MS-308,Cardiac Arrhythmia And Conduction Disorders With Mcc,,,12406.81,12406.81,4
MS-DRG,MS-309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,4646.54,22997.04,280
MS-DRG,MS-309,Cardiac Arrhythmia And Conduction Disorders With Cc,,,7890.92,7890.92,4
MS-DRG,MS-310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,3787.34,17231.04,280
MS-DRG,MS-310,Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc,,,6479.63,6479.63,4
MS-DRG,MS-311,ANGINA PECTORIS,,,4695.87,22084.4,280
MS-DRG,MS-311,Angina Pectoris,,,7852.62,7852.62,4
MS-DRG,MS-312,SYNCOPE AND COLLAPSE,,,5831.2,19413.44,280
MS-DRG,MS-312,Syncope And Collapse,,,8463.1,8463.1,4
MS-DRG,MS-313,CHEST PAIN,,,4816.97,21030.4,280
MS-DRG,MS-313,Chest Pain,,,7759.77,7759.77,4
MS-DRG,MS-314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,13950.47,48526.16,280
MS-DRG,MS-314,Other Circulatory System Diagnoses With Mcc,,,19310.06,19310.06,4
MS-DRG,MS-315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,6444.7,29799.68,280
MS-DRG,MS-315,Other Circulatory System Diagnoses With Cc,,,10207.48,10207.48,4
MS-DRG,MS-316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,4547.64,21828.96,280
MS-DRG,MS-316,Other Circulatory System Diagnoses Without Cc/Mcc,,,8016.26,8016.26,4
MS-DRG,MS-317,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,44734.22,158737.51,280
MS-DRG,MS-318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE,,,16205.07,57503.03,30
MS-DRG,MS-319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,29857.82,108837.28,280
MS-DRG,MS-319,Other Endovascular Cardiac Valve Procedures With Mcc,,,50621.89,50621.89,4
MS-DRG,MS-320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,16092.01,57836.08,280
MS-DRG,MS-320,Other Endovascular Cardiac Valve Procedures Without Mcc,,,29049.82,29049.82,4
MS-DRG,MS-321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,18202.78,70937.92,280
MS-DRG,MS-321,Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ Arteries/Intraluminal Devices,,,41912.75,41912.75,4
MS-DRG,MS-322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,11794.87,45180.64,280
MS-DRG,MS-322,Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc,,,29460.67,29460.67,4
MS-DRG,MS-323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,28951.3,106367.2,280
MS-DRG,MS-323,Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc,,,48048.84,48048.84,4
MS-DRG,MS-324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,21080.91,79997.36,280
MS-DRG,MS-324,Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc,,,34453.57,34453.57,4
MS-DRG,MS-325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,21478.31,76214.9,280
MS-DRG,MS-325,Coronary Intravascular Lithotripsy Without Intraluminal Device,,,30689.75,30689.75,4
MS-DRG,MS-326,STOMACH- ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC,,,33366.85,144827.04,280
MS-DRG,MS-326,"Stomach, Esophageal And Duodenal Procedures With Mcc",,,60168.99,60168.99,4
MS-DRG,MS-327,STOMACH- ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC,,,16352.26,76567.52,280
MS-DRG,MS-327,"Stomach, Esophageal And Duodenal Procedures With Cc",,,30107.12,30107.12,4
MS-DRG,MS-328,STOMACH- ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC,,,10719.75,35917.84,280
MS-DRG,MS-328,"Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc",,,10696.09,10696.09,4
MS-DRG,MS-329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,30751.64,108599.2,280
MS-DRG,MS-329,Major Small And Large Bowel Procedures With Mcc,,,43361.18,43361.18,4
MS-DRG,MS-330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,16037.82,62540.64,280
MS-DRG,MS-330,Major Small And Large Bowel Procedures With Cc,,,22968.27,22968.27,4
MS-DRG,MS-331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,11258.99,48193.84,280
MS-DRG,MS-331,Major Small And Large Bowel Procedures Without Cc/Mcc,,,14541.16,14541.16,4
MS-DRG,MS-332,RECTAL RESECTION WITH MCC,,,24223.31,95259.28,280
MS-DRG,MS-332,Rectal Resection With Mcc,,,47726.19,47726.19,4
MS-DRG,MS-333,RECTAL RESECTION WITH CC,,,15669.86,69846.72,280
MS-DRG,MS-333,Rectal Resection With Cc,,,26249.29,26249.29,4
MS-DRG,MS-334,RECTAL RESECTION WITHOUT CC/MCC,,,10957.93,42018.64,280
MS-DRG,MS-334,Rectal Resection Without Cc/Mcc,,,20152.66,20152.66,4
MS-DRG,MS-335,PERITONEAL ADHESIOLYSIS WITH MCC,,,23890.14,83176.72,280
MS-DRG,MS-335,Peritoneal Adhesiolysis With Mcc,,,43300.83,43300.83,4
MS-DRG,MS-336,PERITONEAL ADHESIOLYSIS WITH CC,,,14107.69,59391.04,280
MS-DRG,MS-336,Peritoneal Adhesiolysis With Cc,,,19964.64,19964.64,4
MS-DRG,MS-337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,10269.5,39236.08,280
MS-DRG,MS-337,Peritoneal Adhesiolysis Without Cc/Mcc,,,18519.69,18519.69,4
MS-DRG,MS-344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,14779.84,66682.24,280
MS-DRG,MS-344,Minor Small And Large Bowel Procedures With Mcc,,,30943.92,30943.92,4
MS-DRG,MS-345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,10066.79,44555.68,280
MS-DRG,MS-345,Minor Small And Large Bowel Procedures With Cc,,,18236.51,18236.51,4
MS-DRG,MS-346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,7935.95,30915.68,280
MS-DRG,MS-346,Minor Small And Large Bowel Procedures Without Cc/Mcc,,,14701.32,14701.32,4
MS-DRG,MS-347,ANAL AND STOMAL PROCEDURES WITH MCC,,,15358.09,58590.0,280
MS-DRG,MS-347,Anal And Stomal Procedures With Mcc,,,29835.54,29835.54,4
MS-DRG,MS-348,ANAL AND STOMAL PROCEDURES WITH CC,,,8756.17,31151.28,280
MS-DRG,MS-348,Anal And Stomal Procedures With Cc,,,16233.31,16233.31,4
MS-DRG,MS-349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,5824.51,21952.96,280
MS-DRG,MS-349,Anal And Stomal Procedures Without Cc/Mcc,,,11722.06,11722.06,4
MS-DRG,MS-350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,16671.38,59859.76,280
MS-DRG,MS-350,Inguinal And Femoral Hernia Procedures With Mcc,,,27705.84,27705.84,4
MS-DRG,MS-351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,10199.25,37262.0,280
MS-DRG,MS-351,Inguinal And Femoral Hernia Procedures With Cc,,,17281.33,17281.33,4
MS-DRG,MS-352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,7812.85,29375.6,280
MS-DRG,MS-352,Inguinal And Femoral Hernia Procedures Without Cc/Mcc,,,12954.62,12954.62,4
MS-DRG,MS-353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,19415.05,58637.12,280
MS-DRG,MS-353,Hernia Procedures Except Inguinal And Femoral With Mcc,,,33709.63,33709.63,4
MS-DRG,MS-354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,11255.64,53654.8,280
MS-DRG,MS-354,Hernia Procedures Except Inguinal And Femoral With Cc,,,16362.14,16362.14,4
MS-DRG,MS-355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,8998.36,38432.56,280
MS-DRG,MS-355,Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc,,,16131.18,16131.18,4
MS-DRG,MS-356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,28473.53,76726.24,280
MS-DRG,MS-356,Other Digestive System O.R. Procedures With Mcc,,,28894.3,28894.3,4
MS-DRG,MS-357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,15558.13,50827.6,280
MS-DRG,MS-357,Other Digestive System O.R. Procedures With Cc,,,26402.49,26402.49,4
MS-DRG,MS-358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,9352.27,29268.96,280
MS-DRG,MS-358,Other Digestive System O.R. Procedures Without Cc/Mcc,,,16305.27,16305.27,4
MS-DRG,MS-359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC,,,23005.02,110399.37,30
MS-DRG,MS-360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,16152.22,60098.73,30
MS-DRG,MS-361,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,40740.61,40740.61,1
MS-DRG,MS-362,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,37998.55,37998.55,1
MS-DRG,MS-363,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,28254.73,28254.73,1
MS-DRG,MS-364,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,30894.39,30894.39,1
MS-DRG,MS-365,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,84612.76,84612.76,1
MS-DRG,MS-366,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,64396.93,64396.93,1
MS-DRG,MS-367,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,49345.78,49345.78,1
MS-DRG,MS-368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,8940.37,44605.28,280
MS-DRG,MS-368,Major Esophageal Disorders With Mcc,,,15164.4,15164.4,4
MS-DRG,MS-369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,6560.65,33259.28,280
MS-DRG,MS-369,Major Esophageal Disorders With Cc,,,10490.66,10490.66,4
MS-DRG,MS-370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,4688.51,23512.88,280
MS-DRG,MS-370,Major Esophageal Disorders Without Cc/Mcc,,,8800.83,8800.83,4
MS-DRG,MS-371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,11862.45,50497.76,280
MS-DRG,MS-371,Major Gastrointestinal Disorders And Peritoneal Infections With Mcc,,,17829.14,17829.14,4
MS-DRG,MS-372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,6830.72,27366.8,280
MS-DRG,MS-372,Major Gastrointestinal Disorders And Peritoneal Infections With Cc,,,11156.85,11156.85,4
MS-DRG,MS-373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,4866.47,20975.84,280
MS-DRG,MS-373,Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc,,,8088.22,8088.22,4
MS-DRG,MS-374,DIGESTIVE MALIGNANCY WITH MCC,,,14308.39,54493.04,280
MS-DRG,MS-374,Digestive Malignancy With Mcc,,,23430.19,23430.19,4
MS-DRG,MS-375,DIGESTIVE MALIGNANCY WITH CC,,,8092.5,32934.4,280
MS-DRG,MS-375,Digestive Malignancy With Cc,,,14159.32,14159.32,4
MS-DRG,MS-376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,6183.78,21942.88,280
MS-DRG,MS-376,Digestive Malignancy Without Cc/Mcc,,,10317.73,10317.73,4
MS-DRG,MS-377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,12229.74,43747.2,280
MS-DRG,MS-377,Gastrointestinal Hemorrhage With Mcc,,,16478.2,16478.2,4
MS-DRG,MS-378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,6561.11,24941.36,280
MS-DRG,MS-378,Gastrointestinal Hemorrhage With Cc,,,9915.01,9915.01,4
MS-DRG,MS-379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,4217.52,18265.2,280
MS-DRG,MS-379,Gastrointestinal Hemorrhage Without Cc/Mcc,,,7449.89,7449.89,4
MS-DRG,MS-380,COMPLICATED PEPTIC ULCER WITH MCC,,,13102.04,38015.92,280
MS-DRG,MS-380,Complicated Peptic Ulcer With Mcc,,,17468.19,17468.19,4
MS-DRG,MS-381,COMPLICATED PEPTIC ULCER WITH CC,,,7248.86,29668.24,280
MS-DRG,MS-381,Complicated Peptic Ulcer With Cc,,,9169.9,9169.9,4
MS-DRG,MS-382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,5189.18,25514.24,280
MS-DRG,MS-382,Complicated Peptic Ulcer Without Cc/Mcc,,,9048.04,9048.04,4
MS-DRG,MS-383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,9237.2,32777.82,280
MS-DRG,MS-383,Uncomplicated Peptic Ulcer With Mcc,,,15986.1,15986.1,4
MS-DRG,MS-384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,5718.81,21469.36,280
MS-DRG,MS-384,Uncomplicated Peptic Ulcer Without Mcc,,,10597.44,10597.44,4
MS-DRG,MS-385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,10585.95,43149.52,280
MS-DRG,MS-385,Inflammatory Bowel Disease With Mcc,,,14216.19,14216.19,4
MS-DRG,MS-386,INFLAMMATORY BOWEL DISEASE WITH CC,,,6531.67,25844.08,280
MS-DRG,MS-386,Inflammatory Bowel Disease With Cc,,,10259.7,10259.7,4
MS-DRG,MS-387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,4558.05,24127.92,280
MS-DRG,MS-387,Inflammatory Bowel Disease Without Cc/Mcc,,,8128.84,8128.84,4
MS-DRG,MS-388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,9880.13,40242.96,280
MS-DRG,MS-388,Gastrointestinal Obstruction With Mcc,,,12181.66,12181.66,4
MS-DRG,MS-389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,5054.4,24073.36,280
MS-DRG,MS-389,Gastrointestinal Obstruction With Cc,,,7402.31,7402.31,4
MS-DRG,MS-390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,3639.48,18126.32,280
MS-DRG,MS-390,Gastrointestinal Obstruction Without Cc/Mcc,,,5786.75,5786.75,4
MS-DRG,MS-391,ESOPHAGITIS- GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC,,,8485.22,27185.76,280
MS-DRG,MS-391,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc",,,11292.64,11292.64,4
MS-DRG,MS-392,ESOPHAGITIS- GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC,,,5215.7,20663.36,280
MS-DRG,MS-392,"Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc",,,7353.56,7353.56,4
MS-DRG,MS-393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,10699.68,34228.96,280
MS-DRG,MS-393,Other Digestive System Diagnoses With Mcc,,,18939.83,18939.83,4
MS-DRG,MS-394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,6260.05,25529.12,280
MS-DRG,MS-394,Other Digestive System Diagnoses With Cc,,,8818.24,8818.24,4
MS-DRG,MS-395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,4341.96,19681.28,280
MS-DRG,MS-395,Other Digestive System Diagnoses Without Cc/Mcc,,,7581.04,7581.04,4
MS-DRG,MS-396,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,37775.37,37775.37,1
MS-DRG,MS-397,Appendix Procedures With Mcc,,,17740.93,17740.93,4
MS-DRG,MS-397,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,16022.43,61476.72,280
MS-DRG,MS-398,Appendix Procedures With Cc,,,13126.39,13126.39,4
MS-DRG,MS-398,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,10126.33,37443.04,280
MS-DRG,MS-399,Appendix Procedures Without Cc/Mcc,,,9713.06,9713.06,4
MS-DRG,MS-399,OTHER EAR  NOSE  MOUTH AND THROAT O.R. PROCEDURES AGE >17 WITH MCC,,,7658.31,27840.48,280
MS-DRG,MS-400,OTHER EAR- NOSE- MOUTH AND THROAT O.R. PROCEDURES AGE 0-17,,,8710.19,8710.19,1
MS-DRG,MS-401,OTHER EAR- NOSE- MOUTH AND THROAT O.R. PROCEDURES AGE >17 WITH CC,,,15201.7,15201.7,1
MS-DRG,MS-402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,10795.84,98887.52,280
MS-DRG,MS-403,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,47202.36,47202.36,1
MS-DRG,MS-404,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,34234.23,34234.23,1
MS-DRG,MS-405,PANCREAS- LIVER AND SHUNT PROCEDURES WITH MCC,,,36598.9,174973.92,280
MS-DRG,MS-405,"Pancreas, Liver And Shunt Procedures With Mcc",,,65142.16,65142.16,4
MS-DRG,MS-406,PANCREAS- LIVER AND SHUNT PROCEDURES WITH CC,,,19403.0,89979.36,280
MS-DRG,MS-406,"Pancreas, Liver And Shunt Procedures With Cc",,,34437.32,34437.32,4
MS-DRG,MS-407,PANCREAS- LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC,,,14849.63,54936.96,280
MS-DRG,MS-407,"Pancreas, Liver And Shunt Procedures Without Cc/Mcc",,,26162.25,26162.25,4
MS-DRG,MS-408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,23854.68,97216.0,280
MS-DRG,MS-408,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Mcc,,,43132.54,43132.54,4
MS-DRG,MS-409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,14566.64,65303.36,280
MS-DRG,MS-409,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. With Cc,,,25053.87,25053.87,4
MS-DRG,MS-410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,10622.08,53518.4,280
MS-DRG,MS-410,Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.D.E. Without Cc/Mcc,,,19955.36,19955.36,4
MS-DRG,MS-411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,22099.83,78420.34,280
MS-DRG,MS-411,Cholecystectomy With C.D.E. With Mcc,,,39708.77,39708.77,4
MS-DRG,MS-412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,14066.21,53086.88,280
MS-DRG,MS-412,Cholecystectomy With C.D.E. With Cc,,,26985.11,26985.11,4
MS-DRG,MS-413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,11109.13,41358.96,280
MS-DRG,MS-413,Cholecystectomy With C.D.E. Without Cc/Mcc,,,19046.61,19046.61,4
MS-DRG,MS-414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,23834.61,86951.28,280
MS-DRG,MS-414,Cholecystectomy Except By Laparoscope Without C.D.E. With Mcc,,,41548.32,41548.32,4
MS-DRG,MS-415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,13826.7,49063.46,280
MS-DRG,MS-415,Cholecystectomy Except By Laparoscope Without C.D.E. With Cc,,,23509.11,23509.11,4
MS-DRG,MS-416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,9120.79,38244.08,280
MS-DRG,MS-416,Cholecystectomy Except By Laparoscope Without C.D.E. Without Cc/Mcc,,,16178.76,16178.76,4
MS-DRG,MS-417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,15965.56,58850.4,280
MS-DRG,MS-417,Laparoscopic Cholecystectomy Without C.D.E. With Mcc,,,20192.12,20192.12,4
MS-DRG,MS-418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,11317.19,41051.44,280
MS-DRG,MS-418,Laparoscopic Cholecystectomy Without C.D.E. With Cc,,,14570.17,14570.17,4
MS-DRG,MS-419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,9137.52,32671.52,280
MS-DRG,MS-419,Laparoscopic Cholecystectomy Without C.D.E. Without Cc/Mcc,,,14223.15,14223.15,4
MS-DRG,MS-420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,22794.28,87546.48,280
MS-DRG,MS-420,Hepatobiliary Diagnostic Procedures With Mcc,,,38333.46,38333.46,4
MS-DRG,MS-421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,11624.27,50227.44,280
MS-DRG,MS-421,Hepatobiliary Diagnostic Procedures With Cc,,,21294.69,21294.69,4
MS-DRG,MS-422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,9362.98,36408.88,280
MS-DRG,MS-422,Hepatobiliary Diagnostic Procedures Without Cc/Mcc,,,16286.7,16286.7,4
MS-DRG,MS-423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,27784.52,136640.56,280
MS-DRG,MS-423,Other Hepatobiliary Or Pancreas O.R. Procedures With Mcc,,,46217.41,46217.41,4
MS-DRG,MS-424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,14637.55,56519.2,280
MS-DRG,MS-424,Other Hepatobiliary Or Pancreas O.R. Procedures With Cc,,,27841.63,27841.63,4
MS-DRG,MS-425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,10037.35,38291.2,280
MS-DRG,MS-425,Other Hepatobiliary Or Pancreas O.R. Procedures Without Cc/Mcc,,,16815.93,16815.93,4
MS-DRG,MS-426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,17773.09,265503.84,280
MS-DRG,MS-427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,13323.47,179502.4,280
MS-DRG,MS-428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,10123.67,138446.0,280
MS-DRG,MS-429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,60276.29,213887.9,280
MS-DRG,MS-430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,38583.22,137540.8,280
MS-DRG,MS-432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,13167.71,39816.4,280
MS-DRG,MS-432,Cirrhosis And Alcoholic Hepatitis With Mcc,,,20426.56,20426.56,4
MS-DRG,MS-433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,7066.22,27577.6,280
MS-DRG,MS-433,Cirrhosis And Alcoholic Hepatitis With Cc,,,9428.71,9428.71,4
MS-DRG,MS-434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,4766.79,17456.72,280
MS-DRG,MS-434,Cirrhosis And Alcoholic Hepatitis Without Cc/Mcc,,,7377.93,7377.93,4
MS-DRG,MS-435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,12287.94,41902.08,280
MS-DRG,MS-435,Malignancy Of Hepatobiliary System Or Pancreas With Mcc,,,20549.58,20549.58,4
MS-DRG,MS-436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,7552.27,20479.84,280
MS-DRG,MS-436,Malignancy Of Hepatobiliary System Or Pancreas With Cc,,,12934.89,12934.89,4
MS-DRG,MS-437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,4822.95,10775.6,280
MS-DRG,MS-437,Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc,,,9942.86,9942.86,4
MS-DRG,MS-438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,10906.41,44518.48,280
MS-DRG,MS-438,Disorders Of Pancreas Except Malignancy With Mcc,,,18517.37,18517.37,4
MS-DRG,MS-439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,5627.82,30451.92,280
MS-DRG,MS-439,Disorders Of Pancreas Except Malignancy With Cc,,,8300.61,8300.61,4
MS-DRG,MS-440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,4157.31,21323.04,280
MS-DRG,MS-440,Disorders Of Pancreas Except Malignancy Without Cc/Mcc,,,6646.76,6646.76,4
MS-DRG,MS-441,DISORDERS OF LIVER EXCEPT MALIGNANCY- CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC,,,12006.95,51028.48,280
MS-DRG,MS-441,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc",,,16080.11,16080.11,4
MS-DRG,MS-442,DISORDERS OF LIVER EXCEPT MALIGNANCY- CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC,,,6458.08,27570.16,280
MS-DRG,MS-442,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc",,,9946.34,9946.34,4
MS-DRG,MS-443,DISORDERS OF LIVER EXCEPT MALIGNANCY- CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,4681.15,22148.88,280
MS-DRG,MS-443,"Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without Cc/Mcc",,,7662.28,7662.28,4
MS-DRG,MS-444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,11178.7,36617.2,280
MS-DRG,MS-444,Disorders Of The Biliary Tract With Mcc,,,10584.67,10584.67,4
MS-DRG,MS-445,DISORDERS OF THE BILIARY TRACT WITH CC,,,7321.79,30335.36,280
MS-DRG,MS-445,Disorders Of The Biliary Tract With Cc,,,8739.32,8739.32,4
MS-DRG,MS-446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,5534.83,22525.84,280
MS-DRG,MS-446,Disorders Of The Biliary Tract Without Cc/Mcc,,,8739.32,8739.32,4
MS-DRG,MS-447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,44701.44,167040.4,280
MS-DRG,MS-448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,28371.92,102850.56,280
MS-DRG,MS-450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,35656.25,127712.56,280
MS-DRG,MS-451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,21612.12,76689.7,280
MS-DRG,MS-456,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE- MALIGNANCY- INFECTION OR EXTENSIVE FUSIONS WITH MCC,,,56220.67,266880.24,280
MS-DRG,MS-456,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With Mcc",,,99316.02,99316.02,4
MS-DRG,MS-457,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE- MALIGNANCY- INFECTION OR EXTENSIVE FUSIONS WITH CC,,,39894.51,198005.68,280
MS-DRG,MS-457,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions With Cc",,,41005.16,41005.16,4
MS-DRG,MS-458,SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE- MALIGNANCY- INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC,,,27915.65,146191.04,280
MS-DRG,MS-458,"Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Extensive Fusions Without Cc/Mcc",,,41005.16,41005.16,4
MS-DRG,MS-461,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC,,,36950.14,110863.44,280
MS-DRG,MS-461,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc,,,75407.66,75407.66,4
MS-DRG,MS-462,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC,,,17796.01,93964.72,280
MS-DRG,MS-462,Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc,,,35094.22,35094.22,4
MS-DRG,MS-463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,38130.96,135395.6,280
MS-DRG,MS-463,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With Mcc,,,61612.77,61612.77,4
MS-DRG,MS-464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,20838.06,71456.24,280
MS-DRG,MS-464,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders With Cc,,,35112.79,35112.79,4
MS-DRG,MS-465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,12200.97,49267.68,280
MS-DRG,MS-465,Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective Tissue Disorders Without Cc/Mcc,,,23423.23,23423.23,4
MS-DRG,MS-466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,34825.32,127238.88,280
MS-DRG,MS-466,Revision Of Hip Or Knee Replacement With Mcc,,,61653.39,61653.39,4
MS-DRG,MS-467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,23593.76,86065.92,280
MS-DRG,MS-467,Revision Of Hip Or Knee Replacement With Cc,,,26671.75,26671.75,4
MS-DRG,MS-468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,18384.75,66126.72,280
MS-DRG,MS-468,Revision Of Hip Or Knee Replacement Without Cc/Mcc,,,22487.79,22487.79,4
MS-DRG,MS-469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,20292.8,81244.8,280
MS-DRG,MS-469,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc Or Total Ankle Replacement,,,37982.96,37982.96,4
MS-DRG,MS-470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,12904.78,56976.0,280
MS-DRG,MS-470,Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without Mcc,,,17207.06,17207.06,4
MS-DRG,MS-471,CERVICAL SPINAL FUSION WITH MCC,,,31429.65,70221.2,280
MS-DRG,MS-471,Cervical Spinal Fusion With Mcc,,,50996.76,50996.76,4
MS-DRG,MS-472,CERVICAL SPINAL FUSION WITH CC,,,19710.08,58121.28,280
MS-DRG,MS-472,Cervical Spinal Fusion With Cc,,,19226.5,19226.5,4
MS-DRG,MS-473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,16332.86,41825.2,280
MS-DRG,MS-473,Cervical Spinal Fusion Without Cc/Mcc,,,17409.0,17409.0,4
MS-DRG,MS-474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,28720.49,124927.52,280
MS-DRG,MS-474,Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc,,,48156.78,48156.78,4
MS-DRG,MS-475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,15224.95,59653.92,280
MS-DRG,MS-475,Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc,,,16085.92,16085.92,4
MS-DRG,MS-476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,7530.39,28768.0,280
MS-DRG,MS-476,Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc/Mcc,,,14428.58,14428.58,4
MS-DRG,MS-477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,23112.07,88803.84,280
MS-DRG,MS-477,Biopsies Of Musculoskeletal System And Connective Tissue With Mcc,,,39997.76,39997.76,4
MS-DRG,MS-478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,16452.61,58381.41,280
MS-DRG,MS-478,Biopsies Of Musculoskeletal System And Connective Tissue With Cc,,,17733.97,17733.97,4
MS-DRG,MS-479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,12436.47,48615.44,280
MS-DRG,MS-479,Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/Mcc,,,11754.56,11754.56,4
MS-DRG,MS-480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,19483.95,88717.04,280
MS-DRG,MS-480,Hip And Femur Procedures Except Major Joint With Mcc,,,24257.7,24257.7,4
MS-DRG,MS-481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,14012.69,63961.68,280
MS-DRG,MS-481,Hip And Femur Procedures Except Major Joint With Cc,,,23178.34,23178.34,4
MS-DRG,MS-482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,10911.76,42130.24,280
MS-DRG,MS-482,Hip And Femur Procedures Except Major Joint Without Cc/Mcc,,,16909.94,16909.94,4
MS-DRG,MS-483,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,18544.65,67076.56,280
MS-DRG,MS-483,Major Joint Or Limb Reattachment Procedures Of Upper Extremities,,,19177.75,19177.75,4
MS-DRG,MS-485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,21590.04,105714.96,280
MS-DRG,MS-485,Knee Procedures With Principal Diagnosis Of Infection With Mcc,,,38213.92,38213.92,4
MS-DRG,MS-486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,13989.94,37276.88,280
MS-DRG,MS-486,Knee Procedures With Principal Diagnosis Of Infection With Cc,,,17668.97,17668.97,4
MS-DRG,MS-487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,10478.24,26513.68,280
MS-DRG,MS-487,Knee Procedures With Principal Diagnosis Of Infection Without Cc/Mcc,,,17668.97,17668.97,4
MS-DRG,MS-488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,11834.35,33356.0,280
MS-DRG,MS-488,Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc,,,16169.48,16169.48,4
MS-DRG,MS-489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,7471.65,29829.44,280
MS-DRG,MS-489,Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc,,,15627.48,15627.48,4
MS-DRG,MS-492,LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP- FOOT AND FEMUR WITH MCC,,,24563.85,105109.84,280
MS-DRG,MS-492,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc",,,40974.98,40974.98,4
MS-DRG,MS-493,LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP- FOOT AND FEMUR WITH CC,,,16967.09,74216.48,280
MS-DRG,MS-493,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc",,,19416.84,19416.84,4
MS-DRG,MS-494,LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP- FOOT AND FEMUR WITHOUT CC/MCC,,,13423.95,50021.6,280
MS-DRG,MS-494,"Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc",,,16089.4,16089.4,4
MS-DRG,MS-495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,19576.92,78494.48,280
MS-DRG,MS-495,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Mcc,,,43660.61,43660.61,4
MS-DRG,MS-496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,12068.5,48508.8,280
MS-DRG,MS-496,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur With Cc,,,19181.24,19181.24,4
MS-DRG,MS-497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,8083.8,27458.56,280
MS-DRG,MS-497,Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Without Cc/Mcc,,,17887.17,17887.17,4
MS-DRG,MS-498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,19635.56,78926.0,280
MS-DRG,MS-498,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc/Mcc,,,30128.02,30128.02,4
MS-DRG,MS-499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,13049.53,33690.8,280
MS-DRG,MS-499,Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without Cc/Mcc,,,15500.97,15500.97,4
MS-DRG,MS-500,SOFT TISSUE PROCEDURES WITH MCC,,,21173.24,97211.04,280
MS-DRG,MS-500,Soft Tissue Procedures With Mcc,,,37667.27,37667.27,4
MS-DRG,MS-501,SOFT TISSUE PROCEDURES WITH CC,,,11695.19,54044.16,280
MS-DRG,MS-501,Soft Tissue Procedures With Cc,,,14856.84,14856.84,4
MS-DRG,MS-502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,9004.38,34201.68,280
MS-DRG,MS-502,Soft Tissue Procedures Without Cc/Mcc,,,14856.84,14856.84,4
MS-DRG,MS-503,FOOT PROCEDURES WITH MCC,,,18673.1,87583.68,280
MS-DRG,MS-503,Foot Procedures With Mcc,,,29777.51,29777.51,4
MS-DRG,MS-504,FOOT PROCEDURES WITH CC,,,12505.38,45547.68,280
MS-DRG,MS-504,Foot Procedures With Cc,,,20861.79,20861.79,4
MS-DRG,MS-505,FOOT PROCEDURES WITHOUT CC/MCC,,,11994.24,42157.52,280
MS-DRG,MS-505,Foot Procedures Without Cc/Mcc,,,20767.78,20767.78,4
MS-DRG,MS-506,MAJOR THUMB OR JOINT PROCEDURES,,,9026.46,36518.0,280
MS-DRG,MS-506,Major Thumb Or Joint Procedures,,,16571.05,16571.05,4
MS-DRG,MS-507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,12085.23,57288.0,280
MS-DRG,MS-507,Major Shoulder Or Elbow Joint Procedures With Cc/Mcc,,,21801.87,21801.87,4
MS-DRG,MS-508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,10131.68,35951.86,280
MS-DRG,MS-508,Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc,,,17022.52,17022.52,4
MS-DRG,MS-509,ARTHROSCOPY,,,17065.91,43524.0,168
MS-DRG,MS-510,SHOULDER- ELBOW OR FOREARM PROCEDURES- EXCEPT MAJOR JOINT PROCEDURES WITH MCC,,,20207.84,70627.92,280
MS-DRG,MS-510,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc",,,33947.55,33947.55,4
MS-DRG,MS-511,SHOULDER- ELBOW OR FOREARM PROCEDURES- EXCEPT MAJOR JOINT PROCEDURES WITH CC,,,13911.66,56387.76,280
MS-DRG,MS-511,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc",,,20341.84,20341.84,4
MS-DRG,MS-512,SHOULDER- ELBOW OR FOREARM PROCEDURES- EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC,,,11075.01,38355.68,280
MS-DRG,MS-512,"Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc",,,18884.12,18884.12,4
MS-DRG,MS-513,HAND OR WRIST PROCEDURES- EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC,,,10532.43,38623.52,280
MS-DRG,MS-513,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc",,,14935.76,14935.76,4
MS-DRG,MS-514,HAND OR WRIST PROCEDURES- EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC,,,6839.42,23825.36,280
MS-DRG,MS-514,"Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/Mcc",,,12138.72,12138.72,4
MS-DRG,MS-515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,21321.09,101684.96,280
MS-DRG,MS-515,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Mcc,,,36648.27,36648.27,4
MS-DRG,MS-516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,13902.97,62515.84,280
MS-DRG,MS-516,Other Musculoskeletal System And Connective Tissue O.R. Procedures With Cc,,,23906.04,23906.04,4
MS-DRG,MS-517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,10280.88,45629.52,280
MS-DRG,MS-517,Other Musculoskeletal System And Connective Tissue O.R. Procedures Without Cc/Mcc,,,11371.56,11371.56,4
MS-DRG,MS-518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,25003.39,92987.6,280
MS-DRG,MS-518,Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurostimulator,,,43817.29,43817.29,4
MS-DRG,MS-519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,13381.8,52070.08,280
MS-DRG,MS-519,Back And Neck Procedures Except Spinal Fusion With Cc,,,15871.21,15871.21,4
MS-DRG,MS-520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,9994.53,36500.64,280
MS-DRG,MS-520,Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc,,,15871.21,15871.21,4
MS-DRG,MS-521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,19202.3,72515.2,280
MS-DRG,MS-521,Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc,,,35488.83,35488.83,4
MS-DRG,MS-522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,14167.9,52590.88,280
MS-DRG,MS-522,Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc,,,20355.76,20355.76,4
MS-DRG,MS-533,FRACTURES OF FEMUR WITH MCC,,,10488.27,39811.44,280
MS-DRG,MS-533,Fractures Of Femur With Mcc,,,16764.87,16764.87,4
MS-DRG,MS-534,FRACTURES OF FEMUR WITHOUT MCC,,,4544.14,21218.88,280
MS-DRG,MS-534,Fractures Of Femur Without Mcc,,,5662.57,5662.57,4
MS-DRG,MS-535,FRACTURES OF HIP AND PELVIS WITH MCC,,,8576.87,27577.6,280
MS-DRG,MS-535,Fractures Of Hip And Pelvis With Mcc,,,15157.44,15157.44,4
MS-DRG,MS-536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,5403.03,24502.4,280
MS-DRG,MS-536,Fractures Of Hip And Pelvis Without Mcc,,,9133.92,9133.92,4
MS-DRG,MS-537,SPRAINS- STRAINS- AND DISLOCATIONS OF HIP- PELVIS AND THIGH WITH CC/MCC,,,6384.49,22687.04,280
MS-DRG,MS-537,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh With Cc/Mcc",,,11676.8,11676.8,4
MS-DRG,MS-538,SPRAINS- STRAINS- AND DISLOCATIONS OF HIP- PELVIS AND THIGH WITHOUT CC/MCC,,,4818.97,17099.92,280
MS-DRG,MS-538,"Sprains, Strains, And Dislocations Of Hip, Pelvis And Thigh Without Cc/Mcc",,,8183.39,8183.39,4
MS-DRG,MS-539,OSTEOMYELITIS WITH MCC,,,13177.74,51427.76,280
MS-DRG,MS-539,Osteomyelitis With Mcc,,,23460.37,23460.37,4
MS-DRG,MS-540,OSTEOMYELITIS WITH CC,,,7919.87,35464.0,280
MS-DRG,MS-540,Osteomyelitis With Cc,,,15828.26,15828.26,4
MS-DRG,MS-541,OSTEOMYELITIS WITHOUT CC/MCC,,,4822.46,21576.0,280
MS-DRG,MS-541,Osteomyelitis Without Cc/Mcc,,,9615.57,9615.57,4
MS-DRG,MS-542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,11818.29,58830.56,280
MS-DRG,MS-542,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Mcc,,,21487.35,21487.35,4
MS-DRG,MS-543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,6877.56,34055.36,280
MS-DRG,MS-543,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With Cc,,,12800.26,12800.26,4
MS-DRG,MS-544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,5048.45,18838.08,280
MS-DRG,MS-544,Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy Without Cc/Mcc,,,9146.69,9146.69,4
MS-DRG,MS-545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,16603.14,81502.72,280
MS-DRG,MS-545,Connective Tissue Disorders With Mcc,,,29487.36,29487.36,4
MS-DRG,MS-546,CONNECTIVE TISSUE DISORDERS WITH CC,,,7716.51,36324.56,280
MS-DRG,MS-546,Connective Tissue Disorders With Cc,,,14170.93,14170.93,4
MS-DRG,MS-547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,5594.37,20762.56,280
MS-DRG,MS-547,Connective Tissue Disorders Without Cc/Mcc,,,8931.98,8931.98,4
MS-DRG,MS-548,SEPTIC ARTHRITIS WITH MCC,,,12918.16,54103.68,280
MS-DRG,MS-548,Septic Arthritis With Mcc,,,22802.31,22802.31,4
MS-DRG,MS-549,SEPTIC ARTHRITIS WITH CC,,,8076.44,29668.24,280
MS-DRG,MS-549,Septic Arthritis With Cc,,,14242.88,14242.88,4
MS-DRG,MS-550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,5847.93,21335.44,280
MS-DRG,MS-550,Septic Arthritis Without Cc/Mcc,,,12322.09,12322.09,4
MS-DRG,MS-551,MEDICAL BACK PROBLEMS WITH MCC,,,10038.77,40845.6,280
MS-DRG,MS-551,Medical Back Problems With Mcc,,,19669.85,19669.85,4
MS-DRG,MS-552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,6431.32,29400.4,280
MS-DRG,MS-552,Medical Back Problems Without Mcc,,,9816.35,9816.35,4
MS-DRG,MS-553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,8672.54,32235.04,280
MS-DRG,MS-553,Bone Diseases And Arthropathies With Mcc,,,15585.7,15585.7,4
MS-DRG,MS-554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,4867.97,20536.88,280
MS-DRG,MS-554,Bone Diseases And Arthropathies Without Mcc,,,7296.69,7296.69,4
MS-DRG,MS-555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,8843.15,49250.32,280
MS-DRG,MS-555,Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc,,,15647.21,15647.21,4
MS-DRG,MS-556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,5556.9,25526.64,280
MS-DRG,MS-556,Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc,,,9497.19,9497.19,4
MS-DRG,MS-557,TENDONITIS- MYOSITIS AND BURSITIS WITH MCC,,,9112.79,24219.68,280
MS-DRG,MS-557,"Tendonitis, Myositis And Bursitis With Mcc",,,16831.02,16831.02,4
MS-DRG,MS-558,TENDONITIS- MYOSITIS AND BURSITIS WITHOUT MCC,,,4402.36,20380.64,280
MS-DRG,MS-558,"Tendonitis, Myositis And Bursitis Without Mcc",,,7442.93,7442.93,4
MS-DRG,MS-559,AFTERCARE- MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,12476.61,45602.24,280
MS-DRG,MS-559,"Aftercare, Musculoskeletal System And Connective Tissue With Mcc",,,20981.33,20981.33,4
MS-DRG,MS-560,AFTERCARE- MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,7533.87,27912.4,280
MS-DRG,MS-560,"Aftercare, Musculoskeletal System And Connective Tissue With Cc",,,12878.02,12878.02,4
MS-DRG,MS-561,AFTERCARE- MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,5378.28,19887.12,280
MS-DRG,MS-561,"Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc",,,9288.28,9288.28,4
MS-DRG,MS-562,FX- SPRN- STRN & DISL EXCEPT FEMUR- HIP- PELVIS & THIGH W MCC,,,9532.24,43429.76,280
MS-DRG,MS-562,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh With Mcc",,,17194.29,17194.29,4
MS-DRG,MS-563,FX- SPRN- STRN & DISL EXCEPT FEMUR- HIP- PELVIS & THIGH W/O MCC,,,5991.1,27532.96,280
MS-DRG,MS-563,"Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Without Mcc",,,8066.17,8066.17,4
MS-DRG,MS-564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,10327.04,38707.84,280
MS-DRG,MS-564,Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc,,,18258.56,18258.56,4
MS-DRG,MS-565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,6518.96,26749.28,280
MS-DRG,MS-565,Other Musculoskeletal System And Connective Tissue Diagnoses With Cc,,,11606.0,11606.0,4
MS-DRG,MS-566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,5012.99,20670.8,280
MS-DRG,MS-566,Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc,,,8730.03,8730.03,4
MS-DRG,MS-570,SKIN DEBRIDEMENT WITH MCC,,,19676.63,78380.4,280
MS-DRG,MS-570,Skin Debridement With Mcc,,,34288.77,34288.77,4
MS-DRG,MS-571,SKIN DEBRIDEMENT WITH CC,,,11303.14,41341.6,280
MS-DRG,MS-571,Skin Debridement With Cc,,,16514.18,16514.18,4
MS-DRG,MS-572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,7669.01,28276.96,280
MS-DRG,MS-572,Skin Debridement Without Cc/Mcc,,,14147.71,14147.71,4
MS-DRG,MS-573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,43830.37,155530.24,280
MS-DRG,MS-573,Skin Graft For Skin Ulcer Or Cellulitis With Mcc,,,69004.63,69004.63,4
MS-DRG,MS-574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,19835.11,85760.88,280
MS-DRG,MS-574,Skin Graft For Skin Ulcer Or Cellulitis With Cc,,,20376.65,20376.65,4
MS-DRG,MS-575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,12022.34,49153.6,280
MS-DRG,MS-575,Skin Graft For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,20376.65,20376.65,4
MS-DRG,MS-576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,32790.15,133629.84,280
MS-DRG,MS-576,Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc,,,66401.41,66401.41,4
MS-DRG,MS-577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,17733.79,65898.56,280
MS-DRG,MS-577,Skin Graft Except For Skin Ulcer Or Cellulitis With Cc,,,30781.43,30781.43,4
MS-DRG,MS-578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,10747.18,41701.2,280
MS-DRG,MS-578,Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc,,,20129.45,20129.45,4
MS-DRG,MS-579,OTHER SKIN- SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC,,,21666.31,69199.44,280
MS-DRG,MS-579,"Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc",,,37046.35,37046.35,4
MS-DRG,MS-580,OTHER SKIN- SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC,,,11560.72,56417.52,280
MS-DRG,MS-580,"Other Skin, Subcutaneous Tissue And Breast Procedures With Cc",,,15021.65,15021.65,4
MS-DRG,MS-581,OTHER SKIN- SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC,,,9654.67,40453.76,280
MS-DRG,MS-581,"Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc",,,15021.65,15021.65,4
MS-DRG,MS-582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,12889.4,63207.75,280
MS-DRG,MS-582,Mastectomy For Malignancy With Cc/Mcc,,,22743.12,22743.12,4
MS-DRG,MS-583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,11536.63,66030.0,280
MS-DRG,MS-583,Mastectomy For Malignancy Without Cc/Mcc,,,17758.34,17758.34,4
MS-DRG,MS-584,BREAST BIOPSY- LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC,,,14321.77,58947.12,280
MS-DRG,MS-584,"Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc",,,25104.94,25104.94,4
MS-DRG,MS-585,BREAST BIOPSY- LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC,,,12906.12,54721.2,280
MS-DRG,MS-585,"Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc",,,21641.71,21641.71,4
MS-DRG,MS-592,SKIN ULCERS WITH MCC,,,12947.6,48674.96,280
MS-DRG,MS-592,Skin Ulcers With Mcc,,,20969.72,20969.72,4
MS-DRG,MS-593,SKIN ULCERS WITH CC,,,5775.58,31312.48,280
MS-DRG,MS-593,Skin Ulcers With Cc,,,13539.56,13539.56,4
MS-DRG,MS-594,SKIN ULCERS WITHOUT CC/MCC,,,5799.09,21008.08,280
MS-DRG,MS-594,Skin Ulcers Without Cc/Mcc,,,9096.78,9096.78,4
MS-DRG,MS-595,MAJOR SKIN DISORDERS WITH MCC,,,14187.97,55450.32,280
MS-DRG,MS-595,Major Skin Disorders With Mcc,,,25171.09,25171.09,4
MS-DRG,MS-596,MAJOR SKIN DISORDERS WITHOUT MCC,,,4820.71,26635.2,280
MS-DRG,MS-596,Major Skin Disorders Without Mcc,,,12833.91,12833.91,4
MS-DRG,MS-597,MALIGNANT BREAST DISORDERS WITH MCC,,,11153.28,43246.24,280
MS-DRG,MS-597,Malignant Breast Disorders With Mcc,,,19794.03,19794.03,4
MS-DRG,MS-598,MALIGNANT BREAST DISORDERS WITH CC,,,7568.66,31176.08,280
MS-DRG,MS-598,Malignant Breast Disorders With Cc,,,12555.37,12555.37,4
MS-DRG,MS-599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,5147.46,21045.28,280
MS-DRG,MS-599,Malignant Breast Disorders Without Cc/Mcc,,,8788.06,8788.06,4
MS-DRG,MS-600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,3969.12,24727.58,280
MS-DRG,MS-600,Non-Malignant Breast Disorders With Cc/Mcc,,,12237.37,12237.37,4
MS-DRG,MS-601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,4047.59,14830.4,280
MS-DRG,MS-601,Non-Malignant Breast Disorders Without Cc/Mcc,,,8273.92,8273.92,4
MS-DRG,MS-602,CELLULITIS WITH MCC,,,9508.82,39945.36,280
MS-DRG,MS-602,Cellulitis With Mcc,,,16940.12,16940.12,4
MS-DRG,MS-603,CELLULITIS WITHOUT MCC,,,4999.26,21605.76,280
MS-DRG,MS-603,Cellulitis Without Mcc,,,6846.38,6846.38,4
MS-DRG,MS-604,TRAUMA TO THE SKIN- SUBCUTANEOUS TISSUE AND BREAST WITH MCC,,,9848.69,49448.72,280
MS-DRG,MS-604,"Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc",,,17739.77,17739.77,4
MS-DRG,MS-605,TRAUMA TO THE SKIN- SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC,,,5696.81,28232.32,280
MS-DRG,MS-605,"Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc",,,10700.73,10700.73,4
MS-DRG,MS-606,MINOR SKIN DISORDERS WITH MCC,,,6438.12,44813.6,280
MS-DRG,MS-606,Minor Skin Disorders With Mcc,,,18041.53,18041.53,4
MS-DRG,MS-607,MINOR SKIN DISORDERS WITHOUT MCC,,,3787.08,16015.84,280
MS-DRG,MS-607,Minor Skin Disorders Without Mcc,,,6549.27,6549.27,4
MS-DRG,MS-608,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,32378.76,32378.76,1
MS-DRG,MS-609,OTHER RESPIRATORY PROBLEMS AFTER BIRTH,,,25190.58,25190.58,1
MS-DRG,MS-610,NEONATE- DIED WITHIN ONE DAY OF BIRTH,,,3182.3,3182.3,1
MS-DRG,MS-611,NEONATE- TRANSFERRED <5 DAYS OLD,,,2057.64,2057.64,1
MS-DRG,MS-612,NEONATE- BIRTH WEIGHT <750 GRAMS- DISCHARGED ALIVE,,,272925.97,272925.97,1
MS-DRG,MS-613,NEONATE- BIRTH WEIGHT <750 GRAMS- DIED,,,38264.62,38264.62,1
MS-DRG,MS-614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,14663.64,78449.84,280
MS-DRG,MS-614,Adrenal And Pituitary Procedures With Cc/Mcc,,,27622.28,27622.28,4
MS-DRG,MS-615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,9361.64,44307.68,280
MS-DRG,MS-615,Adrenal And Pituitary Procedures Without Cc/Mcc,,,11393.61,11393.61,4
MS-DRG,MS-616,AMPUTATION OF LOWER LIMB FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITH MCC,,,21489.28,109142.32,280
MS-DRG,MS-616,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,44250.2,44250.2,4
MS-DRG,MS-617,AMPUTATION OF LOWER LIMB FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITH CC,,,12512.74,37862.16,280
MS-DRG,MS-617,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With Cc",,,18547.55,18547.55,4
MS-DRG,MS-618,AMPUTATION OF LOWER LIMB FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC,,,9488.75,33670.44,280
MS-DRG,MS-618,"Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,13786.77,13786.77,4
MS-DRG,MS-619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,19317.37,73070.72,311
MS-DRG,MS-619,O.R. Procedures For Obesity With Mcc,,,33990.49,33990.49,4
MS-DRG,MS-620,O.R. PROCEDURES FOR OBESITY WITH CC,,,10706.37,54326.88,311
MS-DRG,MS-620,O.R. Procedures For Obesity With Cc,,,12519.39,12519.39,4
MS-DRG,MS-621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,10091.54,43447.12,311
MS-DRG,MS-621,O.R. Procedures For Obesity Without Cc/Mcc,,,11903.11,11903.11,4
MS-DRG,MS-622,SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITH MCC,,,23811.86,92196.48,280
MS-DRG,MS-622,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Mcc",,,42563.84,42563.84,4
MS-DRG,MS-623,SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITH CC,,,12001.6,53267.92,280
MS-DRG,MS-623,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders With Cc",,,22152.37,22152.37,4
MS-DRG,MS-624,SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE- NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC,,,8375.5,29720.11,280
MS-DRG,MS-624,"Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disorders Without Cc/Mcc",,,11625.73,11625.73,4
MS-DRG,MS-625,THYROID- PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC,,,20205.16,61045.2,280
MS-DRG,MS-625,"Thyroid, Parathyroid And Thyroglossal Procedures With Mcc",,,33819.88,33819.88,4
MS-DRG,MS-626,THYROID- PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC,,,10031.33,35806.24,280
MS-DRG,MS-626,"Thyroid, Parathyroid And Thyroglossal Procedures With Cc",,,19032.68,19032.68,4
MS-DRG,MS-627,THYROID- PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC,,,8886.63,27932.24,280
MS-DRG,MS-627,"Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc",,,9068.93,9068.93,4
MS-DRG,MS-628,OTHER ENDOCRINE- NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC,,,24933.15,100643.36,280
MS-DRG,MS-628,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Mcc",,,42842.39,42842.39,4
MS-DRG,MS-629,OTHER ENDOCRINE- NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC,,,14027.15,63366.48,280
MS-DRG,MS-629,"Other Endocrine, Nutritional And Metabolic O.R. Procedures With Cc",,,26374.64,26374.64,4
MS-DRG,MS-630,OTHER ENDOCRINE- NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC,,,9764.39,34648.53,280
MS-DRG,MS-630,"Other Endocrine, Nutritional And Metabolic O.R. Procedures Without Cc/Mcc",,,16506.05,16506.05,4
MS-DRG,MS-631,NEONATE- BIRTH WEIGHT 750-999 GRAMS- DISCHARGED ALIVE,,,197901.24,197901.24,1
MS-DRG,MS-632,NEONATE- BIRTH WEIGHT 750-999 GRAMS- DIED,,,97125.78,97125.78,1
MS-DRG,MS-633,NEONATE- BIRTH WEIGHT 1000-1499 GRAMS- WITH SIGNIFICANT O.R. PROCEDURES- DISCHARGED ALIVE,,,297836.48,297836.48,1
MS-DRG,MS-634,NEONATE- BIRTH WEIGHT 1000-1499 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- DISCHARGED ALIVE,,,106754.08,106754.08,1
MS-DRG,MS-635,NEONATE- BIRTH WEIGHT 1000-1499 GRAMS- DIED,,,59416.06,59416.06,1
MS-DRG,MS-636,NEONATE- BIRTH WEIGHT 1500-1999 GRAMS- WITH SIGNIFICANT O.R. PROCEDURES- WITH MULTIPLE MAJOR PROBLEMS,,,175003.73,175003.73,1
MS-DRG,MS-637,DIABETES WITH MCC,,,9359.6,39593.2,280
MS-DRG,MS-637,Diabetes With Mcc,,,11134.8,11134.8,4
MS-DRG,MS-638,DIABETES WITH CC,,,5542.77,21722.32,280
MS-DRG,MS-638,Diabetes With Cc,,,7186.44,7186.44,4
MS-DRG,MS-639,DIABETES WITHOUT CC/MCC,,,4013.76,15956.32,280
MS-DRG,MS-639,Diabetes Without Cc/Mcc,,,5278.41,5278.41,4
MS-DRG,MS-640,MISCELLANEOUS DISORDERS OF NUTRITION- METABOLISM- FLUIDS AND ELECTROLYTES WITH MCC,,,8935.47,28262.08,280
MS-DRG,MS-640,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With Mcc",,,11607.16,11607.16,4
MS-DRG,MS-641,MISCELLANEOUS DISORDERS OF NUTRITION- METABOLISM- FLUIDS AND ELECTROLYTES WITHOUT MCC,,,5206.34,14567.52,280
MS-DRG,MS-641,"Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Without Mcc",,,7607.73,7607.73,4
MS-DRG,MS-642,INBORN AND OTHER DISORDERS OF METABOLISM,,,9514.18,33760.65,280
MS-DRG,MS-642,Inborn And Other Disorders Of Metabolism,,,16495.61,16495.61,4
MS-DRG,MS-643,ENDOCRINE DISORDERS WITH MCC,,,11012.79,34863.84,280
MS-DRG,MS-643,Endocrine Disorders With Mcc,,,19320.51,19320.51,4
MS-DRG,MS-644,ENDOCRINE DISORDERS WITH CC,,,6857.49,22342.32,280
MS-DRG,MS-644,Endocrine Disorders With Cc,,,11978.55,11978.55,4
MS-DRG,MS-645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,4507.38,15904.24,280
MS-DRG,MS-645,Endocrine Disorders Without Cc/Mcc,,,8728.87,8728.87,4
MS-DRG,MS-646,NEONATE- BIRTH WEIGHT 1500-1999 GRAMS- WITH SIGNIFICANT O.R. PROCEDURES- WITHOUT MULTIPLE MAJOR PROBLEMS,,,55440.81,55440.81,1
MS-DRG,MS-647,NEONATE- BIRTH WEIGHT 1500-1999 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MULTIPLE MAJOR PROBLEMS,,,59540.34,59540.34,1
MS-DRG,MS-648,NEONATE- BIRTH WEIGHT 1500-1999 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MAJOR PROBLEM,,,41504.68,41504.68,1
MS-DRG,MS-649,NEONATE- BIRTH WEIGHT 1500-1999 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MINOR PROBLEM,,,29248.1,29248.1,1
MS-DRG,MS-650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,11500.0,470000.0,212
MS-DRG,MS-650,Kidney Transplant With Hemodialysis With Mcc,,,54586.5,54586.5,4
MS-DRG,MS-651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,11500.0,470000.0,212
MS-DRG,MS-651,Kidney Transplant With Hemodialysis Without Mcc,,,41684.11,41684.11,4
MS-DRG,MS-652,KIDNEY TRANSPLANT,,,11500.0,470000.0,212
MS-DRG,MS-652,Kidney Transplant,,,59892.76,59892.76,4
MS-DRG,MS-653,MAJOR BLADDER PROCEDURES WITH MCC,,,31973.54,138044.24,280
MS-DRG,MS-653,Major Bladder Procedures With Mcc,,,65316.25,65316.25,4
MS-DRG,MS-654,MAJOR BLADDER PROCEDURES WITH CC,,,18727.96,76716.32,280
MS-DRG,MS-654,Major Bladder Procedures With Cc,,,33412.51,33412.51,4
MS-DRG,MS-655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,14160.54,51395.52,280
MS-DRG,MS-655,Major Bladder Procedures Without Cc/Mcc,,,25374.2,25374.2,4
MS-DRG,MS-656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,21300.35,105122.24,280
MS-DRG,MS-656,Kidney And Ureter Procedures For Neoplasm With Mcc,,,38852.25,38852.25,4
MS-DRG,MS-657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,12243.12,58671.84,280
MS-DRG,MS-657,Kidney And Ureter Procedures For Neoplasm With Cc,,,15191.09,15191.09,4
MS-DRG,MS-658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,10381.9,50790.4,280
MS-DRG,MS-658,Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc,,,15191.09,15191.09,4
MS-DRG,MS-659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,16999.2,86395.76,280
MS-DRG,MS-659,Kidney And Ureter Procedures For Non-Neoplasm With Mcc,,,30290.5,30290.5,4
MS-DRG,MS-660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,8842.48,46802.56,280
MS-DRG,MS-660,Kidney And Ureter Procedures For Non-Neoplasm With Cc,,,11303.08,11303.08,4
MS-DRG,MS-661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,6927.06,43576.08,280
MS-DRG,MS-661,Kidney And Ureter Procedures For Non-Neoplasm Without Cc/Mcc,,,9840.73,9840.73,4
MS-DRG,MS-662,MINOR BLADDER PROCEDURES WITH MCC,,,20482.14,76914.72,280
MS-DRG,MS-662,Minor Bladder Procedures With Mcc,,,35718.63,35718.63,4
MS-DRG,MS-663,MINOR BLADDER PROCEDURES WITH CC,,,10170.49,37797.68,280
MS-DRG,MS-663,Minor Bladder Procedures With Cc,,,17925.47,17925.47,4
MS-DRG,MS-664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,7004.0,26970.0,280
MS-DRG,MS-664,Minor Bladder Procedures Without Cc/Mcc,,,13243.61,13243.61,4
MS-DRG,MS-665,PROSTATECTOMY WITH MCC,,,20881.54,80981.92,280
MS-DRG,MS-665,Prostatectomy With Mcc,,,35971.64,35971.64,4
MS-DRG,MS-666,PROSTATECTOMY WITH CC,,,11703.22,41528.38,280
MS-DRG,MS-666,Prostatectomy With Cc,,,20239.7,20239.7,4
MS-DRG,MS-667,PROSTATECTOMY WITHOUT CC/MCC,,,7400.73,26261.19,280
MS-DRG,MS-667,Prostatectomy Without Cc/Mcc,,,11565.38,11565.38,4
MS-DRG,MS-668,TRANSURETHRAL PROCEDURES WITH MCC,,,19535.47,95948.72,280
MS-DRG,MS-668,Transurethral Procedures With Mcc,,,33181.55,33181.55,4
MS-DRG,MS-669,TRANSURETHRAL PROCEDURES WITH CC,,,10111.42,26615.36,280
MS-DRG,MS-669,Transurethral Procedures With Cc,,,18503.45,18503.45,4
MS-DRG,MS-670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,6538.36,22124.08,280
MS-DRG,MS-670,Transurethral Procedures Without Cc/Mcc,,,11607.16,11607.16,4
MS-DRG,MS-671,URETHRAL PROCEDURES WITH CC/MCC,,,12008.96,42747.76,280
MS-DRG,MS-671,Urethral Procedures With Cc/Mcc,,,21527.97,21527.97,4
MS-DRG,MS-672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,7222.1,27277.52,280
MS-DRG,MS-672,Urethral Procedures Without Cc/Mcc,,,12244.33,12244.33,4
MS-DRG,MS-673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,25993.16,85009.44,280
MS-DRG,MS-673,Other Kidney And Urinary Tract Procedures With Mcc,,,29772.87,29772.87,4
MS-DRG,MS-674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,15645.77,59507.6,280
MS-DRG,MS-674,Other Kidney And Urinary Tract Procedures With Cc,,,22567.87,22567.87,4
MS-DRG,MS-675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,10981.34,43407.44,280
MS-DRG,MS-675,Other Kidney And Urinary Tract Procedures Without Cc/Mcc,,,19823.05,19823.05,4
MS-DRG,MS-676,NEONATE- BIRTH WEIGHT 2000-2499 GRAMS- WITH SIGNIFICANT O.R. PROCEDURES- WITHOUT MULTIPLE MAJOR PROBLEMS,,,28263.48,28263.48,1
MS-DRG,MS-677,NEONATE- BIRTH WEIGHT 2000-2499 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MULTIPLE MAJOR PROBLEMS,,,39314.88,39314.88,1
MS-DRG,MS-678,NEONATE- BIRTH WEIGHT 2000-2499 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MAJOR PROBLEM,,,23564.42,23564.42,1
MS-DRG,MS-679,NEONATE- BIRTH WEIGHT 2000-2499 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH MINOR PROBLEM,,,10907.87,10907.87,1
MS-DRG,MS-680,NEONATE- BIRTH WEIGHT 2000-2499 GRAMS- WITHOUT SIGNIFICANT O.R. PROCEDURES- WITH OTHER PROBLEM,,,7352.72,7352.72,1
MS-DRG,MS-681,NEONATE- BIRTH WEIGHT >2499 GRAMS- WITH SIGNIFICANT O.R. PROCEDURES- WITH MULTIPLE MAJOR PROBLEMS,,,119199.71,119199.71,1
MS-DRG,MS-682,RENAL FAILURE WITH MCC,,,9908.23,47650.72,280
MS-DRG,MS-682,Renal Failure With Mcc,,,11398.25,11398.25,4
MS-DRG,MS-683,RENAL FAILURE WITH CC,,,5764.2,24341.2,280
MS-DRG,MS-683,Renal Failure With Cc,,,7770.22,7770.22,4
MS-DRG,MS-684,RENAL FAILURE WITHOUT CC/MCC,,,4016.14,14969.28,280
MS-DRG,MS-684,Renal Failure Without Cc/Mcc,,,7108.68,7108.68,4
MS-DRG,MS-686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,12067.17,56615.92,280
MS-DRG,MS-686,Kidney And Urinary Tract Neoplasms With Mcc,,,19956.52,19956.52,4
MS-DRG,MS-687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,7010.02,33936.32,280
MS-DRG,MS-687,Kidney And Urinary Tract Neoplasms With Cc,,,12222.28,12222.28,4
MS-DRG,MS-688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,5287.29,18761.72,280
MS-DRG,MS-688,Kidney And Urinary Tract Neoplasms Without Cc/Mcc,,,10184.27,10184.27,4
MS-DRG,MS-689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,7762.67,29415.28,280
MS-DRG,MS-689,Kidney And Urinary Tract Infections With Mcc,,,10741.35,10741.35,4
MS-DRG,MS-690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,5415.74,18962.08,280
MS-DRG,MS-690,Kidney And Urinary Tract Infections Without Mcc,,,6675.77,6675.77,4
MS-DRG,MS-691,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,45991.06,45991.06,1
MS-DRG,MS-692,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,28275.73,28275.73,1
MS-DRG,MS-693,URINARY STONES WITH MCC,,,8995.01,41884.72,280
MS-DRG,MS-693,Urinary Stones With Mcc,,,16818.25,16818.25,4
MS-DRG,MS-694,URINARY STONES WITHOUT MCC,,,5083.28,16241.52,280
MS-DRG,MS-694,Urinary Stones Without Mcc,,,6798.79,6798.79,4
MS-DRG,MS-695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,7652.28,27788.4,280
MS-DRG,MS-695,Kidney And Urinary Tract Signs And Symptoms With Mcc,,,13497.78,13497.78,4
MS-DRG,MS-696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,4006.76,18533.04,280
MS-DRG,MS-696,Kidney And Urinary Tract Signs And Symptoms Without Mcc,,,8146.25,8146.25,4
MS-DRG,MS-697,URETHRAL STRICTURE,,,7210.73,26568.24,280
MS-DRG,MS-697,Urethral Stricture,,,11665.19,11665.19,4
MS-DRG,MS-698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,11068.32,38653.28,280
MS-DRG,MS-698,Other Kidney And Urinary Tract Diagnoses With Mcc,,,14191.82,14191.82,4
MS-DRG,MS-699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,6790.58,33294.0,280
MS-DRG,MS-699,Other Kidney And Urinary Tract Diagnoses With Cc,,,11268.27,11268.27,4
MS-DRG,MS-700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,4615.59,21858.72,280
MS-DRG,MS-700,Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc,,,8707.98,8707.98,4
MS-DRG,MS-707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,13382.47,46519.84,280
MS-DRG,MS-707,Major Male Pelvic Procedures With Cc/Mcc,,,23453.4,23453.4,4
MS-DRG,MS-708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,10264.15,37579.44,280
MS-DRG,MS-708,Major Male Pelvic Procedures Without Cc/Mcc,,,17451.94,17451.94,4
MS-DRG,MS-709,PENIS PROCEDURES WITH CC/MCC,,,15568.83,56055.44,280
MS-DRG,MS-709,Penis Procedures With Cc/Mcc,,,28352.3,28352.3,4
MS-DRG,MS-710,PENIS PROCEDURES WITHOUT CC/MCC,,,9374.35,37477.76,280
MS-DRG,MS-710,Penis Procedures Without Cc/Mcc,,,16942.44,16942.44,4
MS-DRG,MS-711,TESTES PROCEDURES WITH CC/MCC,,,13941.1,49469.41,280
MS-DRG,MS-711,Testes Procedures With Cc/Mcc,,,24018.62,24018.62,4
MS-DRG,MS-712,TESTES PROCEDURES WITHOUT CC/MCC,,,7357.25,26526.08,280
MS-DRG,MS-712,Testes Procedures Without Cc/Mcc,,,14594.55,14594.55,4
MS-DRG,MS-713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,10058.09,23388.88,280
MS-DRG,MS-713,Transurethral Prostatectomy With Cc/Mcc,,,17419.45,17419.45,4
MS-DRG,MS-714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,7074.25,19924.32,280
MS-DRG,MS-714,Transurethral Prostatectomy Without Cc/Mcc,,,11263.62,11263.62,4
MS-DRG,MS-715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,14968.05,55819.84,280
MS-DRG,MS-715,Other Male Reproductive System O.R. Procedures For Malignancy With Cc/Mcc,,,26250.45,26250.45,4
MS-DRG,MS-716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,9841.33,35292.88,280
MS-DRG,MS-716,Other Male Reproductive System O.R. Procedures For Malignancy Without Cc/Mcc,,,15448.75,15448.75,4
MS-DRG,MS-717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,12647.88,45721.28,280
MS-DRG,MS-717,Other Male Reproductive System O.R. Procedures Except Malignancy With Cc/Mcc,,,20808.4,20808.4,4
MS-DRG,MS-718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,8985.65,31885.19,280
MS-DRG,MS-718,Other Male Reproductive System O.R. Procedures Except Malignancy Without Cc/Mcc,,,14916.03,14916.03,4
MS-DRG,MS-722,MALIGNANCY- MALE REPRODUCTIVE SYSTEM WITH MCC,,,12107.31,42962.28,280
MS-DRG,MS-722,"Malignancy, Male Reproductive System With Mcc",,,19955.36,19955.36,4
MS-DRG,MS-723,MALIGNANCY- MALE REPRODUCTIVE SYSTEM WITH CC,,,7644.93,27743.76,280
MS-DRG,MS-723,"Malignancy, Male Reproductive System With Cc",,,13545.36,13545.36,4
MS-DRG,MS-724,MALIGNANCY- MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC,,,4386.78,18069.28,280
MS-DRG,MS-724,"Malignancy, Male Reproductive System Without Cc/Mcc",,,8993.49,8993.49,4
MS-DRG,MS-725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,7828.91,31168.64,280
MS-DRG,MS-725,Benign Prostatic Hypertrophy With Mcc,,,14685.07,14685.07,4
MS-DRG,MS-726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,3409.86,20861.76,280
MS-DRG,MS-726,Benign Prostatic Hypertrophy Without Mcc,,,9070.09,9070.09,4
MS-DRG,MS-727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,9920.94,36232.8,280
MS-DRG,MS-727,Inflammation Of The Male Reproductive System With Mcc,,,16889.05,16889.05,4
MS-DRG,MS-728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,5340.59,21893.44,280
MS-DRG,MS-728,Inflammation Of The Male Reproductive System Without Mcc,,,9658.51,9658.51,4
MS-DRG,MS-729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,7082.95,27108.88,280
MS-DRG,MS-729,Other Male Reproductive System Diagnoses With Cc/Mcc,,,12669.11,12669.11,4
MS-DRG,MS-730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,3084.28,15953.28,280
MS-DRG,MS-730,Other Male Reproductive System Diagnoses Without Cc/Mcc,,,7708.71,7708.71,4
MS-DRG,MS-734,PELVIC EVISCERATION- RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC,,,14250.19,58421.36,280
MS-DRG,MS-734,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc",,,25686.4,25686.4,4
MS-DRG,MS-735,PELVIC EVISCERATION- RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC,,,9001.7,37579.44,280
MS-DRG,MS-735,"Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/Mcc",,,14954.33,14954.33,4
MS-DRG,MS-736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,23914.22,139306.56,280
MS-DRG,MS-736,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc,,,50135.6,50135.6,4
MS-DRG,MS-737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,13785.89,49570.24,280
MS-DRG,MS-737,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc,,,23785.34,23785.34,4
MS-DRG,MS-738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,9824.6,37616.64,280
MS-DRG,MS-738,Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/Mcc,,,16501.41,16501.41,4
MS-DRG,MS-739,UTERINE- ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC,,,23969.75,93560.48,280
MS-DRG,MS-739,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Mcc,,,45869.23,45869.23,4
MS-DRG,MS-740,UTERINE- ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC,,,12106.64,45994.08,280
MS-DRG,MS-740,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy With Cc,,,21186.75,21186.75,4
MS-DRG,MS-741,UTERINE- ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC,,,9540.94,31944.88,280
MS-DRG,MS-741,Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy Without Cc/Mcc,,,15432.5,15432.5,4
MS-DRG,MS-742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,11578.41,25868.88,280
MS-DRG,MS-742,Uterine And Adnexa Procedures For Non-Malignancy With Cc/Mcc,,,11700.01,11700.01,4
MS-DRG,MS-743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,8300.57,20259.12,280
MS-DRG,MS-743,Uterine And Adnexa Procedures For Non-Malignancy Without Cc/Mcc,,,9843.05,9843.05,4
MS-DRG,MS-744,"D&C, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc",,,22313.7,22313.7,4
MS-DRG,MS-744,D&C- CONIZATION- LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC,,,13341.85,48645.63,280
MS-DRG,MS-745,"D&C, Conization, Laparoscopy And Tubal Interruption Without Cc/Mcc",,,13526.79,13526.79,4
MS-DRG,MS-745,D&C- CONIZATION- LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC,,,3807.21,27004.25,280
MS-DRG,MS-746,VAGINA- CERVIX AND VULVA PROCEDURES WITH CC/MCC,,,11621.6,41515.2,280
MS-DRG,MS-746,"Vagina, Cervix And Vulva Procedures With Cc/Mcc",,,18376.94,18376.94,4
MS-DRG,MS-747,VAGINA- CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC,,,5751.59,28787.84,280
MS-DRG,MS-747,"Vagina, Cervix And Vulva Procedures Without Cc/Mcc",,,11502.71,11502.71,4
MS-DRG,MS-748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,9281.36,25286.08,280
MS-DRG,MS-748,Female Reproductive System Reconstructive Procedures,,,16658.09,16658.09,4
MS-DRG,MS-749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,15417.0,79714.64,280
MS-DRG,MS-749,Other Female Reproductive System O.R. Procedures With Cc/Mcc,,,29693.95,29693.95,4
MS-DRG,MS-750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,9873.44,36314.64,280
MS-DRG,MS-750,Other Female Reproductive System O.R. Procedures Without Cc/Mcc,,,16774.15,16774.15,4
MS-DRG,MS-754,MALIGNANCY- FEMALE REPRODUCTIVE SYSTEM WITH MCC,,,12321.4,48064.88,280
MS-DRG,MS-754,"Malignancy, Female Reproductive System With Mcc",,,20416.11,20416.11,4
MS-DRG,MS-755,MALIGNANCY- FEMALE REPRODUCTIVE SYSTEM WITH CC,,,6900.23,27929.76,280
MS-DRG,MS-755,"Malignancy, Female Reproductive System With Cc",,,12707.41,12707.41,4
MS-DRG,MS-756,MALIGNANCY- FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC,,,6425.97,23919.6,280
MS-DRG,MS-756,"Malignancy, Female Reproductive System Without Cc/Mcc",,,11717.42,11717.42,4
MS-DRG,MS-757,INFECTIONS- FEMALE REPRODUCTIVE SYSTEM WITH MCC,,,8572.78,34950.64,280
MS-DRG,MS-757,"Infections, Female Reproductive System With Mcc",,,16130.02,16130.02,4
MS-DRG,MS-758,INFECTIONS- FEMALE REPRODUCTIVE SYSTEM WITH CC,,,6312.96,26335.12,280
MS-DRG,MS-758,"Infections, Female Reproductive System With Cc",,,8738.16,8738.16,4
MS-DRG,MS-759,INFECTIONS- FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC,,,3737.19,15753.86,280
MS-DRG,MS-759,"Infections, Female Reproductive System Without Cc/Mcc",,,7292.05,7292.05,4
MS-DRG,MS-760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,4470.62,17536.08,280
MS-DRG,MS-760,Menstrual And Other Female Reproductive System Disorders With Cc/Mcc,,,11362.27,11362.27,4
MS-DRG,MS-761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,3659.29,16129.92,280
MS-DRG,MS-761,Menstrual And Other Female Reproductive System Disorders Without Cc/Mcc,,,6649.08,6649.08,4
MS-DRG,MS-762,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,9339.47,9339.47,1
MS-DRG,MS-763,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,7123.42,7123.42,1
MS-DRG,MS-764,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,6238.57,6238.57,1
MS-DRG,MS-768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,5030.76,11422.88,280
MS-DRG,MS-768,Vaginal Delivery With O.R. Procedures Except Sterilization And/Or D&C,,,6269.56,6269.56,4
MS-DRG,MS-769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,11305.15,32287.12,280
MS-DRG,MS-769,Postpartum And Post Abortion Diagnoses With O.R. Procedures,,,12994.08,12994.08,4
MS-DRG,MS-770,ABORTION WITH D&C- ASPIRATION CURETTAGE OR HYSTEROTOMY,,,6708.29,15227.2,280
MS-DRG,MS-770,"Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,5988.7,5988.7,4
MS-DRG,MS-771,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,9559.15,9559.15,1
MS-DRG,MS-772,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,7757.95,7757.95,1
MS-DRG,MS-773,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,6607.04,6607.04,1
MS-DRG,MS-776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,3494.75,16447.36,280
MS-DRG,MS-776,Postpartum And Post Abortion Diagnoses Without O.R. Procedures,,,5237.79,5237.79,4
MS-DRG,MS-779,ABORTION WITHOUT D&C,,,4014.63,11656.0,280
MS-DRG,MS-779,Abortion Without D&C,,,11972.75,11972.75,4
MS-DRG,MS-783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,12739.7,34630.72,280
MS-DRG,MS-783,Cesarean Section With Sterilization With Mcc,,,22682.77,22682.77,4
MS-DRG,MS-784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,7092.31,24051.04,311
MS-DRG,MS-784,Cesarean Section With Sterilization With Cc,,,8970.28,8970.28,4
MS-DRG,MS-785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,6407.9,16774.72,311
MS-DRG,MS-785,Cesarean Section With Sterilization Without Cc/Mcc,,,7528.81,7528.81,4
MS-DRG,MS-786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,11035.53,30847.23,272
MS-DRG,MS-786,Cesarean Section Without Sterilization With Mcc,,,9538.97,9538.97,4
MS-DRG,MS-787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,7471.65,21449.02,311
MS-DRG,MS-787,Cesarean Section Without Sterilization With Cc,,,8110.27,8110.27,4
MS-DRG,MS-788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,6414.59,17869.89,311
MS-DRG,MS-788,Cesarean Section Without Sterilization Without Cc/Mcc,,,7064.57,7064.57,4
MS-DRG,MS-789,NEONATES- DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY,,,3015.87,21610.06,280
MS-DRG,MS-789,"Neonates, Died Or Transferred To Another Acute Care Facility",,,21461.82,21461.82,4
MS-DRG,MS-790,EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME- NEONATE,,,6428.49,139874.48,280
MS-DRG,MS-790,"Extreme Immaturity Or Respiratory Distress Syndrome, Neonate",,,84628.63,84628.63,4
MS-DRG,MS-791,PREMATURITY WITH MAJOR PROBLEMS,,,2538.14,42135.2,280
MS-DRG,MS-791,Prematurity With Major Problems,,,26086.81,26086.81,4
MS-DRG,MS-792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,1983.25,19023.81,280
MS-DRG,MS-792,Prematurity Without Major Problems,,,7687.81,7687.81,4
MS-DRG,MS-793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,4366.74,40516.56,280
MS-DRG,MS-793,Full Term Neonate With Major Problems,,,10809.83,10809.83,4
MS-DRG,MS-794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,2155.62,23192.45,280
MS-DRG,MS-794,Neonate With Other Significant Problems,,,2301.47,2301.47,4
MS-DRG,MS-795,NORMAL NEWBORN,,,1129.91,4290.4,415
MS-DRG,MS-795,Normal Newborn,,,1490.21,1490.21,4
MS-DRG,MS-796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,7807.5,29129.09,280
MS-DRG,MS-796,Vaginal Delivery With Sterilization And/Or D&C With Mcc,,,15433.66,15433.66,4
MS-DRG,MS-797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,6018.0,16802.5,311
MS-DRG,MS-797,Vaginal Delivery With Sterilization And/Or D&C With Cc,,,5489.64,5489.64,4
MS-DRG,MS-798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,6018.0,18483.44,303
MS-DRG,MS-798,Vaginal Delivery With Sterilization And/Or D&C Without Cc/Mcc,,,5489.64,5489.64,4
MS-DRG,MS-799,SPLENIC PROCEDURES WITH MCC,,,30299.38,113782.4,280
MS-DRG,MS-799,Splenic Procedures With Mcc,,,61213.53,61213.53,4
MS-DRG,MS-800,SPLENIC PROCEDURES WITH CC,,,18795.53,65132.24,280
MS-DRG,MS-800,Splenic Procedures With Cc,,,31249.16,31249.16,4
MS-DRG,MS-801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,12770.98,43670.32,280
MS-DRG,MS-801,Splenic Procedures Without Cc/Mcc,,,21111.31,21111.31,4
MS-DRG,MS-802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,26654.54,94582.53,280
MS-DRG,MS-802,Other O.R. Procedures Of The Blood And Blood Forming Organs With Mcc,,,44808.44,44808.44,4
MS-DRG,MS-803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,12436.47,48603.04,280
MS-DRG,MS-803,Other O.R. Procedures Of The Blood And Blood Forming Organs With Cc,,,24135.84,24135.84,4
MS-DRG,MS-804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,9071.95,37172.72,280
MS-DRG,MS-804,Other O.R. Procedures Of The Blood And Blood Forming Organs Without Cc/Mcc,,,14831.31,14831.31,4
MS-DRG,MS-805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,5057.02,20300.29,280
MS-DRG,MS-805,Vaginal Delivery Without Sterilization Or D&C With Mcc,,,5876.12,5876.12,4
MS-DRG,MS-806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,4201.93,12527.71,304
MS-DRG,MS-806,Vaginal Delivery Without Sterilization Or D&C With Cc,,,5143.78,5143.78,4
MS-DRG,MS-807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,3675.92,11761.76,304
MS-DRG,MS-807,Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc,,,4323.24,4323.24,4
MS-DRG,MS-808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,14771.36,81837.52,280
MS-DRG,MS-808,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders With Mcc,,,25166.45,25166.45,4
MS-DRG,MS-809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,8469.16,39213.76,280
MS-DRG,MS-809,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders With Cc,,,9340.51,9340.51,4
MS-DRG,MS-810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,6814.46,24643.76,280
MS-DRG,MS-810,Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Coagulation Disorders Without Cc/Mcc,,,9340.51,9340.51,4
MS-DRG,MS-811,RED BLOOD CELL DISORDERS WITH MCC,,,9395.09,29725.28,280
MS-DRG,MS-811,Red Blood Cell Disorders With Mcc,,,11313.53,11313.53,4
MS-DRG,MS-812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,6142.97,21189.12,280
MS-DRG,MS-812,Red Blood Cell Disorders Without Mcc,,,9089.82,9089.82,4
MS-DRG,MS-813,COAGULATION DISORDERS,,,10204.61,33279.12,280
MS-DRG,MS-813,Coagulation Disorders,,,18396.67,18396.67,4
MS-DRG,MS-814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,14228.11,47953.28,280
MS-DRG,MS-814,Reticuloendothelial And Immunity Disorders With Mcc,,,22087.38,22087.38,4
MS-DRG,MS-815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,6783.89,30995.04,280
MS-DRG,MS-815,Reticuloendothelial And Immunity Disorders With Cc,,,8759.05,8759.05,4
MS-DRG,MS-816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,4228.22,23081.36,280
MS-DRG,MS-816,Reticuloendothelial And Immunity Disorders Without Cc/Mcc,,,8568.71,8568.71,4
MS-DRG,MS-817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,12352.85,62870.48,280
MS-DRG,MS-817,Other Antepartum Diagnoses With O.R. Procedures With Mcc,,,36788.7,36788.7,4
MS-DRG,MS-818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,7755.31,34752.24,280
MS-DRG,MS-818,Other Antepartum Diagnoses With O.R. Procedures With Cc,,,15600.79,15600.79,4
MS-DRG,MS-819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,5752.93,20414.03,280
MS-DRG,MS-819,Other Antepartum Diagnoses With O.R. Procedures Without Cc/Mcc,,,4683.02,4683.02,4
MS-DRG,MS-820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,39236.86,143827.6,280
MS-DRG,MS-820,Lymphoma And Leukemia With Major O.R. Procedures With Mcc,,,62505.27,62505.27,4
MS-DRG,MS-821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,14976.75,55668.56,280
MS-DRG,MS-821,Lymphoma And Leukemia With Major O.R. Procedures With Cc,,,25418.3,25418.3,4
MS-DRG,MS-822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,8055.04,28582.96,280
MS-DRG,MS-822,Lymphoma And Leukemia With Major O.R. Procedures Without Cc/Mcc,,,14163.96,14163.96,4
MS-DRG,MS-823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,30673.36,115399.36,280
MS-DRG,MS-823,Lymphoma And Non-Acute Leukemia With Other Procedures With Mcc,,,50854.01,50854.01,4
MS-DRG,MS-824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,15157.38,63428.48,280
MS-DRG,MS-824,Lymphoma And Non-Acute Leukemia With Other Procedures With Cc,,,26921.28,26921.28,4
MS-DRG,MS-825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,9027.8,32034.76,280
MS-DRG,MS-825,Lymphoma And Non-Acute Leukemia With Other Procedures Without Cc/Mcc,,,15475.44,15475.44,4
MS-DRG,MS-826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,31295.55,136809.2,280
MS-DRG,MS-826,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Mcc,,,60440.57,60440.57,4
MS-DRG,MS-827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,15462.46,63185.44,280
MS-DRG,MS-827,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures With Cc,,,28618.07,28618.07,4
MS-DRG,MS-828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,11398.81,45074.0,280
MS-DRG,MS-828,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.R. Procedures Without Cc/Mcc,,,20441.65,20441.65,4
MS-DRG,MS-829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,21141.12,85656.72,280
MS-DRG,MS-829,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures With Cc/Mcc,,,43500.45,43500.45,4
MS-DRG,MS-830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,10068.8,36272.48,280
MS-DRG,MS-830,Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Procedures Without Cc/Mcc,,,17284.82,17284.82,4
MS-DRG,MS-831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,4798.83,28547.35,280
MS-DRG,MS-831,Other Antepartum Diagnoses Without O.R. Procedures With Mcc,,,8656.92,8656.92,4
MS-DRG,MS-832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,3900.86,18195.76,280
MS-DRG,MS-832,Other Antepartum Diagnoses Without O.R. Procedures With Cc,,,5388.67,5388.67,4
MS-DRG,MS-833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,2569.65,14515.44,280
MS-DRG,MS-833,Other Antepartum Diagnoses Without O.R. Procedures Without Cc/Mcc,,,5086.91,5086.91,4
MS-DRG,MS-834,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC,,,36728.69,136662.88,280
MS-DRG,MS-834,Acute Leukemia Without Major O.R. Procedures With Mcc,,,106798.41,106798.41,4
MS-DRG,MS-835,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC,,,13954.48,52881.04,280
MS-DRG,MS-835,Acute Leukemia Without Major O.R. Procedures With Cc,,,24649.98,24649.98,4
MS-DRG,MS-836,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,8158.73,31513.36,280
MS-DRG,MS-836,Acute Leukemia Without Major O.R. Procedures Without Cc/Mcc,,,18440.77,18440.77,4
MS-DRG,MS-837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,32141.87,123370.08,280
MS-DRG,MS-837,Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemotherapy Agent With Mcc,,,63265.47,63265.47,4
MS-DRG,MS-838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,13608.8,50353.92,280
MS-DRG,MS-838,Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Chemotherapy Agent,,,14439.02,14439.02,4
MS-DRG,MS-839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,9001.64,34278.19,280
MS-DRG,MS-839,Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,11145.24,11145.24,4
MS-DRG,MS-840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,21642.22,78888.8,280
MS-DRG,MS-840,Lymphoma And Non-Acute Leukemia With Mcc,,,36520.6,36520.6,4
MS-DRG,MS-841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,10914.44,38729.44,280
MS-DRG,MS-841,Lymphoma And Non-Acute Leukemia With Cc,,,18746.01,18746.01,4
MS-DRG,MS-842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,6759.81,26037.52,280
MS-DRG,MS-842,Lymphoma And Non-Acute Leukemia Without Cc/Mcc,,,12973.19,12973.19,4
MS-DRG,MS-843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,12668.81,52045.28,280
MS-DRG,MS-843,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Mcc,,,22773.29,22773.29,4
MS-DRG,MS-844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,8144.69,38945.92,280
MS-DRG,MS-844,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses With Cc,,,13407.25,13407.25,4
MS-DRG,MS-845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,5697.4,20844.4,280
MS-DRG,MS-845,Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses Without Cc/Mcc,,,9938.22,9938.22,4
MS-DRG,MS-846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,13648.18,63056.48,280
MS-DRG,MS-846,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc,,,28316.32,28316.32,4
MS-DRG,MS-847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,7909.36,31409.2,280
MS-DRG,MS-847,Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc,,,15051.82,15051.82,4
MS-DRG,MS-848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,5682.68,26771.6,280
MS-DRG,MS-848,Chemotherapy Without Acute Leukemia As Secondary Diagnosis Without Cc/Mcc,,,10921.25,10921.25,4
MS-DRG,MS-849,RADIOTHERAPY,,,18127.18,65749.76,280
MS-DRG,MS-849,Radiotherapy,,,27492.29,27492.29,4
MS-DRG,MS-850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,57934.04,228643.6,280
MS-DRG,MS-853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,33040.37,150647.6,280
MS-DRG,MS-853,Infectious And Parasitic Diseases With O.R. Procedures With Mcc,,,54475.08,54475.08,4
MS-DRG,MS-854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,13367.75,57967.52,280
MS-DRG,MS-854,Infectious And Parasitic Diseases With O.R. Procedures With Cc,,,16550.16,16550.16,4
MS-DRG,MS-855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,10016.61,32426.0,280
MS-DRG,MS-855,Infectious And Parasitic Diseases With O.R. Procedures Without Cc/Mcc,,,16550.16,16550.16,4
MS-DRG,MS-856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,30431.85,106411.84,280
MS-DRG,MS-856,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Mcc,,,51869.54,51869.54,4
MS-DRG,MS-857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,14327.13,37415.76,280
MS-DRG,MS-857,Postoperative Or Post-Traumatic Infections With O.R. Procedures With Cc,,,14643.29,14643.29,4
MS-DRG,MS-858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,9318.82,28616.72,280
MS-DRG,MS-858,Postoperative Or Post-Traumatic Infections With O.R. Procedures Without Cc/Mcc,,,14643.29,14643.29,4
MS-DRG,MS-862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,11564.28,35225.92,280
MS-DRG,MS-862,Postoperative And Post-Traumatic Infections With Mcc,,,11984.36,11984.36,4
MS-DRG,MS-863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,6102.03,24822.32,280
MS-DRG,MS-863,Postoperative And Post-Traumatic Infections Without Mcc,,,8990.01,8990.01,4
MS-DRG,MS-864,FEVER AND INFLAMMATORY CONDITIONS,,,5527.89,17583.2,280
MS-DRG,MS-864,Fever And Inflammatory Conditions,,,6247.51,6247.51,4
MS-DRG,MS-865,VIRAL ILLNESS WITH MCC,,,9625.67,26977.44,280
MS-DRG,MS-865,Viral Illness With Mcc,,,10021.78,10021.78,4
MS-DRG,MS-866,VIRAL ILLNESS WITHOUT MCC,,,5134.92,24542.08,280
MS-DRG,MS-866,Viral Illness Without Mcc,,,10021.78,10021.78,4
MS-DRG,MS-867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,14003.99,53052.16,280
MS-DRG,MS-867,Other Infectious And Parasitic Diseases Diagnoses With Mcc,,,24841.48,24841.48,4
MS-DRG,MS-868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,6898.3,29926.16,280
MS-DRG,MS-868,Other Infectious And Parasitic Diseases Diagnoses With Cc,,,12409.14,12409.14,4
MS-DRG,MS-869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,4881.86,17677.44,280
MS-DRG,MS-869,Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc,,,8707.98,8707.98,4
MS-DRG,MS-870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,46241.53,193452.4,280
MS-DRG,MS-870,Septicemia Or Severe Sepsis With Mv >96 Hours,,,83080.39,83080.39,4
MS-DRG,MS-871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,12995.77,48526.16,280
MS-DRG,MS-871,Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc,,,17558.72,17558.72,4
MS-DRG,MS-872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,6585.16,20455.04,280
MS-DRG,MS-872,Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc,,,8558.26,8558.26,4
MS-DRG,MS-876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,25857.07,99299.2,280
MS-DRG,MS-876,O.R. Procedures With Principal Diagnosis Of Mental Illness,,,37570.94,37570.94,4
MS-DRG,MS-880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,2243.0,6873.64,25
MS-DRG,MS-880,Acute Adjustment Reaction And Psychosocial Dysfunction,,,7101.71,7101.71,4
MS-DRG,MS-881,DEPRESSIVE NEUROSES,,,2243.0,6735.48,25
MS-DRG,MS-881,Depressive Neuroses,,,5431.61,5431.61,4
MS-DRG,MS-882,NEUROSES EXCEPT DEPRESSIVE,,,2243.0,7686.85,25
MS-DRG,MS-882,Neuroses Except Depressive,,,10267.83,10267.83,4
MS-DRG,MS-883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,2243.0,14075.85,25
MS-DRG,MS-883,Disorders Of Personality And Impulse Control,,,8081.26,8081.26,4
MS-DRG,MS-884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,2243.0,11517.38,25
MS-DRG,MS-884,Organic Disturbances And Intellectual Disability,,,18454.7,18454.7,4
MS-DRG,MS-885,PSYCHOSES,,,2243.0,9999.06,25
MS-DRG,MS-885,Psychoses,,,7993.05,7993.05,4
MS-DRG,MS-886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,2243.0,14856.13,25
MS-DRG,MS-886,Behavioral And Developmental Disorders,,,16045.3,16045.3,4
MS-DRG,MS-887,OTHER MENTAL DISORDER DIAGNOSES,,,2243.0,10820.34,25
MS-DRG,MS-887,Other Mental Disorder Diagnoses,,,15239.84,15239.84,4
MS-DRG,MS-894,ALCOHOL/DRUG ABUSE OR DEPENDENCE- LEFT AMA,,,3376.6,9177.35,184
MS-DRG,MS-894,"Alcohol, Drug Abuse Or Dependence, Left Ama",,,4264.04,4264.04,4
MS-DRG,MS-895,ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY,,,6441.62,19777.69,184
MS-DRG,MS-895,"Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy",,,8913.41,8913.41,4
MS-DRG,MS-896,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC,,,10260.2,24315.3,184
MS-DRG,MS-896,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc",,,12188.62,12188.62,4
MS-DRG,MS-897,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,,5906.13,12496.26,176
MS-DRG,MS-897,"Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc",,,6440.17,6440.17,4
MS-DRG,MS-898,ALCOHOL- DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY AGE >21 WITHOUT MCC,,,7523.39,7523.39,1
MS-DRG,MS-899,ALCOHOL- DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY AGE <=21 WITHOUT MCC,,,7671.3,7671.3,1
MS-DRG,MS-901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,28076.22,108462.8,280
MS-DRG,MS-901,Wound Debridements For Injuries With Mcc,,,51703.57,51703.57,4
MS-DRG,MS-902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,12808.44,53657.28,280
MS-DRG,MS-902,Wound Debridements For Injuries With Cc,,,23295.56,23295.56,4
MS-DRG,MS-903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,7824.89,30360.16,280
MS-DRG,MS-903,Wound Debridements For Injuries Without Cc/Mcc,,,14289.31,14289.31,4
MS-DRG,MS-904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,24573.88,95232.0,280
MS-DRG,MS-904,Skin Grafts For Injuries With Cc/Mcc,,,41750.26,41750.26,4
MS-DRG,MS-905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,9924.29,40887.76,280
MS-DRG,MS-905,Skin Grafts For Injuries Without Cc/Mcc,,,18336.32,18336.32,4
MS-DRG,MS-906,HAND PROCEDURES FOR INJURIES,,,13141.62,51358.32,280
MS-DRG,MS-906,Hand Procedures For Injuries,,,21014.98,21014.98,4
MS-DRG,MS-907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,25685.8,128615.28,280
MS-DRG,MS-907,Other O.R. Procedures For Injuries With Mcc,,,45439.81,45439.81,4
MS-DRG,MS-908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,13348.35,51467.44,280
MS-DRG,MS-908,Other O.R. Procedures For Injuries With Cc,,,24172.98,24172.98,4
MS-DRG,MS-909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,8782.26,37326.48,280
MS-DRG,MS-909,Other O.R. Procedures For Injuries Without Cc/Mcc,,,16041.81,16041.81,4
MS-DRG,MS-913,TRAUMATIC INJURY WITH MCC,,,10935.85,40153.68,280
MS-DRG,MS-913,Traumatic Injury With Mcc,,,17797.8,17797.8,4
MS-DRG,MS-914,TRAUMATIC INJURY WITHOUT MCC,,,5924.2,23507.92,280
MS-DRG,MS-914,Traumatic Injury Without Mcc,,,10451.2,10451.2,4
MS-DRG,MS-915,ALLERGIC REACTIONS WITH MCC,,,11250.29,26077.2,280
MS-DRG,MS-915,Allergic Reactions With Mcc,,,21394.5,21394.5,4
MS-DRG,MS-916,ALLERGIC REACTIONS WITHOUT MCC,,,3865.85,12276.0,280
MS-DRG,MS-916,Allergic Reactions Without Mcc,,,7807.36,7807.36,4
MS-DRG,MS-917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,10492.96,36148.48,280
MS-DRG,MS-917,Poisoning And Toxic Effects Of Drugs With Mcc,,,15224.75,15224.75,4
MS-DRG,MS-918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,4850.47,16896.24,280
MS-DRG,MS-918,Poisoning And Toxic Effects Of Drugs Without Mcc,,,5982.89,5982.89,4
MS-DRG,MS-919,COMPLICATIONS OF TREATMENT WITH MCC,,,12248.47,35183.76,280
MS-DRG,MS-919,Complications Of Treatment With Mcc,,,21082.3,21082.3,4
MS-DRG,MS-920,COMPLICATIONS OF TREATMENT WITH CC,,,6705.62,23212.8,280
MS-DRG,MS-920,Complications Of Treatment With Cc,,,12011.05,12011.05,4
MS-DRG,MS-921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,4605.55,16293.6,280
MS-DRG,MS-921,Complications Of Treatment Without Cc/Mcc,,,8555.94,8555.94,4
MS-DRG,MS-922,OTHER INJURY- POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC,,,11703.89,51700.56,280
MS-DRG,MS-922,"Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc",,,18287.57,18287.57,4
MS-DRG,MS-923,OTHER INJURY- POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC,,,4541.52,18304.88,280
MS-DRG,MS-923,"Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc",,,11087.21,11087.21,4
MS-DRG,MS-927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,142839.74,588325.44,216
MS-DRG,MS-927,Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft,,,223125.35,223125.35,4
MS-DRG,MS-928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,30111.07,170279.9,216
MS-DRG,MS-928,Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc,,,72775.42,72775.42,4
MS-DRG,MS-929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,15248.96,78960.72,216
MS-DRG,MS-929,Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc,,,34544.1,34544.1,4
MS-DRG,MS-933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,26053.09,106952.48,216
MS-DRG,MS-933,Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft,,,35651.31,35651.31,4
MS-DRG,MS-934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,3185.8,53208.4,216
MS-DRG,MS-934,Full Thickness Burn Without Skin Graft Or Inhalation Injury,,,22051.4,22051.4,4
MS-DRG,MS-935,NON-EXTENSIVE BURNS,,,9499.64,54527.76,216
MS-DRG,MS-935,Non-Extensive Burns,,,23792.3,23792.3,4
MS-DRG,MS-939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,24275.5,86140.59,280
MS-DRG,MS-939,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Mcc,,,36404.54,36404.54,4
MS-DRG,MS-940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,15634.4,55478.01,280
MS-DRG,MS-940,O.R. Procedures With Diagnoses Of Other Contact With Health Services With Cc,,,25898.79,25898.79,4
MS-DRG,MS-941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,12955.88,48960.16,280
MS-DRG,MS-941,O.R. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/Mcc,,,22184.87,22184.87,4
MS-DRG,MS-945,REHABILITATION WITH CC/MCC,,,10360.49,46916.64,280
MS-DRG,MS-945,Rehabilitation With Cc/Mcc,,,17693.35,17693.35,4
MS-DRG,MS-946,REHABILITATION WITHOUT CC/MCC,,,7672.36,27036.96,280
MS-DRG,MS-946,Rehabilitation Without Cc/Mcc,,,13196.02,13196.02,4
MS-DRG,MS-947,SIGNS AND SYMPTOMS WITH MCC,,,8492.58,34908.48,280
MS-DRG,MS-947,Signs And Symptoms With Mcc,,,14289.31,14289.31,4
MS-DRG,MS-948,SIGNS AND SYMPTOMS WITHOUT MCC,,,5355.53,19914.4,280
MS-DRG,MS-948,Signs And Symptoms Without Mcc,,,7381.42,7381.42,4
MS-DRG,MS-949,AFTERCARE WITH CC/MCC,,,7959.37,35106.88,280
MS-DRG,MS-949,Aftercare With Cc/Mcc,,,14010.76,14010.76,4
MS-DRG,MS-950,AFTERCARE WITHOUT CC/MCC,,,4199.46,23887.36,280
MS-DRG,MS-950,Aftercare Without Cc/Mcc,,,8340.07,8340.07,4
MS-DRG,MS-951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,3505.26,14924.64,280
MS-DRG,MS-951,Other Factors Influencing Health Status,,,6690.86,6690.86,4
MS-DRG,MS-955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,45032.6,165877.28,280
MS-DRG,MS-955,Craniotomy For Multiple Significant Trauma,,,79178.45,79178.45,4
MS-DRG,MS-956,LIMB REATTACHMENT- HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,25175.33,110099.6,280
MS-DRG,MS-956,"Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma",,,34509.28,34509.28,4
MS-DRG,MS-957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,50978.88,242806.88,280
MS-DRG,MS-957,Other O.R. Procedures For Multiple Significant Trauma With Mcc,,,99520.29,99520.29,4
MS-DRG,MS-958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,28191.96,114328.0,280
MS-DRG,MS-958,Other O.R. Procedures For Multiple Significant Trauma With Cc,,,35392.5,35392.5,4
MS-DRG,MS-959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,15182.44,89255.2,280
MS-DRG,MS-959,Other O.R. Procedures For Multiple Significant Trauma Without Cc/Mcc,,,30194.17,30194.17,4
MS-DRG,MS-963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,18289.75,87856.48,280
MS-DRG,MS-963,Other Multiple Significant Trauma With Mcc,,,32597.77,32597.77,4
MS-DRG,MS-964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,10253.45,48151.68,280
MS-DRG,MS-964,Other Multiple Significant Trauma With Cc,,,15858.44,15858.44,4
MS-DRG,MS-965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,6292.16,40121.44,280
MS-DRG,MS-965,Other Multiple Significant Trauma Without Cc/Mcc,,,10694.93,10694.93,4
MS-DRG,MS-969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,40952.9,153395.44,280
MS-DRG,MS-969,Hiv With Extensive O.R. Procedures With Mcc,,,85191.52,85191.52,4
MS-DRG,MS-970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,17644.81,65481.92,280
MS-DRG,MS-970,Hiv With Extensive O.R. Procedures Without Mcc,,,36302.41,36302.41,4
MS-DRG,MS-974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,19308.0,86207.28,280
MS-DRG,MS-974,Hiv With Major Related Condition With Mcc,,,33771.14,33771.14,4
MS-DRG,MS-975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,8663.85,35052.32,280
MS-DRG,MS-975,Hiv With Major Related Condition With Cc,,,9090.98,9090.98,4
MS-DRG,MS-976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,6039.27,24609.04,280
MS-DRG,MS-976,Hiv With Major Related Condition Without Cc/Mcc,,,9090.98,9090.98,4
MS-DRG,MS-977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,8681.91,35478.88,280
MS-DRG,MS-977,Hiv With Or Without Other Related Condition,,,15279.3,15279.3,4
MS-DRG,MS-981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,31389.22,145144.48,280
MS-DRG,MS-981,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,37991.08,37991.08,4
MS-DRG,MS-982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,16447.93,78601.12,280
MS-DRG,MS-982,Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,21657.96,21657.96,4
MS-DRG,MS-983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,11115.29,41113.44,280
MS-DRG,MS-983,Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,10044.99,10044.99,4
MS-DRG,MS-987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,22936.78,76795.68,280
MS-DRG,MS-987,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Mcc,,,39006.61,39006.61,4
MS-DRG,MS-988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,10996.06,33765.2,280
MS-DRG,MS-988,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis With Cc,,,19940.27,19940.27,4
MS-DRG,MS-989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,8022.92,26317.76,280
MS-DRG,MS-989,Non-Extensive O.R. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc,,,12958.1,12958.1,4
MS-DRG,MS-998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,,,,,0
MS-DRG,MS-999,UNGROUPABLE,,,,,0
NDC,00002120001,FLORBETAPIR F-18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,10543.81,7907.85,126.53,9489.43,119
NDC,00002751001,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,398.4,298.8,4.78,358.56,119
NDC,00002751101,INSULIN LISPRO PROTAMINE-LISPRO 100 UNIT/ML (75-25) SUBCUTANEOUS SUSP,512.46,384.34,6.15,461.21,119
NDC,00002766901,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,4483.97,3362.98,53.81,4035.57,119
NDC,00002767801,RAMUCIRUMAB 10 MG/ML INTRAVENOUS SOLUTION,22419.85,16814.89,269.04,20177.86,119
NDC,00002773701,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,150.0,112.5,1.8,135.0,119
NDC,00002821501,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,267.66,200.74,3.21,240.89,119
NDC,00002831501,INSULIN NPH ISOPHANE U-100 HUMAN 100 UNIT/ML SUBCUTANEOUS SUSPENSION,267.66,200.74,3.21,240.89,119
NDC,00002850101,INSULIN REGULAR HUMAN U-500(CONCENTRATE) 500 UNIT/ML SUBCUTANEOUS SOLN,6171.05,4628.29,74.05,5553.95,119
NDC,00002871501,INSULIN HUMAN U-100 NPH-REGULR 70-30 MIX 100 UNIT/ML SUBCUTANEOUS SUSP,267.66,200.74,3.21,240.89,119
NDC,00003037113,BELATACEPT 250 MG INTRAVENOUS SOLUTION,2760.28,2070.21,33.12,2484.25,119
NDC,00003049420,TRIAMCINOLONE ACETONIDE 10 MG/ML SUSPENSION FOR INJECTION,72.54,54.4,0.87,65.29,119
NDC,00003089331,APIXABAN 2.5 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,00003089431,APIXABAN 5 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,00003218713,ABATACEPT (WITH MALTOSE) 250 MG INTRAVENOUS SOLUTION,4160.32,3120.24,49.92,3744.29,119
NDC,00003232711,IPILIMUMAB 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,25264.51,18948.38,303.17,22738.06,119
NDC,00003373413,NIVOLUMAB 240 MG/24 ML INTRAVENOUS SOLUTION,22162.74,16622.05,265.95,19946.47,119
NDC,00003375614,NIVOLUMAB 120 MG/12 ML INTRAVENOUS SOLUTION,11081.37,8311.03,132.98,9973.23,119
NDC,00003377211,NIVOLUMAB 40 MG/4 ML INTRAVENOUS SOLUTION,3693.8,2770.35,44.33,3324.42,119
NDC,00003377412,NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,9234.44,6925.83,110.81,8311.0,119
NDC,00003712511,NIVOLUMAB 240 MG-RELATLIMAB-RMBW 80 MG/20 ML INTRAVENOUS SOLUTION,43030.32,32272.74,516.36,38727.29,119
NDC,00004026129,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,8284.8,6213.6,99.42,7456.32,119
NDC,00005010001,"N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE",793.22,594.92,9.52,713.9,119
NDC,00005010005,"N.MENINGITIDIS GROUP B,LIPID FHBP 120 MCG/0.5 ML INTRAMUSCULAR SYRINGE",793.22,594.92,9.52,713.9,119
NDC,00005200001,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,564.92,423.69,6.78,508.43,119
NDC,00005200010,PNEUMOCOCCAL 20-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,547.7,410.78,6.57,492.93,119
NDC,00006003310,SUVOREXANT 10 MG TABLET,66.64,49.98,0.8,59.98,119
NDC,00006022761,RALTEGRAVIR 400 MG TABLET,149.76,112.32,1.8,134.78,119
NDC,00006302602,PEMBROLIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,15892.05,11919.04,190.7,14302.84,119
NDC,00006307603,LETERMOVIR 480 MG TABLET,1003.47,752.6,12.04,903.12,119
NDC,00006360301,RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,49.92,37.44,0.6,44.93,119
NDC,00006360361,RALTEGRAVIR 100 MG POWDER PACKET FOR ORAL SUSPENSION,49.92,37.44,0.6,44.93,119
NDC,00006385601,IMIPENEM-CILASTATIN-RELEBACTAM 1.25 GRAM INTRAVENOUS SOLUTION,1178.61,883.96,14.14,1060.75,119
NDC,00006404702,"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",441.31,330.98,5.3,397.18,119
NDC,00006404741,"ROTAVIRUS VACCINE LIVE, PENTAVALENT 2 ML ORAL SOLUTION",441.31,330.98,5.3,397.18,119
NDC,00006412101,"HUMAN PAPILLOMAVIRUS VACCINE,9-VALENT(PF) 0.5 ML INTRAMUSCULAR SYRINGE",1178.34,883.76,14.14,1060.51,119
NDC,00006434702,PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,574.0,430.5,6.89,516.6,119
NDC,00006434799,PNEUMOCOCCAL 21-VALENT CONJ VACCINE-DIP CRM (PF) 0.5 ML IM SYRINGE,574.0,430.5,6.89,516.6,119
NDC,00006468100,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",385.75,289.31,4.63,347.18,119
NDC,00006468101,"MEASLES,MUMPS,RUBELLA VACCINE LIVE(PF)1,000-12,500TCID50/0.5 ML SUBCUT",385.75,289.31,4.63,347.18,119
NDC,00006482700,"VARICELLA VIRUS VACCINE LIVE (PF) 1,350 UNIT/0.5 ML SUBCUTANEOUS SUSP",756.35,567.26,9.08,680.72,119
NDC,00006483701,PNEUMOCOCCAL 23 POLYVALENT VACCINE 25 MCG/0.5 ML INJECTION SYRINGE,234.16,175.62,2.81,210.74,119
NDC,00006542302,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,538.09,403.57,6.46,484.28,119
NDC,00006542312,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,538.09,403.57,6.46,484.28,119
NDC,00006542402,"ANTIVENIN LATRODECTUS MACTANS 6,000 UNIT SOLUTION FOR INJECTION",90.75,68.06,1.09,81.68,119
NDC,00006542505,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,1068.75,801.56,12.82,961.88,119
NDC,00006542515,SUGAMMADEX 100 MG/ML INTRAVENOUS SOLUTION,1068.75,801.56,12.82,961.88,119
NDC,00009001103,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,103.14,77.36,1.24,92.83,119
NDC,00009001104,HYDROCORTISONE SOD SUCCINATE (PF) 100 MG/2 ML SOLUTION FOR INJECTION,101.25,75.94,1.22,91.12,119
NDC,00009003932,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,38.81,29.11,0.47,34.93,119
NDC,00009003933,METHYLPREDNISOLONE SOD SUCC (PF) 40 MG/ML SOLUTION FOR INJECTION,38.81,29.11,0.47,34.93,119
NDC,00009004722,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00009004725,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00009004726,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,51.26,38.45,0.62,46.13,119
NDC,00009004727,METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00009043601,ARGININE HCL (L-ARGININE) 10 % INTRAVENOUS SOLUTION,178.5,133.88,2.14,160.65,119
NDC,00009075801,METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION,109.26,81.94,1.31,98.33,119
NDC,00009082501,HYDROCORTISONE SODIUM SUCCINATE 100 MG SOLUTION FOR INJECTION,82.08,61.56,0.98,73.87,119
NDC,00009090211,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,25.6,19.2,0.31,23.04,119
NDC,00009090218,CLINDAMYCIN 150 MG/ML INJECTION SOLUTION,25.6,19.2,0.31,23.04,119
NDC,00009307301,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00009307303,METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00009316901,ALPROSTADIL 500 MCG/ML INJECTION SOLUTION,669.31,501.98,8.03,602.38,119
NDC,00009379401,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,2323.3,1742.47,27.88,2090.97,119
NDC,00009379422,IBUTILIDE FUMARATE 0.1 MG/ML INTRAVENOUS SOLUTION,2277.73,1708.3,27.33,2049.96,119
NDC,00019905040,INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT,14169.6,10627.2,170.04,12752.64,119
NDC,00019909240,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.7,5.88,441.23,119
NDC,00023114501,ONABOTULINUMTOXINA 100 UNIT SOLUTION FOR INJECTION,1838.52,1378.89,22.06,1654.67,119
NDC,00023320503,BIMATOPROST 0.01 % EYE DROPS,1095.43,821.58,13.15,985.89,119
NDC,00023455430,CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE GEL IN A DROPPERETTE,2.2,1.65,0.03,1.98,119
NDC,00023608201,IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,122.11,91.58,1.47,109.9,119
NDC,00023608210,IRON DEXTRAN 50 MG/ML INJECTION SOLUTION,122.11,91.58,1.47,109.9,119
NDC,00023916360,CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE,60.0,45.0,0.72,54.0,119
NDC,00023921105,BRIMONIDINE 0.2 %-TIMOLOL 0.5 % EYE DROPS,918.58,688.94,11.02,826.72,119
NDC,00023963708,OXYBUTYNIN 3.9 MG/24 HOUR TRANSDERMAL 4 DAY PATCH,14.89,11.16,0.18,13.4,119
NDC,00024065401,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,2568.86,1926.64,30.83,2311.97,119
NDC,00024065601,ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION,12844.38,9633.28,154.13,11559.94,119
NDC,00024414260,DRONEDARONE 400 MG TABLET,60.75,45.56,0.73,54.68,119
NDC,00024515010,RASBURICASE 1.5 MG INTRAVENOUS SOLUTION,4024.44,3018.33,48.29,3622.0,119
NDC,00024582411,CABAZITAXEL 10 MG/ML (FIRST DILUTION) INTRAVENOUS SOLUTION,36945.01,27708.76,443.34,33250.51,119
NDC,00024584001,ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION,4553.6,3415.2,54.64,4098.24,119
NDC,00024592410,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,588.42,441.31,7.06,529.58,119
NDC,00024592605,INSULIN LISPRO (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,180.0,135.0,2.16,162.0,119
NDC,00026382225,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 500 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
NDC,00026382425,"ANTIHEMOPHILIC FACTOR VIII, FULL LENGTH 1,000 (+/-) UNIT IV SOLUTION",10.24,7.68,0.12,9.22,119
NDC,00032004670,"LIPASE-PROTEASE-AMYLASE (PORK)6,000-19,000-30,000 UNIT CAPSULE,DEL REL",12.88,9.66,0.15,11.59,119
NDC,00032004770,"LIPASE-PROTEASE-AMYLASE(PORK)12,000-38,000-60,000 UNIT CAPSULE,DEL REL",25.75,19.31,0.31,23.18,119
NDC,00032120370,"LIPASE-PROTEASE-AMYLASE (PORK) 3,000-9,500-15,000 UNIT CAPSULE,DEL REL",10.88,8.16,0.13,9.79,119
NDC,00032263601,"LIPASE-PROTEASE-AMYLAS(PORK)24,000-76,000-120,000 UNIT CAPSULE,DEL REL",51.02,38.27,0.61,45.92,119
NDC,00032301613,"LIPASE-PROTEASE-AMYLASE (PORK)36,000-114,000-180K UNIT CAPSULE,DEL REL",60.0,45.0,0.72,54.0,119
NDC,00037682210,HYDROCORTISONE 1 %-PRAMOXINE 1 % RECTAL FOAM,833.04,624.78,10.0,749.74,119
NDC,00046074905,CONJUGATED ESTROGENS 25 MG SOLUTION FOR INJECTION,1447.22,1085.42,17.37,1302.5,119
NDC,00046110081,CONJUGATED ESTROGENS 0.3 MG TABLET,42.43,31.82,0.51,38.19,119
NDC,00046110281,CONJUGATED ESTROGENS 0.625 MG TABLET,42.43,31.82,0.51,38.19,119
NDC,00049052083,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00049052084,PENICILLIN G POTASSIUM 5 MILLION UNIT SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,00049053022,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,225.0,168.75,2.7,202.5,119
NDC,00054023524,MORPHINE 15 MG IMMEDIATE RELEASE TABLET,4.55,3.41,0.05,4.1,119
NDC,00054023763,MORPHINE 10 MG/5 ML ORAL SOLUTION,138.0,103.5,1.66,124.2,119
NDC,00054026425,HYDROMORPHONE 4 MG TABLET,1.1,0.82,0.01,0.99,119
NDC,00054026525,HYDROMORPHONE 8 MG TABLET,4.76,3.57,0.06,4.28,119
NDC,00054032656,FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,562.32,421.74,6.75,506.09,119
NDC,00054032756,FLUTICASONE 250 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,698.76,524.07,8.39,628.88,119
NDC,00054038663,HYDROMORPHONE 1 MG/ML ORAL LIQUID (REPACKAGING),1362.24,1021.68,16.35,1226.02,119
NDC,00054042523,RUFINAMIDE 200 MG TABLET,18.43,13.82,0.22,16.59,119
NDC,00054044949,POSACONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,6300.0,4725.0,75.6,5670.0,119
NDC,00054051741,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,51.57,38.68,0.62,46.41,119
NDC,00054317644,DEXAMETHASONE 1 MG/ML DROPS (CONCENTRATE),143.1,107.32,1.72,128.79,119
NDC,00054317757,DEXAMETHASONE 0.5 MG/5 ML ORAL SOLUTION,305.28,228.96,3.66,274.75,119
NDC,00054350547,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,240.0,180.0,2.88,216.0,119
NDC,00054372763,PROPRANOLOL 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,291.0,218.25,3.49,261.9,119
NDC,00054458111,MERCAPTOPURINE 50 MG TABLET,19.02,14.26,0.23,17.12,119
NDC,00054817525,DEXAMETHASONE 4 MG TABLET,6.02,4.52,0.07,5.42,119
NDC,00054817625,DEXAMETHASONE 2 MG TABLET,3.71,2.78,0.04,3.34,119
NDC,00054829725,FUROSEMIDE 20 MG TABLET,1.01,0.76,0.01,0.91,119
NDC,00054852625,LITHIUM CARBONATE 150 MG CAPSULE,0.9,0.68,0.01,0.81,119
NDC,00065002315,CARBACHOL 0.01 % INTRAOCULAR SOLUTION,201.06,150.8,2.41,180.95,119
NDC,00065035902,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,158.67,119.0,1.9,142.8,119
NDC,00065035905,CYCLOPENTOLATE-PHENYLEPHRINE 0.2 %-1 % EYE DROPS,300.0,225.0,3.6,270.0,119
NDC,00065039702,CYCLOPENTOLATE 2 % EYE DROPS,198.72,149.04,2.38,178.85,119
NDC,00065040872,ARTIFICIAL TEARS (HYPROMELLOSE) 0.5 % EYE DROPS,167.76,125.82,2.01,150.98,119
NDC,00065041130,POVIDONE-IODINE 5 % EYE SOLUTION,102.42,76.82,1.23,92.18,119
NDC,00065042915,PEG 400-PROPYLENE GLYCOL 0.4 %-0.3 % EYE DROPS,52.2,39.15,0.63,46.98,119
NDC,00065051801,WHITE PETROLATUM-MINERAL OIL 94 %-3 % EYE OINTMENT,39.0,29.25,0.47,35.1,119
NDC,00065074114,TETRACAINE HCL (PF) 0.5 % EYE DROPS,79.32,59.49,0.95,71.39,119
NDC,00065079515,BALANCED SALT SOLUTION COMBINATION NO.2 INTRAOCULAR IRRIGATION,75.87,56.9,0.91,68.28,119
NDC,00068059701,RIFAMPIN 600 MG INTRAVENOUS SOLUTION,741.02,555.77,8.89,666.92,119
NDC,00069023801,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,2184.45,1638.34,26.21,1966.0,119
NDC,00069024901,RITUXIMAB-PVVR 10 MG/ML INTRAVENOUS SOLUTION,10922.24,8191.68,131.07,9830.02,119
NDC,00069031501,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,1869.34,1402.0,22.43,1682.41,119
NDC,00069033621,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,42218.25,31663.69,506.62,37996.43,119
NDC,00069034201,BEVACIZUMAB-BVZR 25 MG/ML INTRAVENOUS SOLUTION,7477.35,5608.01,89.73,6729.62,119
NDC,00069034401,"RESP SYNCYTIAL VIRUS VAC, PREF A AND B (PF) 120 MCG/0.5 ML IM SOLUTION",1178.11,883.58,14.14,1060.3,119
NDC,00069080901,INFLIXIMAB-DYYB 100 MG INTRAVENOUS SOLUTION,2693.11,2019.83,32.32,2423.8,119
NDC,00069152068,AMLODIPINE 2.5 MG TABLET,50.83,38.12,0.61,45.75,119
NDC,00069252801,COVID VACC 2025-2026 (12 YRS UP) (PFIZER)(PF) 30 MCG/0.3 ML IM SYRINGE,292.49,219.37,3.51,263.24,119
NDC,00069547101,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,122.9,92.17,1.47,110.61,119
NDC,00069547401,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,491.58,368.68,5.9,442.42,119
NDC,00069547402,FOSPHENYTOIN 500 MG PE/10 ML INJECTION SOLUTION,491.58,368.68,5.9,442.42,119
NDC,00071374066,PHENYTOIN SODIUM EXTENDED 30 MG CAPSULE,8.71,6.53,0.1,7.84,119
NDC,00074231030,"UPADACITINIB ER 30 MG TABLET,EXTENDED RELEASE 24 HR",864.35,648.27,10.37,777.92,119
NDC,00074262501,GLECAPREVIR 100 MG-PIBRENTASVIR 40 MG TABLET,652.14,489.11,7.83,586.93,119
NDC,00074262528,GLECAPREVIR 100 MG-PIBRENTASVIR 40 MG TABLET,652.14,489.11,7.83,586.93,119
NDC,00074310832,CYCLOSPORINE MODIFIED 25 MG CAPSULE (GENGRAF),11.03,8.28,0.13,9.93,119
NDC,00074310932,CYCLOSPORINE MODIFIED 100 MG CAPSULE (GENGRAF),44.08,33.06,0.53,39.67,119
NDC,00074334603,LEUPROLIDE ACETATE 22.5 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,16567.24,12425.43,198.81,14910.52,119
NDC,00074347303,LEUPROLIDE ACETATE (6 MONTH) 45 MG INTRAMUSCULAR SYRINGE KIT,29117.14,21837.85,349.41,26205.43,119
NDC,00074364103,LEUPROLIDE 3.75 MG INTRAMUSCULAR SYRINGE KIT,4950.35,3712.76,59.4,4455.32,119
NDC,00074364203,LEUPROLIDE 7.5 MG INTRAMUSCULAR SYRINGE KIT,5899.13,4424.35,70.79,5309.22,119
NDC,00074366303,LEUPROLIDE ACETATE 11.25 MG (3 MONTH) INTRAMUSCULAR SYRINGE KIT,13902.87,10427.15,166.83,12512.58,119
NDC,00074368303,LEUPROLIDE 30 MG (4 MONTH) INTRAMUSCULAR SYRINGE KIT,22089.72,16567.29,265.08,19880.75,119
NDC,00074463701,PARICALCITOL 2 MCG/ML INTRAVENOUS SOLUTION,36.36,27.27,0.44,32.72,119
NDC,00074501501,RISANKIZUMAB-RZAA 60 MG/ML INTRAVENOUS SOLUTION,29222.11,21916.58,350.67,26299.9,119
NDC,00074897510,CYSTEINE (L-CYSTEINE) 50 MG/ML INTRAVENOUS SOLUTION,50.78,38.08,0.61,45.7,119
NDC,00078010901,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION (SANDIMMUNE),307.85,230.88,3.69,277.07,119
NDC,00078010961,CYCLOSPORINE 250 MG/5 ML INTRAVENOUS SOLUTION (SANDIMMUNE),307.89,230.92,3.69,277.1,119
NDC,00078024615,CYCLOSPORINE MODIFIED 25 MG CAPSULE (NEORAL),16.07,12.05,0.19,14.46,119
NDC,00078033184,BASILIXIMAB 20 MG INTRAVENOUS SOLUTION,12285.16,9213.87,147.42,11056.64,119
NDC,00078056845,ARTEMETHER-LUMEFANTRINE 20 MG-120 MG TABLET,33.69,25.27,0.4,30.32,119
NDC,00078065920,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,00078068615,ELTROMBOPAG OLAMINE 50 MG TABLET,1678.61,1258.96,20.14,1510.75,119
NDC,00078068715,ELTROMBOPAG OLAMINE 75 MG TABLET,2517.92,1888.44,30.22,2266.13,119
NDC,00078069620,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,00078077720,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,00078081301,TOBRAMYCIN 0.3 % EYE OINTMENT,1057.33,793.0,12.69,951.6,119
NDC,00078081881,"OCTREOTIDE,MICROSPHERES ER 20 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",12687.9,9515.93,152.25,11419.11,119
NDC,00078082581,"OCTREOTIDE,MICROSPHERES ER 30 MG INTRAMUSCULAR SUSP, EXTENDED RELEASE",17786.02,13339.51,213.43,16007.42,119
NDC,00078084101,CIPROFLOXACIN 0.3 % EYE OINTMENT,1128.17,846.13,13.54,1015.35,119
NDC,00078087601,TOBRAMYCIN-DEXAMETHASONE 0.3 %-0.1 % EYE OINTMENT,1125.64,844.23,13.51,1013.08,119
NDC,00078091105,LIFITEGRAST 5 % EYE DROPS IN A DROPPERETTE,60.0,45.0,0.72,54.0,119
NDC,00078100060,INCLISIRAN 284 MG/1.5 ML SUBCUTANEOUS SYRINGE,12603.49,9452.62,151.24,11343.14,119
NDC,00087074002,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,53.4,40.05,0.64,48.06,119
NDC,00087086644,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,49.2,36.9,0.59,44.28,119
NDC,00088222033,INSULIN GLARGINE (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,385.56,289.17,4.63,347.0,119
NDC,00093077198,PRAVASTATIN 10 MG TABLET,1.59,1.19,0.02,1.43,119
NDC,00093081105,NORTRIPTYLINE 25 MG CAPSULE,1.55,1.17,0.02,1.4,119
NDC,00093106101,SOTALOL 80 MG TABLET,1.68,1.26,0.02,1.51,119
NDC,00093117701,NEOMYCIN 500 MG TABLET,6.66,5.0,0.08,5.99,119
NDC,00093171201,WARFARIN 1 MG TABLET,1.31,0.98,0.02,1.18,119
NDC,00093171401,WARFARIN 2.5 MG TABLET,1.41,1.06,0.02,1.27,119
NDC,00093172001,WARFARIN 10 MG TABLET,2.18,1.64,0.03,1.96,119
NDC,00093172101,WARFARIN 5 MG TABLET,1.43,1.07,0.02,1.29,119
NDC,00093206406,CILOSTAZOL 100 MG TABLET,2.19,1.64,0.03,1.97,119
NDC,00093206506,CILOSTAZOL 50 MG TABLET,1.91,1.43,0.02,1.72,119
NDC,00093312901,DISOPYRAMIDE PHOSPHATE 150 MG CAPSULE,13.48,10.11,0.16,12.13,119
NDC,00093342501,LORAZEPAM 0.5 MG TABLET,0.26,0.2,0.01,0.23,119
NDC,00093342701,LORAZEPAM 2 MG TABLET,0.46,0.35,0.01,0.41,119
NDC,00093363020,ACYCLOVIR 5 % TOPICAL CREAM,3027.3,2270.48,36.33,2724.57,119
NDC,00093770198,LEVOCETIRIZINE 5 MG TABLET,2.0,1.5,0.02,1.8,119
NDC,00093811956,FAMCICLOVIR 500 MG TABLET,19.38,14.54,0.23,17.44,119
NDC,00093914801,VENLAFAXINE 37.5 MG TABLET,1.93,1.44,0.02,1.74,119
NDC,00093970101,CARBIDOPA 10 MG-LEVODOPA 100 MG TABLET,1.33,1.0,0.02,1.2,119
NDC,00115136529,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,11.66,8.75,0.14,10.49,119
NDC,00115136530,SEVELAMER CARBONATE 0.8 GRAM ORAL POWDER PACKET,11.66,8.75,0.14,10.49,119
NDC,00115169449,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",622.5,466.88,7.47,560.25,119
NDC,00115441101,DANTROLENE 25 MG CAPSULE,4.86,3.65,0.06,4.37,119
NDC,00116200116,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH (REPACKAGING),31.22,23.41,0.37,28.1,119
NDC,00121043130,MAGNESIUM HYDROXIDE 400 MG/5 ML ORAL SUSPENSION,11.7,8.77,0.14,10.53,119
NDC,00121048905,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL ELIXIR,24.99,18.74,0.3,22.49,119
NDC,00121063805,DEXTROMETHORPHAN-GUAIFENESIN 10 MG-100 MG/5 ML ORAL SYRUP,12.48,9.36,0.15,11.23,119
NDC,00121064610,AMANTADINE HCL 50 MG/5 ML ORAL SOLUTION,23.7,17.77,0.28,21.33,119
NDC,00121090405,MORPHINE 10 MG/5 ML ORAL SOLUTION,8.13,6.1,0.1,7.32,119
NDC,00121094216,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,215.69,161.77,2.59,194.12,119
NDC,00121097410,SUCRALFATE 100 MG/ML ORAL SUSPENSION,54.0,40.5,0.65,48.6,119
NDC,00121115430,LACTULOSE 20 GRAM/30 ML ORAL SOLUTION,10.98,8.24,0.13,9.88,119
NDC,00121119030,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION (REPACKAGING),30.42,22.82,0.37,27.38,119
NDC,00121131411,ACETAMINOPHEN 325 MG/10.15 ML ORAL SOLUTION,10.9,8.18,0.13,9.81,119
NDC,00121157610,METOCLOPRAMIDE 5 MG/5 ML ORAL SOLUTION,24.3,18.23,0.29,21.87,119
NDC,00121176230,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP (REPACKAGING),22.68,17.01,0.27,20.41,119
NDC,00121178105,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,6.96,5.22,0.08,6.26,119
NDC,00121179620,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,217.5,163.12,2.61,195.75,119
NDC,00121187010,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,11.1,8.32,0.13,9.99,119
NDC,00121231615,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,27.99,20.99,0.34,25.19,119
NDC,00121467505,VALPROIC ACID (AS SODIUM SALT) 250 MG/5 ML (5 ML) ORAL SOLUTION,8.22,6.17,0.1,7.4,119
NDC,00121472105,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,34.2,25.65,0.41,30.78,119
NDC,00121476605,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",15.36,11.52,0.18,13.82,119
NDC,00121479905,LEVETIRACETAM 500 MG/5 ML (5 ML) ORAL SOLUTION,34.5,25.88,0.41,31.05,119
NDC,00121482705,OXYCODONE 5 MG/5 ML ORAL SOLUTION,37.17,27.88,0.45,33.45,119
NDC,00121495015,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,36.99,27.74,0.44,33.29,119
NDC,00132019012,GLYCERIN (LAXATIVE) 2.8 GRAM/2.7 ML RECTAL SOLUTION,5.02,3.76,0.06,4.52,119
NDC,00132020140,SODIUM PHOSPHATES 19 GRAM-7 GRAM/118 ML ENEMA,6.38,4.79,0.08,5.74,119
NDC,00132020220,SODIUM PHOSPHATES 9.5 GRAM-3.5 GRAM/59 ML ENEMA,8.32,6.24,0.1,7.49,119
NDC,00132030140,MINERAL OIL ENEMA,11.97,8.98,0.14,10.77,119
NDC,00132070336,BISACODYL 10 MG/30 ML ENEMA,14.43,10.82,0.17,12.99,119
NDC,00135019902,METHYLCELLULOSE (LAXATIVE) 500 MG TABLET,0.89,0.67,0.01,0.8,119
NDC,00143909801,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,114.62,85.97,1.38,103.16,119
NDC,00143909801,BORTEZOMIB 3.5 MG SOLUTION FOR SUBCUTANEOUS INJECTION (UW),114.62,85.97,1.38,103.16,119
NDC,00143916201,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",36.0,27.0,0.43,32.4,119
NDC,00143916210,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",36.0,27.0,0.43,32.4,119
NDC,00143916401,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,332.0,249.0,3.98,298.8,119
NDC,00143923201,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00143923210,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00143924501,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
NDC,00143924510,DACARBAZINE 200 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
NDC,00143926201,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,6.31,4.73,0.08,5.68,119
NDC,00143926225,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,6.31,4.73,0.08,5.68,119
NDC,00143927901,MITOMYCIN 20 MG INTRAVENOUS SOLUTION,1798.67,1349.0,21.58,1618.8,119
NDC,00143928501,AMOXICILLIN 875 MG TABLET,2.62,1.96,0.03,2.36,119
NDC,00143929701,DANTROLENE 20 MG INTRAVENOUS SOLUTION,294.28,220.71,3.53,264.85,119
NDC,00143931001,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,00143931010,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,00143931110,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00143931601,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,12.6,9.45,0.15,11.34,119
NDC,00143937501,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,7.8,5.85,0.09,7.02,119
NDC,00143937510,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,7.8,5.85,0.09,7.02,119
NDC,00143938401,FOSAPREPITANT 150 MG INTRAVENOUS POWDER FOR SOLUTION,198.09,148.57,2.38,178.28,119
NDC,00143938401,FOSAPREPITANT 150 MG/5 ML (30 MG/ML) INTRAVENOUS SOLUTION (UW),198.09,148.57,2.38,178.28,119
NDC,00143950701,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,40.32,30.24,0.48,36.29,119
NDC,00143950901,KETAMINE 100 MG/ML INJECTION SOLUTION,76.44,57.33,0.92,68.8,119
NDC,00143951501,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,29.04,21.78,0.35,26.14,119
NDC,00143951525,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,29.04,21.78,0.35,26.14,119
NDC,00143951901,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,14.28,10.71,0.17,12.85,119
NDC,00143951910,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,14.28,10.71,0.17,12.85,119
NDC,00143955301,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,78.6,58.95,0.94,70.74,119
NDC,00143956410,PHENTOLAMINE 5 MG INJECTION SOLUTION,1881.46,1411.09,22.58,1693.31,119
NDC,00143959525,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,14.76,11.07,0.18,13.28,119
NDC,00143963301,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,975.6,731.7,11.71,878.04,119
NDC,00143963701,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,14.82,11.12,0.18,13.34,119
NDC,00143963710,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,14.82,11.12,0.18,13.34,119
NDC,00143967401,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,579.02,434.27,6.95,521.12,119
NDC,00143968401,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,119
NDC,00143970901,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,55.08,41.31,0.66,49.57,119
NDC,00143970910,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,55.08,41.31,0.66,49.57,119
NDC,00143971001,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,37.5,28.12,0.45,33.75,119
NDC,00143971010,MILRINONE 1 MG/ML INTRAVENOUS SOLUTION,37.5,28.12,0.45,33.75,119
NDC,00143971901,MILRINONE 20 MG/100 ML(200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS PIGGYBK,91.2,68.4,1.09,82.08,119
NDC,00143972001,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,37.8,28.35,0.45,34.02,119
NDC,00143972101,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,36.6,27.45,0.44,32.94,119
NDC,00143972901,BENZTROPINE 1 MG/ML INJECTION SOLUTION,270.0,202.5,3.24,243.0,119
NDC,00143972905,BENZTROPINE 1 MG/ML INJECTION SOLUTION,270.0,202.5,3.24,243.0,119
NDC,00143978401,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,119
NDC,00143978410,FLUMAZENIL 0.1 MG/ML INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,119
NDC,00143978501,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,103.71,77.78,1.24,93.34,119
NDC,00143978510,VALPROATE SODIUM 500 MG/5 ML (100 MG/ML) INTRAVENOUS SOLUTION,103.71,77.78,1.24,93.34,119
NDC,00143978701,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,31.85,23.89,0.38,28.67,119
NDC,00143978710,ENALAPRILAT 1.25 MG/ML INTRAVENOUS SOLUTION,31.85,23.89,0.38,28.67,119
NDC,00143985101,"METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION",188.5,141.38,2.26,169.65,119
NDC,00143985201,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,214.02,160.52,2.57,192.62,119
NDC,00143985210,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,214.02,160.52,2.57,192.62,119
NDC,00143987501,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,12.01,9.0,0.14,10.81,119
NDC,00143987525,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,12.01,9.0,0.14,10.81,119
NDC,00143992490,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,8.21,6.16,0.1,7.39,119
NDC,00143992950,CIPROFLOXACIN 750 MG TABLET,1.92,1.44,0.02,1.73,119
NDC,00143997722,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,24.85,18.63,0.3,22.36,119
NDC,00143997790,CEFUROXIME SODIUM 1.5 GRAM INTRAVENOUS SOLUTION,24.85,18.63,0.3,22.36,119
NDC,00168005760,BETAMETHASONE DIPROPIONATE 0.05 % LOTION,240.12,180.09,2.88,216.11,119
NDC,00168008031,HYDROCORTISONE 2.5 % TOPICAL CREAM,19.8,14.85,0.24,17.82,119
NDC,00168014630,HYDROCORTISONE 2.5 % TOPICAL OINTMENT,19.73,14.8,0.24,17.76,119
NDC,00168016260,CLOBETASOL 0.05 % TOPICAL OINTMENT,781.92,586.44,9.38,703.73,119
NDC,00168027740,CLINDAMYCIN 2 % VAGINAL CREAM,625.68,469.26,7.51,563.11,119
NDC,00169183311,INSULIN U-100 REGULAR HUMAN 100 UNIT/ML INJECTION SOLUTION,289.2,216.9,3.47,260.28,119
NDC,00169368512,INSULIN ASPAR PRT-INSULIN ASPART 100 UNIT/ML (70-30) SUBCUTANEOUS SOLN,434.04,325.53,5.21,390.64,119
NDC,00169368712,INSULIN DETEMIR (U-100) 100 UNIT/ML SUBCUTANEOUS SOLUTION,600.0,450.0,7.2,540.0,119
NDC,00169720101,"COAGULATION FACTOR VIIA RECOMB 1 MG (1,000 MCG) INTRAVENOUS SOLUTION",11.94,8.96,0.14,10.75,119
NDC,00172731320,CYCLOSPORINE MODIFIED 100 MG/ML ORAL SOLUTION,1414.8,1061.1,16.98,1273.32,119
NDC,00173068224,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,136.32,102.24,1.64,122.69,119
NDC,00173088101,MEPOLIZUMAB 100 MG SUBCUTANEOUS SOLUTION,9708.2,7281.15,116.5,8737.38,119
NDC,00173088714,FLUTICASONE FUR. 100 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,1680.0,1260.0,20.16,1512.0,119
NDC,00173089314,FLUTICASONE FUR. 200 MCG-UMECLID 62.5 MCG-VILANT 25 MCG INHALAT.POWDER,1680.0,1260.0,20.16,1512.0,119
NDC,00173089803,DOSTARLIMAB-GXLY 50 MG/ML INTRAVENOUS SOLUTION,32416.85,24312.64,389.0,29175.16,119
NDC,00179801230,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,12.61,9.46,0.15,11.35,119
NDC,00185012201,NITROFURANTOIN MONOHYDRATE/MACROCRYSTALS 100 MG CAPSULE,3.0,2.25,0.04,2.7,119
NDC,00186037028,BUDESONIDE-FORMOTEROL HFA 160 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,716.39,537.29,8.6,644.75,119
NDC,00186037228,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,622.8,467.1,7.47,560.52,119
NDC,00186077660,TICAGRELOR 60 MG TABLET,46.48,34.86,0.56,41.83,119
NDC,00186077739,TICAGRELOR 90 MG TABLET,46.48,34.86,0.56,41.83,119
NDC,00199180006,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,560.29,420.22,6.72,504.26,119
NDC,00225080547,PHENYLEPHRINE 0.5 % NASAL SPRAY,20.79,15.59,0.25,18.71,119
NDC,00228203110,ALPRAZOLAM 1 MG TABLET,0.37,0.27,0.01,0.33,119
NDC,00228212710,CLONIDINE HCL 0.1 MG TABLET,0.25,0.19,0.01,0.22,119
NDC,00228259711,INDAPAMIDE 1.25 MG TABLET,1.91,1.43,0.02,1.72,119
NDC,00228305911,"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",7.0,5.25,0.08,6.3,119
NDC,00228306211,"DEXTROAMPHETAMINE-AMPHETAMINE ER 5 MG 24HR CAPSULE,EXTEND RELEASE",7.0,5.25,0.08,6.3,119
NDC,00245014701,AMIODARONE 200 MG TABLET,2.24,1.68,0.03,2.02,119
NDC,00245014789,AMIODARONE 200 MG TABLET,2.22,1.66,0.03,2.0,119
NDC,00245036001,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,9.12,6.84,0.11,8.21,119
NDC,00245036089,POTASSIUM CHLORIDE 20 MEQ ORAL PACKET,9.12,6.84,0.11,8.21,119
NDC,00245531601,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",3.02,2.27,0.04,2.72,119
NDC,00245531689,"POTASSIUM CHLORIDE ER 10 MEQ TABLET,EXTENDED RELEASE",3.0,2.25,0.04,2.7,119
NDC,00254302902,LUBIPROSTONE 24 MCG CAPSULE,6.0,4.5,0.07,5.4,119
NDC,00264140000,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,66.06,49.54,0.79,59.45,119
NDC,00264180032,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,16.2,12.15,0.19,14.58,119
NDC,00264194420,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,141.0,105.75,1.69,126.9,119
NDC,00264194420,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),141.0,105.75,1.69,126.9,119
NDC,00264210100,"WATER FOR IRRIGATION, STERILE SOLUTION",24.0,18.0,0.29,21.6,119
NDC,00264751020,DEXTROSE 5 % IN WATER (D5W) (UW) IV BOLUS,22.5,16.88,0.27,20.25,119
NDC,00264751020,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,22.5,16.88,0.27,20.25,119
NDC,00264761000,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00264761010,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE (UW) IV BOLUS,24.0,18.0,0.29,21.6,119
NDC,00264762200,DEXTROSE 10 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,00264763800,POTASSIUM CHLORIDE 1.2 MEQ/30 ML (0.04 MEQ/ML) IN D5-1/2NS IV DRIP NEO/PED (PERIPHERAL LINE) (UW),60.0,45.0,0.72,54.0,119
NDC,00264773010,ELECTROLYTE-P IN DEXTROSE 5 % INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00264780510,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,33.0,24.75,0.4,29.7,119
NDC,00264780510,SODIUM CHLORIDE 3 % HYPERTONIC IV BOLUS (UW),33.0,24.75,0.4,29.7,119
NDC,00268024901,DILUENT FOR ALLERGENIC EXTRACTS NO.1 INJECTION SOLUTION,110.4,82.8,1.32,99.36,119
NDC,00270008320,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,267.3,200.48,3.21,240.57,119
NDC,00270009101,RUBIDIUM RB-82 CHLORIDE INTRAVENOUS SOLUTION,754.72,566.04,9.06,679.25,119
NDC,00270014957,DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLUTION,331.2,248.4,3.97,298.08,119
NDC,00270014960,DIATRIZOATE MEGLUMINE 30 % URETHRAL SOLUTION,184.8,138.6,2.22,166.32,119
NDC,00270044535,DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,138.42,103.82,1.66,124.58,119
NDC,00270044540,DIATRIZOATE MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION,398.88,299.16,4.79,358.99,119
NDC,00270131430,IOPAMIDOL 200 MG IODINE/ML (41 %) INJECTION SOLUTION,131.4,98.55,1.58,118.26,119
NDC,00270131525,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,132.3,99.22,1.59,119.07,119
NDC,00270131530,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,140.7,105.52,1.69,126.63,119
NDC,00270131535,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,274.8,206.1,3.3,247.32,119
NDC,00270131550,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,400.5,300.38,4.81,360.45,119
NDC,00270131595,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,1464.0,1098.0,17.57,1317.6,119
NDC,00270131598,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRAVENOUS SOLUTION,1170.0,877.5,14.04,1053.0,119
NDC,00270131604,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,360.75,270.56,4.33,324.68,119
NDC,00270131630,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,153.0,114.75,1.84,137.7,119
NDC,00270131635,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,304.8,228.6,3.66,274.32,119
NDC,00270131637,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,422.1,316.58,5.07,379.89,119
NDC,00270131641,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,1034.4,775.8,12.41,930.96,119
NDC,00270131645,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,607.2,455.4,7.29,546.48,119
NDC,00270131652,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,229.5,172.12,2.75,206.55,119
NDC,00270131695,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,1524.0,1143.0,18.29,1371.6,119
NDC,00270131698,IOPAMIDOL 370 MG IODINE/ML (76 %) INTRAVENOUS SOLUTION,1221.0,915.75,14.65,1098.9,119
NDC,00270131702,IOPAMIDOL 250 MG IODINE/ML (51 %) INTRAVENOUS SOLUTION,240.0,180.0,2.88,216.0,119
NDC,00270131705,IOPAMIDOL 250 MG IODINE/ML (51 %) INTRAVENOUS SOLUTION,135.3,101.48,1.62,121.77,119
NDC,00270141030,DIATRIZOATE MEGLUMINE 18 % URETHRAL SOLUTION,194.4,145.8,2.33,174.96,119
NDC,00270141111,IOPAMIDOL 200 MG IODINE/ML (41 %) INTRATHECAL SOLUTION,387.72,290.79,4.65,348.95,119
NDC,00270141125,IOPAMIDOL 200 MG IODINE/ML (41 %) INTRATHECAL SOLUTION,531.24,398.43,6.37,478.12,119
NDC,00270141215,IOPAMIDOL 300 MG IODINE/ML (61 %) INTRATHECAL SOLUTION,515.25,386.44,6.18,463.72,119
NDC,00270516412,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,177.87,133.4,2.13,160.08,119
NDC,00270516413,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,348.96,261.72,4.19,314.06,119
NDC,00270516414,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,510.66,383.0,6.13,459.59,119
NDC,00270516415,GADOBENATE DIMEGLUMINE 529 MG/ML(0.1 MMOL/0.2 ML) INTRAVENOUS SOLUTION,630.6,472.95,7.57,567.54,119
NDC,00281032608,NITROGLYCERIN 2 % TRANSDERMAL OINTMENT,14.53,10.9,0.17,13.08,119
NDC,00299024133,VIT E-GLYCERIN-DIMETHICONE LOTION,65.27,48.96,0.78,58.74,119
NDC,00310111001,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,129.23,96.92,1.55,116.31,119
NDC,00310111039,SODIUM ZIRCONIUM CYCLOSILICATE 10 GRAM ORAL POWDER PACKET,129.23,96.92,1.55,116.31,119
NDC,00310173030,BENRALIZUMAB 30 MG/ML SUBCUTANEOUS SYRINGE,15044.46,11283.34,180.53,13540.01,119
NDC,00310304000,ANIFROLUMAB-FNIA 300 MG/2 ML (150 MG/ML) INTRAVENOUS SOLUTION,14660.39,10995.29,175.92,13194.35,119
NDC,00310320004,"FACTOR XA,INACTIVATED-ZHZO (RECOMBINANT) 200 MG INTRAVENOUS SOLUTION",6871.25,5153.44,82.46,6184.12,119
NDC,00310453530,TREMELIMUMAB-ACTL 20 MG/ML INTRAVENOUS SOLUTION,111522.04,83641.53,1338.26,100369.84,119
NDC,00310461150,DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,11982.94,8987.21,143.8,10784.65,119
NDC,00310621039,DAPAGLIFLOZIN PROPANEDIOL 10 MG TABLET,89.96,67.47,1.08,80.96,119
NDC,00310737220,BUDESONIDE-FORMOTEROL HFA 80 MCG-4.5 MCG/ACTUATION AEROSOL INHALER,984.46,738.35,11.81,886.01,119
NDC,00316022530,MICONAZOLE NITRATE 2 % TOPICAL POWDER,33.15,24.86,0.4,29.84,119
NDC,00327000110,OXYCHLOROSENE SODIUM TOPICAL POWDER FOR SOLUTION,33.6,25.2,0.4,30.24,119
NDC,00338000402,"WATER FOR IRRIGATION, STERILE SOLUTION",28.5,21.38,0.34,25.65,119
NDC,00338001308,"WATER FOR INJECTION, STERILE INTRAVENOUS SOLUTION",72.0,54.0,0.86,64.8,119
NDC,00338001702,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,25.5,19.12,0.31,22.95,119
NDC,00338001703,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00338001704,DEXTROSE 5 % IN WATER (D5W) (UW) IV BOLUS,36.0,27.0,0.43,32.4,119
NDC,00338001704,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338001711,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,15.3,11.48,0.18,13.77,119
NDC,00338001748,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS SOLUTION,16.2,12.15,0.19,14.58,119
NDC,00338002302,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,37.5,28.12,0.45,33.75,119
NDC,00338002302,DEXTROSE 10% IN WATER (D10W) IV BOLUS (UW),37.5,28.12,0.45,33.75,119
NDC,00338002304,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,48.0,36.0,0.58,43.2,119
NDC,00338004303,SODIUM CHLORIDE 0.45 % (UW) IV BOLUS,27.0,20.25,0.32,24.3,119
NDC,00338004303,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,27.0,20.25,0.32,24.3,119
NDC,00338004304,SODIUM CHLORIDE 0.45 % INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338004804,SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00338004902,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,25.5,19.12,0.31,22.95,119
NDC,00338004902,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),25.5,19.12,0.31,22.95,119
NDC,00338004902,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),25.5,19.12,0.31,22.95,119
NDC,00338004903,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00338004903,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),24.0,18.0,0.29,21.6,119
NDC,00338004903,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),24.0,18.0,0.29,21.6,119
NDC,00338004904,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00338004904,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),30.0,22.5,0.36,27.0,119
NDC,00338004904,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),30.0,22.5,0.36,27.0,119
NDC,00338004910,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,00338004938,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,15.6,11.7,0.19,14.04,119
NDC,00338004941,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,15.3,11.48,0.18,13.77,119
NDC,00338004948,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,16.2,12.15,0.19,14.58,119
NDC,00338004948,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),16.2,12.15,0.19,14.58,119
NDC,00338004948,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),16.2,12.15,0.19,14.58,119
NDC,00338005403,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,39.0,29.25,0.47,35.1,119
NDC,00338005403,SODIUM CHLORIDE 3 % HYPERTONIC IV BOLUS (UW),39.0,29.25,0.47,35.1,119
NDC,00338006301,"DOXORUBICIN, PEGYLATED LIPOSOMAL 2 MG/ML INTRAVENOUS SUSPENSION",1048.52,786.39,12.58,943.67,119
NDC,00338007704,DEXTROSE 5 % AND 0.2 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338008504,DEXTROSE 5 % AND 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338008904,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE (UW) IV BOLUS,36.0,27.0,0.43,32.4,119
NDC,00338008904,DEXTROSE 5 % AND 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338011702,LACTATED RINGERS (UW),27.0,20.25,0.32,24.3,119
NDC,00338011702,LACTATED RINGERS INTRAVENOUS SOLUTION,27.0,20.25,0.32,24.3,119
NDC,00338011703,LACTATED RINGERS (UW),27.0,20.25,0.32,24.3,119
NDC,00338011703,LACTATED RINGERS INTRAVENOUS SOLUTION,27.0,20.25,0.32,24.3,119
NDC,00338011704,LACTATED RINGERS (UW),30.0,22.5,0.36,27.0,119
NDC,00338011704,LACTATED RINGERS INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00338012504,DEXTROSE 5 % AND LACTATED RINGERS INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00338012612,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,210.0,157.5,2.52,189.0,119
NDC,00338022104,ELECTROLYTE-A INTRAVENOUS SOLUTION,102.0,76.5,1.22,91.8,119
NDC,00338032201,"THROMBIN (RECOMBINANT) 5,000 UNIT TOPICAL SOLUTION",356.9,267.67,4.28,321.21,119
NDC,00338032601,"THROMBIN (RECOMBINANT) 20,000 UNIT TOPICAL SOLUTION",1320.96,990.72,15.85,1188.86,119
NDC,00338035702,MANNITOL 20 % INTRAVENOUS SOLUTION,300.0,225.0,3.6,270.0,119
NDC,00338041102,LIDOCAINE (PF) 8 MG/ML (0.8 %) IN 5 % DEXTROSE INTRAVENOUS SOLUTION,37.19,27.89,0.45,33.47,119
NDC,00338050206,PARENTERAL AMINO ACID 15 % COMBINATION NO.5 INTRAVENOUS SOLUTION,792.0,594.0,9.5,712.8,119
NDC,00338055118,DEXTROSE 5 % IN WATER (D5W) INTRAVENOUS PIGGYBACK,40.2,30.15,0.48,36.18,119
NDC,00338064406,PARENTERAL AMINO ACID 10 % COMBINATION NO.6 INTRAVENOUS SOLUTION,336.0,252.0,4.03,302.4,119
NDC,00338067103,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,57.0,42.75,0.68,51.3,119
NDC,00338067104,POTASSIUM CHLORIDE 20 MEQ/L IN DEXTROSE 5 %-0.45 % SODIUM CHLORIDE IV,36.0,27.0,0.43,32.4,119
NDC,00338069104,POTASSIUM CHLORIDE 20 MEQ/L IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,66.0,49.5,0.79,59.4,119
NDC,00338070348,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,24.6,18.45,0.3,22.14,119
NDC,00338070434,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,42.0,31.5,0.5,37.8,119
NDC,00338071906,DEXTROSE 70 % IN WATER (D70W) INTRAVENOUS SOLUTION,120.0,90.0,1.44,108.0,119
NDC,00338100502,DOPAMINE 200 MG/250 ML (800 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN,49.94,37.45,0.6,44.95,119
NDC,00338100902,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",118.5,88.88,1.42,106.65,119
NDC,00338104702,NITROGLYCERIN 25 MG/250 ML (100 MCG/ML) IN 5 % DEXTROSE  INTRAVENOUS,123.0,92.25,1.48,110.7,119
NDC,00338105102,NITROGLYCERIN 100 MG/250 ML (400 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS,147.0,110.25,1.76,132.3,119
NDC,00338107302,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,135.0,101.25,1.62,121.5,119
NDC,00338107702,"DOBUTAMINE 1,000 MG/250 ML (4 MG/ML) IN 5 % DEXTROSE IV DRIP",175.5,131.62,2.11,157.95,119
NDC,00338113003,PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,324.0,243.0,3.89,291.6,119
NDC,00338113004,PARENTERAL AMINO ACID 10 % COMBINATION NO.7 INTRAVENOUS SOLUTION,600.0,450.0,7.2,540.0,119
NDC,00338114803,AMINO ACID 5 % NO.6-DEXTROSE 20 %-ELECTROLYTES NO.23 IV SOLUTION,270.0,202.5,3.24,243.0,119
NDC,00338358301,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE 1 GRAM OR LESS),142.8,107.1,1.71,128.52,119
NDC,00338358301,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE GREATER THAN 1 GRAM),142.8,107.1,1.71,128.52,119
NDC,00338361224,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.2,48.15,0.77,57.78,119
NDC,00338702201,AMINO ACID 4.25 % NO.1-DEXTROSE 5 %-ELECTROLYTES NO.39 IV SOLUTION,258.0,193.5,3.1,232.2,119
NDC,00338702404,AMINO ACID 4.25 % NO.1-DEXTROSE 5 %-ELECTROLYTES NO.39 IV SOLUTION,480.0,360.0,5.76,432.0,119
NDC,00338915930,SODIUM CHLORIDE 0.9 % INTRAVENOUS PIGGYBACK,43.2,32.4,0.52,38.88,119
NDC,00338954302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,31.5,23.62,0.38,28.35,119
NDC,00338954302,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),31.5,23.62,0.38,28.35,119
NDC,00338954302,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),31.5,23.62,0.38,28.35,119
NDC,00338954304,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,33.0,24.75,0.4,29.7,119
NDC,00338954304,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),33.0,24.75,0.4,29.7,119
NDC,00338954304,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),33.0,24.75,0.4,29.7,119
NDC,00338955712,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,168.6,126.45,2.02,151.74,119
NDC,00338979101,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,25.5,19.12,0.31,22.95,119
NDC,00338979101,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION FOR EXTRACORPOREAL PRIME (PRE-DIALYSIS ONLY),25.5,19.12,0.31,22.95,119
NDC,00338979101,SODIUM CHLORIDE 0.9 % IV BOLUS (UW),25.5,19.12,0.31,22.95,119
NDC,00362055705,"BUPIVACAINE 0.5 %-EPINEPHRINE BITARTRATE 1:200,000 INJECTION,CARTRIDGE",20.48,15.36,0.25,18.43,119
NDC,00362901150,"BUPIVACAINE 0.5 %-EPINEPHRINE BITARTRATE 1:200,000 INJECTION,CARTRIDGE",7.5,5.62,0.09,6.75,119
NDC,00378087116,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,119.24,89.43,1.43,107.32,119
NDC,00378087199,CLONIDINE 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,119.24,89.43,1.43,107.32,119
NDC,00378087299,CLONIDINE 0.2 MG/24 HR WEEKLY TRANSDERMAL PATCH,200.76,150.57,2.41,180.68,119
NDC,00378334999,ESTRADIOL 0.025 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
NDC,00378335099,ESTRADIOL 0.05 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
NDC,00378335116,ESTRADIOL 0.075 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
NDC,00378335299,ESTRADIOL 0.1 MG/24 HR WEEKLY TRANSDERMAL PATCH,83.54,62.66,1.0,75.19,119
NDC,00378354752,MERCAPTOPURINE 50 MG TABLET,19.02,14.26,0.23,17.12,119
NDC,00378520877,AMLODIPINE 2.5 MG TABLET,0.52,0.39,0.01,0.47,119
NDC,00378580793,VALSARTAN 40 MG TABLET,1.6,1.2,0.02,1.44,119
NDC,00378623201,CITALOPRAM 20 MG TABLET,0.49,0.36,0.01,0.44,119
NDC,00378699331,LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,32.15,24.12,0.39,28.94,119
NDC,00378699393,LEVALBUTEROL CONCENTRATE 1.25 MG/0.5 ML SOLUTION FOR NEBULIZATION,32.15,24.12,0.39,28.94,119
NDC,00378727285,NORETHINDRONE (CONTRACEPTIVE) 0.35 MG TABLET,0.8,0.6,0.01,0.72,119
NDC,00378808245,TRETINOIN 0.025 % TOPICAL CREAM,950.94,713.2,11.41,855.85,119
NDC,00378876058,CYCLOSPORINE 0.05 % EYE DROPS IN A DROPPERETTE,23.0,17.25,0.28,20.7,119
NDC,00378912416,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,124.01,93.01,1.49,111.61,119
NDC,00395100392,GENTIAN VIOLET 1 % TOPICAL SOLUTION,42.48,31.86,0.51,38.23,119
NDC,00395103116,GLYCERIN 99.5 % TOPICAL SOLUTION,127.71,95.78,1.53,114.94,119
NDC,00395103196,GLYCERIN 99.5% RECTAL ENEMA SOLUTION (UW),42.48,31.86,0.51,38.23,119
NDC,00406012323,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,2.64,1.98,0.03,2.38,119
NDC,00406012362,HYDROCODONE 5 MG-ACETAMINOPHEN 325 MG TABLET,2.64,1.98,0.03,2.38,119
NDC,00406012423,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,2.92,2.19,0.04,2.63,119
NDC,00406012462,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG TABLET,2.92,2.19,0.04,2.63,119
NDC,00406012523,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,2.96,2.22,0.04,2.66,119
NDC,00406012562,HYDROCODONE 10 MG-ACETAMINOPHEN 325 MG TABLET,2.96,2.22,0.04,2.66,119
NDC,00406051223,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,2.46,1.84,0.03,2.21,119
NDC,00406051262,OXYCODONE-ACETAMINOPHEN 5 MG-325 MG TABLET,2.44,1.83,0.03,2.2,119
NDC,00406052223,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,9.6,7.2,0.12,8.64,119
NDC,00406052262,OXYCODONE-ACETAMINOPHEN 7.5 MG-325 MG TABLET,9.62,7.21,0.12,8.66,119
NDC,00406052323,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,11.34,8.5,0.14,10.21,119
NDC,00406052362,OXYCODONE-ACETAMINOPHEN 10 MG-325 MG TABLET,11.36,8.52,0.14,10.22,119
NDC,00406052710,METHADONE 10 MG/ML ORAL CONCENTRATE,468.0,351.0,5.62,421.2,119
NDC,00406055223,OXYCODONE 5 MG TABLET,2.7,2.03,0.03,2.43,119
NDC,00406114401,METHYLPHENIDATE 10 MG TABLET,1.69,1.26,0.02,1.52,119
NDC,00406117003,NALTREXONE 50 MG TABLET,11.61,8.71,0.14,10.45,119
NDC,00406324301,HYDROMORPHONE 2 MG TABLET,1.13,0.85,0.01,1.02,119
NDC,00406324401,HYDROMORPHONE 4 MG TABLET,1.32,0.99,0.02,1.19,119
NDC,00406575523,METHADONE 5 MG TABLET,1.74,1.3,0.02,1.57,119
NDC,00406577123,METHADONE 10 MG TABLET,1.98,1.48,0.02,1.78,119
NDC,00406577162,METHADONE 10 MG TABLET,2.1,1.58,0.03,1.89,119
NDC,00406833023,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",9.54,7.15,0.11,8.59,119
NDC,00406833062,"MORPHINE ER 30 MG TABLET,EXTENDED RELEASE",9.55,7.16,0.11,8.6,119
NDC,00406855730,OXYCODONE 20 MG/ML ORAL CONCENTRATE,660.06,495.04,7.92,594.05,119
NDC,00406996001,TEMAZEPAM 7.5 MG CAPSULE,15.96,11.97,0.19,14.36,119
NDC,00406996101,TEMAZEPAM 15 MG CAPSULE,0.56,0.42,0.01,0.5,119
NDC,00407141120,IOHEXOL 180 MG IODINE/ML INTRATHECAL SOLUTION,268.44,201.33,3.22,241.6,119
NDC,00407141210,IOHEXOL 240 MG IODINE/ML INTRAVENOUS SOLUTION,261.24,195.93,3.13,235.12,119
NDC,00407141230,IOHEXOL 240 MG IODINE/ML INTRAVENOUS SOLUTION,235.2,176.4,2.82,211.68,119
NDC,00407141310,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,241.2,180.9,2.89,217.08,119
NDC,00407141351,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,270.0,202.5,3.24,243.0,119
NDC,00407141359,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,249.84,187.38,3.0,224.86,119
NDC,00407141361,IOHEXOL 300 MG IODINE/ML INTRAVENOUS SOLUTION,278.1,208.58,3.34,250.29,119
NDC,00407141491,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,605.4,454.05,7.26,544.86,119
NDC,00407141493,IOHEXOL 350 MG IODINE/ML INTRAVENOUS SOLUTION,835.2,626.4,10.02,751.68,119
NDC,00409012501,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,23.76,17.82,0.29,21.38,119
NDC,00409012525,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,23.76,17.82,0.29,21.38,119
NDC,00409015201,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,12.6,9.45,0.15,11.34,119
NDC,00409018201,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,972.23,729.17,11.67,875.01,119
NDC,00409018301,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,39.66,29.74,0.48,35.69,119
NDC,00409018601,GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION,163.75,122.81,1.96,147.38,119
NDC,00409033220,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,84.27,63.2,1.01,75.84,119
NDC,00409114112,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,79.2,59.4,0.95,71.28,119
NDC,00409116202,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,14.76,11.07,0.18,13.28,119
NDC,00409116501,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,16.14,12.1,0.19,14.53,119
NDC,00409116518,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,16.14,12.1,0.19,14.53,119
NDC,00409117630,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,36.24,27.18,0.43,32.62,119
NDC,00409117803,MEPERIDINE (PF) 50 MG/ML INJECTION SYRINGE,45.32,33.99,0.54,40.79,119
NDC,00409121941,NALOXONE 0.4 MG/ML INJECTION SOLUTION,600.0,450.0,7.2,540.0,119
NDC,00409127303,DIAZEPAM 5 MG/ML INJECTION SYRINGE,151.48,113.61,1.82,136.33,119
NDC,00409127332,DIAZEPAM 5 MG/ML INJECTION SYRINGE,151.48,113.61,1.82,136.33,119
NDC,00409136201,MEPERIDINE (PF) 25 MG/ML INJECTION SYRINGE,58.42,43.81,0.7,52.58,119
NDC,00409146301,NALBUPHINE 10 MG/ML INJECTION SOLUTION,26.75,20.06,0.32,24.08,119
NDC,00409146371,NALBUPHINE 10 MG/ML INJECTION SOLUTION,26.75,20.06,0.32,24.08,119
NDC,00409163401,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.25,45.19,0.72,54.22,119
NDC,00409163485,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.25,45.19,0.72,54.22,119
NDC,00409166020,DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,159.12,119.34,1.91,143.21,119
NDC,00409166022,DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,159.12,119.34,1.91,143.21,119
NDC,00409174610,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",40.32,30.24,0.48,36.29,119
NDC,00409174630,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",69.66,52.24,0.84,62.69,119
NDC,00409174670,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",40.32,30.24,0.48,36.29,119
NDC,00409174671,"BUPIVACAINE-EPINEPHRINE (PF) 0.25 %-1:200,000 INJECTION SOLUTION",69.66,52.24,0.84,62.69,119
NDC,00409174929,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",58.86,44.14,0.71,52.97,119
NDC,00409174971,"BUPIVACAINE-EPINEPHRINE (PF) 0.5 %-1:200,000 INJECTION SOLUTION",58.86,44.14,0.71,52.97,119
NDC,00409175250,"BUPIVACAINE-EPINEPHRINE 0.25 %-1:200,000 INJECTION SOLUTION",102.0,76.5,1.22,91.8,119
NDC,00409177510,DEXTROSE 25 % IN WATER (D25W) INTRAVENOUS SYRINGE,112.26,84.2,1.35,101.03,119
NDC,00409177805,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,7.77,5.83,0.09,6.99,119
NDC,00409177815,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,7.77,5.83,0.09,6.99,119
NDC,00409188602,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,23.34,17.5,0.28,21.01,119
NDC,00409188622,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,23.34,17.5,0.28,21.01,119
NDC,00409189001,MORPHINE 2 MG/ML PF INTRAVENOUS SYRINGE,12.77,9.58,0.15,11.49,119
NDC,00409189003,MORPHINE 2 MG/ML PF INTRAVENOUS SYRINGE,12.77,9.58,0.15,11.49,119
NDC,00409205105,KETAMINE 100 MG/ML INJECTION SOLUTION,49.89,37.42,0.6,44.9,119
NDC,00409205115,KETAMINE 100 MG/ML INJECTION SOLUTION,49.89,37.42,0.6,44.9,119
NDC,00409230516,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,7.08,5.31,0.08,6.37,119
NDC,00409230517,MIDAZOLAM (PF) 1 MG/ML INJECTION SOLUTION,7.08,5.31,0.08,6.37,119
NDC,00409230801,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,6.97,5.22,0.08,6.27,119
NDC,00409230849,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,6.89,5.17,0.08,6.2,119
NDC,00409230869,MIDAZOLAM (PF) 5 MG/ML INJECTION SOLUTION,6.89,5.17,0.08,6.2,119
NDC,00409233725,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,174.53,130.9,2.09,157.08,119
NDC,00409233924,LABETALOL 20 MG/4 ML (5 MG/ML) INTRAVENOUS SYRINGE,54.5,40.88,0.65,49.05,119
NDC,00409234631,DOBUTAMINE 250 MG/250 ML (1 MG/ML) IN 5 % DEXTROSE INTRAVENOUS,72.0,54.0,0.86,64.8,119
NDC,00409263450,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,735.0,551.25,8.82,661.5,119
NDC,00409272330,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",12.12,9.09,0.15,10.91,119
NDC,00409329451,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,67.2,50.4,0.81,60.48,119
NDC,00409329451,POTASSIUM ACETATE 2 MEQ/ML IV(UW),67.2,50.4,0.81,60.48,119
NDC,00409329906,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,38.4,28.8,0.46,34.56,119
NDC,00409329906,SODIUM ACETATE 2 MEQ/ML IV(UW),38.4,28.8,0.46,34.56,119
NDC,00409329916,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,38.4,28.8,0.46,34.56,119
NDC,00409329925,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,35.4,26.55,0.42,31.86,119
NDC,00409329945,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,35.4,26.55,0.42,31.86,119
NDC,00409330001,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,24.0,18.0,0.29,21.6,119
NDC,00409338211,SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION,56.62,42.46,0.68,50.96,119
NDC,00409338221,SUFENTANIL CITRATE 50 MCG/ML INTRAVENOUS SOLUTION,56.62,42.46,0.68,50.96,119
NDC,00409361301,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,17.1,12.82,0.21,15.39,119
NDC,00409361311,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION,17.1,12.82,0.21,15.39,119
NDC,00409379319,KETOROLAC 15 MG/ML INJECTION SOLUTION,18.05,13.54,0.22,16.24,119
NDC,00409381411,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,120.9,90.68,1.45,108.81,119
NDC,00409381412,MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION,120.9,90.68,1.45,108.81,119
NDC,00409403101,MANNITOL 25 % INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,119
NDC,00409403116,MANNITOL 25 % INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,119
NDC,00409409101,MANGANESE CHLORIDE 0.1 MG/ML INTRAVENOUS SOLUTION,223.68,167.76,2.68,201.31,119
NDC,00409409201,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,190.26,142.7,2.28,171.23,119
NDC,00409409211,CUPRIC CHLORIDE 0.4 MG/ML INTRAVENOUS SOLUTION,190.26,142.7,2.28,171.23,119
NDC,00409409301,CHROMIUM CHLORIDE 4 MCG/ML INTRAVENOUS SOLUTION,118.98,89.24,1.43,107.08,119
NDC,00409427601,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,9.48,7.11,0.11,8.53,119
NDC,00409427616,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,9.48,7.11,0.11,8.53,119
NDC,00409427902,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,19.62,14.72,0.24,17.66,119
NDC,00409427916,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,19.62,14.72,0.24,17.66,119
NDC,00409428311,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,29.01,21.76,0.35,26.11,119
NDC,00409428325,LIDOCAINE (PF) 40 MG/ML (4 %) INJECTION SOLUTION,29.01,21.76,0.35,26.11,119
NDC,00409433201,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,48.97,36.72,0.59,44.07,119
NDC,00409433211,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,48.97,36.72,0.59,44.07,119
NDC,00409444401,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,21.6,16.2,0.26,19.44,119
NDC,00409452002,HEPARIN (PORCINE) 100 UNIT/ML IN DEXTROSE 5 % IV BOLUS (UW),66.0,49.5,0.79,59.4,119
NDC,00409452002,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",66.0,49.5,0.79,59.4,119
NDC,00409475901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,43.2,32.4,0.52,38.88,119
NDC,00409555502,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,46.47,34.85,0.56,41.82,119
NDC,00409555512,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,46.47,34.85,0.56,41.82,119
NDC,00409582001,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,24.03,18.02,0.29,21.63,119
NDC,00409582011,DOPAMINE 200 MG/5 ML (40 MG/ML) INTRAVENOUS SOLUTION,24.03,18.02,0.29,21.63,119
NDC,00409592101,AMINOPHYLLINE 250 MG/10 ML INTRAVENOUS SOLUTION,109.08,81.81,1.31,98.17,119
NDC,00409592201,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.2,52.65,0.84,63.18,119
NDC,00409592216,AMINOPHYLLINE 500 MG/20 ML INTRAVENOUS SOLUTION,70.2,52.65,0.84,63.18,119
NDC,00409610210,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,35.04,26.28,0.42,31.54,119
NDC,00409610220,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,35.04,26.28,0.42,31.54,119
NDC,00409610225,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,20.52,15.39,0.25,18.47,119
NDC,00409610227,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00409610235,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,20.52,15.39,0.25,18.47,119
NDC,00409648201,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,396.03,297.02,4.75,356.43,119
NDC,00409648211,ERYTHROMYCIN LACTOBIONATE 500 MG INTRAVENOUS SOLUTION,396.03,297.02,4.75,356.43,119
NDC,00409653311,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",73.26,54.95,0.88,65.93,119
NDC,00409653321,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",73.26,54.95,0.88,65.93,119
NDC,00409653331,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",16.19,12.15,0.19,14.57,119
NDC,00409658101,"BUPIVACAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",98.1,73.57,1.18,88.29,119
NDC,00409662514,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,59.1,44.32,0.71,53.19,119
NDC,00409662522,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,59.1,44.32,0.71,53.19,119
NDC,00409664802,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,28.5,21.38,0.34,25.65,119
NDC,00409664816,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SOLUTION,28.5,21.38,0.34,25.65,119
NDC,00409672903,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,33.0,24.75,0.4,29.7,119
NDC,00409703701,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,42.96,32.22,0.52,38.66,119
NDC,00409703710,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,42.96,32.22,0.52,38.66,119
NDC,00409729501,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,88.74,66.55,1.06,79.87,119
NDC,00409729511,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,88.74,66.55,1.06,79.87,119
NDC,00409729973,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,119
NDC,00409729983,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,19.2,14.4,0.23,17.28,119
NDC,00409733211,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,9.14,6.85,0.11,8.23,119
NDC,00409733220,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,7.5,5.62,0.09,6.75,119
NDC,00409733221,CEFTRIAXONE 1 GRAM SOLUTION FOR INJECTION,9.14,6.85,0.11,8.23,119
NDC,00409733503,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,17.36,13.02,0.21,15.62,119
NDC,00409733513,CEFTRIAXONE 2 GRAM SOLUTION FOR INJECTION,17.36,13.02,0.21,15.62,119
NDC,00409733711,CEFTRIAXONE 250 MG SOLUTION FOR INJECTION,4.57,3.43,0.05,4.11,119
NDC,00409733801,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,5.79,4.34,0.07,5.21,119
NDC,00409733820,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,5.79,4.34,0.07,5.21,119
NDC,00409733821,CEFTRIAXONE 500 MG SOLUTION FOR INJECTION,5.79,4.34,0.07,5.21,119
NDC,00409739172,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,109.62,82.22,1.32,98.66,119
NDC,00409762049,"HEPARIN (PORCINE) (PF) 2,000 UNIT/1,000 ML IN 0.9 % SODIUM CHLORIDE IV",42.0,31.5,0.5,37.8,119
NDC,00409765005,HEPARIN (PORCINE) 100 UNIT/ML IN 0.45 % SODIUM CHLORIDE IV BOLUS (UW),63.75,47.81,0.76,57.38,119
NDC,00409765005,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",63.75,47.81,0.76,57.38,119
NDC,00409781011,"DOPAMINE 800 MG/250 ML (3,200 MCG/ML) IN 5 % DEXTROSE INTRAVENOUS SOLN",136.5,102.38,1.64,122.85,119
NDC,00409818301,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,22.8,17.1,0.27,20.52,119
NDC,00409818311,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,22.8,17.1,0.27,20.52,119
NDC,00409909412,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,11.46,8.6,0.14,10.31,119
NDC,00409909416,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,46.56,34.92,0.56,41.9,119
NDC,00409909422,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,11.46,8.6,0.14,10.31,119
NDC,00409909431,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,46.56,34.92,0.56,41.9,119
NDC,00456040001,CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,119
NDC,00456040010,CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,119
NDC,00456045801,THYROID (PORK) 30 MG TABLET,6.07,4.55,0.07,5.46,119
NDC,00456045901,THYROID (PORK) 60 MG TABLET,6.74,5.05,0.08,6.07,119
NDC,00456060001,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,119
NDC,00456060010,CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION,988.65,741.49,11.86,889.78,119
NDC,00456120130,LINACLOTIDE 145 MCG CAPSULE,85.19,63.9,1.02,76.67,119
NDC,00456120230,LINACLOTIDE 290 MCG CAPSULE,85.19,63.9,1.02,76.67,119
NDC,00456120330,LINACLOTIDE 72 MCG CAPSULE,85.19,63.9,1.02,76.67,119
NDC,00456155060,MILNACIPRAN 50 MG TABLET,51.18,38.38,0.61,46.06,119
NDC,00456222030,"LEVOMILNACIPRAN ER 20 MG CAPSULE,24 HR,EXTENDED RELEASE",78.96,59.22,0.95,71.06,119
NDC,00456270001,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1595.0,1196.25,19.14,1435.5,119
NDC,00456270010,CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION,1595.0,1196.25,19.14,1435.5,119
NDC,00469042001,ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION,1089.7,817.28,13.08,980.73,119
NDC,00469052001,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,466.36,349.77,5.6,419.72,119
NDC,00469052002,ISAVUCONAZONIUM SULFATE 186 MG CAPSULE,466.36,349.77,5.6,419.72,119
NDC,00469060773,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",21.55,16.16,0.26,19.4,119
NDC,00469061773,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE (PROGRAF)",43.1,32.33,0.52,38.79,119
NDC,00469301601,TACROLIMUS 5 MG/ML INTRAVENOUS SOLUTION,704.67,528.5,8.46,634.2,119
NDC,00469342510,ZOLBETUXIMAB-CLZB 100 MG INTRAVENOUS SOLUTION,4397.6,3298.2,52.77,3957.84,119
NDC,00472103016,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,420.02,315.02,5.04,378.02,119
NDC,00480268806,TICAGRELOR 60 MG TABLET,40.15,30.11,0.48,36.14,119
NDC,00480331001,"THEOPHYLLINE ER 300 MG TABLET,EXTENDED RELEASE,12 HR",17.53,13.14,0.21,15.78,119
NDC,00486111101,"POTASSIUM PHOSPHATE, MONOBASIC 500 MG SOLUBLE TABLET",2.91,2.18,0.03,2.62,119
NDC,00487278401,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,12.0,9.0,0.14,10.8,119
NDC,00487590199,RACEPINEPHRINE 2.25 % SOLUTION FOR NEBULIZATION,12.0,9.0,0.14,10.8,119
NDC,00487950101,ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION,1.8,1.35,0.02,1.62,119
NDC,00487960101,BUDESONIDE 0.25 MG/2 ML SUSPENSION FOR NEBULIZATION,47.44,35.58,0.57,42.7,119
NDC,00487970101,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,55.82,41.87,0.67,50.24,119
NDC,00487990130,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,3.0,2.25,0.04,2.7,119
NDC,00496088205,LIDOCAINE 4 % TOPICAL CREAM,42.0,31.5,0.5,37.8,119
NDC,00496088206,LIDOCAINE 4 % TOPICAL CREAM,42.0,31.5,0.5,37.8,119
NDC,00517038101,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,119
NDC,00517038105,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,119
NDC,00517065001,FERRIC CARBOXYMALTOSE 50 MG IRON/ML INTRAVENOUS SOLUTION,6111.27,4583.45,73.34,5500.14,119
NDC,00517071001,FOMEPIZOLE 1 GRAM/ML INTRAVENOUS SOLUTION,6389.64,4792.23,76.68,5750.68,119
NDC,00517072001,BETAMETHASONE ACETATE AND SODIUM PHOS 6 MG/ML SUSPENSION FOR INJECTION,300.0,225.0,3.6,270.0,119
NDC,00517074001,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,136.66,102.5,1.64,122.99,119
NDC,00517074020,METHYLERGONOVINE 0.2 MG/ML (1 ML) INJECTION SOLUTION,136.66,102.5,1.64,122.99,119
NDC,00517100401,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00517100425,ATROPINE 0.4 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00517102001,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,119
NDC,00517102025,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,119
NDC,00517210201,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,287.73,215.8,3.45,258.96,119
NDC,00517210225,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,287.73,215.8,3.45,258.96,119
NDC,00517231005,IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION,425.0,318.75,5.1,382.5,119
NDC,00517234001,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,212.5,159.38,2.55,191.25,119
NDC,00517234025,IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION,212.5,159.38,2.55,191.25,119
NDC,00517400201,PAPAVERINE 30 MG/ML INJECTION SOLUTION,186.34,139.76,2.24,167.71,119
NDC,00517400225,PAPAVERINE 30 MG/ML INJECTION SOLUTION,186.34,139.76,2.24,167.71,119
NDC,00517430001,PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION,4504.71,3378.53,54.06,4054.24,119
NDC,00517481001,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,93.3,69.97,1.12,83.97,119
NDC,00517481025,NITROGLYCERIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,93.3,69.97,1.12,83.97,119
NDC,00517560125,HYDROXYZINE HCL 50 MG/ML INTRAMUSCULAR SOLUTION,138.92,104.19,1.67,125.03,119
NDC,00517610101,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,184.2,138.15,2.21,165.78,119
NDC,00517671001,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,85.94,64.45,1.03,77.35,119
NDC,00517671010,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,85.94,64.45,1.03,77.35,119
NDC,00517750401,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,62.4,46.8,0.75,56.16,119
NDC,00517750425,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,62.4,46.8,0.75,56.16,119
NDC,00517760401,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,82.92,62.19,1.0,74.63,119
NDC,00517760425,ACETYLCYSTEINE 200 MG/ML (20 %) SOLUTION,82.92,62.19,1.0,74.63,119
NDC,00517912001,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,56.52,42.39,0.68,50.87,119
NDC,00517912025,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,56.52,42.39,0.68,50.87,119
NDC,00517930201,"TRACE ELEMENTS ZINC 1,000 MCG-CU 60 MCG-MANG 3 MCG-SE 6 MCG/ML IV SOLN",107.32,80.49,1.29,96.59,119
NDC,00517930501,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,116.19,87.14,1.39,104.57,119
NDC,00517930525,TRACE ELEMENTS ZN 3 MG-CU 0.3 MG-MN 55 MCG-SE 60 MCG/ML IV SOLUTION,116.19,87.14,1.39,104.57,119
NDC,00517970225,DROPERIDOL 2.5 MG/ML INJECTION SOLUTION,63.78,47.84,0.77,57.4,119
NDC,00521234500,WHITE PETROLATUM TOPICAL JELLY,14.04,10.53,0.17,12.64,119
NDC,00527128201,DICYCLOMINE 20 MG TABLET,1.08,0.81,0.01,0.97,119
NDC,00527131301,PILOCARPINE 5 MG TABLET,2.45,1.84,0.03,2.2,119
NDC,00527143501,METAXALONE 800 MG TABLET,3.6,2.7,0.04,3.24,119
NDC,00527411637,"PROPRANOLOL ER 60 MG CAPSULE,24 HR,EXTENDED RELEASE",1.22,0.91,0.01,1.1,119
NDC,00527411737,"PROPRANOLOL ER 80 MG CAPSULE,24 HR,EXTENDED RELEASE",1.35,1.01,0.02,1.22,119
NDC,00527600480,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,168.0,126.0,2.02,151.2,119
NDC,00536001583,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP (REPACKAGING),21.3,15.98,0.26,19.17,119
NDC,00536009185,ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION,39.73,29.8,0.48,35.76,119
NDC,00536111825,CAPSAICIN 0.075 % TOPICAL CREAM,28.04,21.03,0.34,25.24,119
NDC,00536121195,DIBUCAINE 1 % TOPICAL OINTMENT,29.4,22.05,0.35,26.46,119
NDC,00536125494,SODIUM CHLORIDE 5 % EYE DROPS,26.28,19.71,0.32,23.65,119
NDC,00536127180,POVIDONE-IODINE 10 % TOPICAL OINTMENT,9.03,6.77,0.11,8.13,119
NDC,00536128636,BISMUTH SUBSALICYLATE 262 MG/15 ML ORAL SUSPENSION,18.49,13.86,0.22,16.64,119
NDC,00536130375,"SIMETHICONE 40 MG/0.6 ML ORAL DROPS,SUSPENSION",13.14,9.86,0.16,11.83,119
NDC,00536131625,ZINC OXIDE 20 % TOPICAL OINTMENT,18.0,13.5,0.22,16.2,119
NDC,00536132601,ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET,0.16,0.12,0.01,0.14,119
NDC,00536136223,NICOTINE (POLACRILEX) 2 MG GUM,1.27,0.95,0.02,1.14,119
NDC,00536136225,NICOTINE (POLACRILEX) 2 MG GUM,1.92,1.44,0.02,1.73,119
NDC,00536137785,SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,354.75,266.06,4.26,319.28,119
NDC,00536137801,VITAMIN B COMPLEX CAPSULE,0.34,0.26,0.01,0.31,119
NDC,00536199553,SELENIUM SULFIDE 1 % SHAMPOO,17.39,13.04,0.21,15.65,119
NDC,00536322301,CALCIUM 200 MG (AS CITRATE)-VITAMIN D3 6.25 MCG (250 UNIT) TABLET,0.27,0.2,0.01,0.24,119
NDC,00548590000,COSYNTROPIN 0.25 MG SOLUTION FOR INJECTION,442.31,331.73,5.31,398.08,119
NDC,00548909010,HYALURONIDASE 150 UNIT/ML INJECTION SOLUTION,231.57,173.68,2.78,208.41,119
NDC,00548950200,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,900.0,675.0,10.8,810.0,119
NDC,00555007102,ISONIAZID 300 MG TABLET,1.49,1.12,0.02,1.34,119
NDC,00555015802,CHLORDIAZEPOXIDE 5 MG CAPSULE,1.15,0.86,0.01,1.03,119
NDC,00555015902,CHLORDIAZEPOXIDE 25 MG CAPSULE,1.0,0.75,0.01,0.9,119
NDC,00555057202,METHOTREXATE SODIUM 2.5 MG TABLET,4.24,3.18,0.05,3.82,119
NDC,00555060702,MEGESTROL 40 MG TABLET,4.19,3.14,0.05,3.77,119
NDC,00555077902,MEDROXYPROGESTERONE 10 MG TABLET,1.59,1.19,0.02,1.43,119
NDC,00555087202,MEDROXYPROGESTERONE 2.5 MG TABLET,0.85,0.64,0.01,0.76,119
NDC,00555088602,ESTRADIOL 1 MG TABLET,1.84,1.38,0.02,1.66,119
NDC,00574006915,DEXTROSE 40 % ORAL GEL,7.56,5.67,0.09,6.8,119
NDC,00574006930,DEXTROSE 40 % ORAL GEL,7.56,5.67,0.09,6.8,119
NDC,00574010601,BROMOCRIPTINE 2.5 MG TABLET,18.02,13.52,0.22,16.22,119
NDC,00574010770,CLOTRIMAZOLE 10 MG TROCHE,7.72,5.79,0.09,6.95,119
NDC,00574029201,AMILORIDE 5 MG TABLET,1.34,1.0,0.02,1.21,119
NDC,00574030316,COMPOUNDING VEHICLE SUSPENSION SUGAR-FREE NO.20 ORAL,105.01,78.75,1.26,94.51,119
NDC,00574030416,COMPOUNDING VEHICLE SYRUP NO.23,105.01,78.75,1.26,94.51,119
NDC,00574031116,COMPOUNDING VEHICLE SUSPENSION NO.19 ORAL,105.01,78.75,1.26,94.51,119
NDC,00574052076,ACTIVATED CHARCOAL-SORBITOL 50 GRAM/240 ML ORAL SUSPENSION,113.76,85.32,1.37,102.38,119
NDC,00574202007,HYDROCORTISONE 100 MG/60 ML ENEMA,41.4,31.05,0.5,37.26,119
NDC,00574403125,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",170.68,128.01,2.05,153.61,119
NDC,00574703412,ASPIRIN 300 MG RECTAL SUPPOSITORY,7.0,5.25,0.08,6.3,119
NDC,00574705012,BISACODYL 10 MG RECTAL SUPPOSITORY,2.12,1.59,0.03,1.91,119
NDC,00574711212,MORPHINE 10 MG RECTAL SUPPOSITORY,30.0,22.5,0.36,27.0,119
NDC,00574985510,"BUDESONIDE DR - ER 3 MG CAPSULE,DELAYED,EXTENDED RELEASE",5.92,4.44,0.07,5.33,119
NDC,00591040401,VERAPAMIL 40 MG TABLET,0.93,0.7,0.01,0.84,119
NDC,00591267911,LIDOCAINE 5 % TOPICAL PATCH,17.97,13.48,0.22,16.17,119
NDC,00591267930,LIDOCAINE 5 % TOPICAL PATCH,17.97,13.48,0.22,16.17,119
NDC,00591288001,"VERAPAMIL ER 120 MG 24 HR CAPSULE,EXTENDED RELEASE",8.73,6.55,0.1,7.86,119
NDC,00591288201,"VERAPAMIL ER 180 MG 24 HR CAPSULE,EXTENDED RELEASE",9.14,6.86,0.11,8.23,119
NDC,00591292754,LEVALBUTEROL HFA 45 MCG/ACTUATION AEROSOL INHALER,353.79,265.34,4.25,318.41,119
NDC,00591321630,TESTOSTERONE 1 % (25 MG/2.5 GRAM) TRANSDERMAL GEL PACKET,72.92,54.69,0.88,65.63,119
NDC,00591354160,"BUPROPION HCL SR 150 MG TABLET,12 HR SUSTAINED-RELEASE",1.62,1.22,0.02,1.46,119
NDC,00591405094,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,5909.57,4432.18,70.91,5318.61,119
NDC,00591410301,PERPHENAZINE 8 MG TABLET,4.52,3.39,0.05,4.07,119
NDC,00591533501,TRIHEXYPHENIDYL 2 MG TABLET,0.9,0.68,0.01,0.81,119
NDC,00591534701,PROBENECID 500 MG TABLET,3.56,2.67,0.04,3.2,119
NDC,00597002402,IPRATROPIUM 20 MCG-ALBUTEROL 100 MCG/ACTUATION MIST FOR INHALATION,2091.68,1568.76,25.1,1882.51,119
NDC,00597008717,IPRATROPIUM BROMIDE 17 MCG/ACTUATION HFA AEROSOL INHALER,1380.78,1035.58,16.57,1242.7,119
NDC,00597010051,TIOTROPIUM BROMIDE 2.5 MCG/ACTUATION MIST FOR INHALATION,337.5,253.12,4.05,303.75,119
NDC,00597014061,LINAGLIPTIN 5 MG TABLET,78.76,59.07,0.95,70.88,119
NDC,00597015237,EMPAGLIFLOZIN 10 MG TABLET,94.42,70.81,1.13,84.98,119
NDC,00597015337,EMPAGLIFLOZIN 25 MG TABLET,94.42,70.81,1.13,84.98,119
NDC,00597019705,IDARUCIZUMAB 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,8187.5,6140.62,98.25,7368.75,119
NDC,00597035556,DABIGATRAN ETEXILATE 75 MG CAPSULE,19.84,14.88,0.24,17.86,119
NDC,00641037621,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,7.03,5.27,0.08,6.33,119
NDC,00641037625,DIPHENHYDRAMINE 50 MG/ML INJECTION SOLUTION,7.03,5.27,0.08,6.33,119
NDC,00641041125,HEPARIN LOCK FLUSH (PORCINE) 100 UNIT/ML INTRAVENOUS SOLUTION,6.15,4.61,0.07,5.54,119
NDC,00641047621,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,118.59,88.94,1.42,106.73,119
NDC,00641047625,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,118.59,88.94,1.42,106.73,119
NDC,00641049321,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,8.34,6.26,0.1,7.51,119
NDC,00641049325,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,8.34,6.26,0.1,7.51,119
NDC,00641092821,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,11.09,8.32,0.13,9.98,119
NDC,00641092825,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,11.09,8.32,0.13,9.98,119
NDC,00641139731,CHLORPROMAZINE 25 MG/ML INJECTION SOLUTION,130.0,97.5,1.56,117.0,119
NDC,00641255510,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,11.97,8.98,0.14,10.77,119
NDC,00641255541,PHENYTOIN SODIUM 50 MG/ML INTRAVENOUS SOLUTION,11.97,8.98,0.14,10.77,119
NDC,00641601510,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,38.67,29.01,0.46,34.8,119
NDC,00641604401,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.53,6.4,0.1,7.68,119
NDC,00641604425,LORAZEPAM 2 MG/ML INJECTION SOLUTION,8.53,6.4,0.1,7.68,119
NDC,00641604801,LORAZEPAM 2 MG/ML INJECTION SOLUTION,7.76,5.82,0.09,6.98,119
NDC,00641604825,LORAZEPAM 2 MG/ML INJECTION SOLUTION,7.76,5.82,0.09,6.98,119
NDC,00641605201,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,15.22,11.41,0.18,13.7,119
NDC,00641605225,MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION,15.22,11.41,0.18,13.7,119
NDC,00641605301,MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION,15.85,11.89,0.19,14.26,119
NDC,00641605401,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,17.38,13.03,0.21,15.64,119
NDC,00641605425,MEPERIDINE (PF) 100 MG/ML INJECTION SOLUTION,17.38,13.03,0.21,15.64,119
NDC,00641605701,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,3.9,2.92,0.05,3.51,119
NDC,00641605725,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,3.9,2.92,0.05,3.51,119
NDC,00641606001,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,41.4,31.05,0.5,37.26,119
NDC,00641606010,MIDAZOLAM 5 MG/ML INJECTION SOLUTION,41.4,31.05,0.5,37.26,119
NDC,00641607901,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,47.16,35.37,0.57,42.44,119
NDC,00641608001,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,3.6,2.7,0.04,3.24,119
NDC,00641608025,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,3.6,2.7,0.04,3.24,119
NDC,00641608401,PROMETHAZINE 25 MG/ML INJECTION SOLUTION,20.23,15.17,0.24,18.21,119
NDC,00641611601,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,17.85,13.39,0.21,16.07,119
NDC,00641611610,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,17.85,13.39,0.21,16.07,119
NDC,00641612525,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,14.98,11.24,0.18,13.48,119
NDC,00641612701,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,15.29,11.47,0.18,13.76,119
NDC,00641612725,MORPHINE 10 MG/ML INTRAVENOUS SOLUTION,15.29,11.47,0.18,13.76,119
NDC,00641613225,NALOXONE 0.4 MG/ML INJECTION SOLUTION,36.0,27.0,0.43,32.4,119
NDC,00641613625,FOSPHENYTOIN 100 MG PE/2 ML INJECTION SOLUTION,88.8,66.6,1.07,79.92,119
NDC,00641614201,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00641614225,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,24.0,18.0,0.29,21.6,119
NDC,00641614901,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,00641614910,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,00641615101,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,18.0,13.5,0.22,16.2,119
NDC,00641615125,HYDROMORPHONE (PF) 2 MG/ML INJECTION SOLUTION,18.0,13.5,0.22,16.2,119
NDC,00641616910,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,22.41,16.81,0.27,20.17,119
NDC,00641617401,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,19.12,14.34,0.23,17.21,119
NDC,00641617410,OCTREOTIDE ACETATE 50 MCG/ML INJECTION SOLUTION,19.12,14.34,0.23,17.21,119
NDC,00641618401,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,33.0,24.75,0.4,29.7,119
NDC,00641618425,DIGOXIN 250 MCG/ML (0.25 MG/ML) INJECTION SOLUTION,33.0,24.75,0.4,29.7,119
NDC,00641626701,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,59.99,45.0,0.72,53.99,119
NDC,00641921701,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,9.26,6.95,0.11,8.33,119
NDC,00641921710,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,9.26,6.95,0.11,8.33,119
NDC,00641921901,DILTIAZEM 5 MG/ML INTRAVENOUS SOLUTION,24.65,18.49,0.3,22.18,119
NDC,00699310002,BENZOCAINE 20 % MUCOSAL AEROSOL SPRAY,196.31,147.23,2.36,176.68,119
NDC,00703001801,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,621.0,465.75,7.45,558.9,119
NDC,00703066601,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,5020.09,3765.07,60.24,4518.08,119
NDC,00703067601,TREPROSTINIL SODIUM 2.5 MG/ML INJECTION SOLUTION,12550.18,9412.64,150.6,11295.16,119
NDC,00703068601,TREPROSTINIL SODIUM 5 MG/ML INJECTION SOLUTION,23225.4,17419.05,278.7,20902.86,119
NDC,00703069601,TREPROSTINIL SODIUM 10 MG/ML INJECTION SOLUTION,46450.71,34838.04,557.41,41805.64,119
NDC,00703424601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,89.25,66.94,1.07,80.32,119
NDC,00703450291,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,20.1,15.08,0.24,18.09,119
NDC,00703450293,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,20.1,15.08,0.24,18.09,119
NDC,00713028031,BACITRACIN 500 UNIT/GRAM TOPICAL OINTMENT,13.29,9.97,0.16,11.96,119
NDC,00713063537,MOMETASONE 0.1 % TOPICAL OINTMENT,126.09,94.57,1.51,113.48,119
NDC,00713065540,TRIAMCINOLONE ACETONIDE 0.1 % DENTAL PASTE,300.0,225.0,3.6,270.0,119
NDC,00713067831,"NYSTATIN 100,000 UNIT/GRAM TOPICAL CREAM",119.88,89.91,1.44,107.89,119
NDC,00713070915,FLUOCINOLONE 0.025 % TOPICAL CREAM,175.5,131.62,2.11,157.95,119
NDC,00713093681,COLESEVELAM 625 MG TABLET,2.5,1.88,0.03,2.25,119
NDC,00781210201,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",2.77,2.08,0.03,2.49,119
NDC,00781210301,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",5.5,4.13,0.07,4.95,119
NDC,00781210401,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",27.02,20.27,0.32,24.32,119
NDC,00781315270,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00781315295,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,00781340278,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),11.38,8.54,0.14,10.24,119
NDC,00781340295,AMPICILLIN 250 MG SOLUTION FOR INJECTION,11.38,8.54,0.14,10.24,119
NDC,00781340295,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),11.38,8.54,0.14,10.24,119
NDC,00781340795,AMPICILLIN 500 MG SOLUTION FOR IM INJECTION (UW),16.91,12.69,0.2,15.22,119
NDC,00781340795,AMPICILLIN 500 MG/5 ML SOLUTION FOR INJECTION,16.91,12.69,0.2,15.22,119
NDC,00781340880,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,42.62,31.96,0.51,38.36,119
NDC,00781341575,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,63.75,47.81,0.76,57.38,119
NDC,00781348170,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,119
NDC,00781348192,TIGECYCLINE 50 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,119
NDC,00781348556,IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION,113.5,85.13,1.36,102.15,119
NDC,00781349380,DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,156.0,117.0,1.87,140.4,119
NDC,00781349395,DEXMEDETOMIDINE 80 MCG/20 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,156.0,117.0,1.87,140.4,119
NDC,00781353212,FULVESTRANT 250 MG/5 ML INTRAMUSCULAR SYRINGE,532.19,399.14,6.39,478.97,119
NDC,00781528306,CETIRIZINE 5 MG CHEWABLE TABLET,25.75,19.31,0.31,23.18,119
NDC,00781602194,DILUENT FOR TREPROSTINIL (GLYCINE) INTRAVENOUS SOLUTION,108.6,81.45,1.3,97.74,119
NDC,00781602246,CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION,717.6,538.2,8.61,645.84,119
NDC,00781602252,CLARITHROMYCIN 125 MG/5 ML ORAL SUSPENSION,388.2,291.15,4.66,349.38,119
NDC,00781613694,PENICILLIN G POTASSIUM 20 MILLION UNIT SOLUTION FOR INJECTION,225.0,168.75,2.7,202.5,119
NDC,00781905370,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,57.0,42.75,0.68,51.3,119
NDC,00781905395,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJECTION SOLUTION,57.0,42.75,0.68,51.3,119
NDC,00781940278,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),14.23,10.67,0.17,12.81,119
NDC,00781940295,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),14.23,10.67,0.17,12.81,119
NDC,00781940495,AMPICILLIN 1 GRAM/10 ML SOLUTION FOR INJECTION,41.45,31.09,0.5,37.31,119
NDC,00781940880,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,60.31,45.23,0.72,54.28,119
NDC,00832121189,WARFARIN 1 MG TABLET,2.22,1.66,0.03,2.0,119
NDC,00832121289,WARFARIN 2 MG TABLET,2.28,1.71,0.03,2.05,119
NDC,00832121589,WARFARIN 4 MG TABLET,2.4,1.8,0.03,2.16,119
NDC,00832121789,WARFARIN 6 MG TABLET,3.36,2.52,0.04,3.02,119
NDC,00832121800,WARFARIN 7.5 MG TABLET,3.47,2.61,0.04,3.12,119
NDC,00832142505,BRIMONIDINE 0.2 %-TIMOLOL 0.5 % EYE DROPS,575.96,431.97,6.91,518.36,119
NDC,00904052361,ASCORBIC ACID (VITAMIN C) 500 MG TABLET,0.2,0.15,0.01,0.18,119
NDC,00904053961,MULTIVITAMIN WITH FOLIC ACID 400 MCG TABLET,0.23,0.17,0.01,0.21,119
NDC,00904188260,CALCIUM 250 MG (AS CARBONATE)-VITAMIN D3 3.125 MCG (125 UNIT) TABLET,0.08,0.06,0.01,0.07,119
NDC,00904208560,"VITAMIN A 3,000 MCG (10,000 UNIT) CAPSULE",0.25,0.19,0.01,0.22,119
NDC,00904227260,NIACIN 500 MG TABLET,0.16,0.12,0.01,0.14,119
NDC,00904253321,CALAMINE 8 %-ZINC OXIDE 8 % LOTION,8.5,6.37,0.1,7.65,119
NDC,00904272561,SULFAMETHOXAZOLE 800 MG-TRIMETHOPRIM 160 MG TABLET,1.12,0.84,0.01,1.01,119
NDC,00904386575,SODIUM CHLORIDE 0.65 % NASAL SPRAY AEROSOL,5.54,4.16,0.07,4.99,119
NDC,00904421551,ARGININE (L-ARGININE) 500 MG TABLET,0.44,0.33,0.01,0.4,119
NDC,00904505359,PSEUDOEPHEDRINE 30 MG TABLET,0.13,0.09,0.01,0.12,119
NDC,00904522452,"LACTASE 3,000 UNIT TABLET",0.47,0.35,0.01,0.42,119
NDC,00904530760,DIPHENHYDRAMINE 50 MG CAPSULE,0.15,0.11,0.01,0.14,119
NDC,00904531360,PRENATAL VITS NO.130-FERROUS FUM 27 MG IRON-FOLIC ACID 800 MCG TABLET,0.19,0.14,0.01,0.17,119
NDC,00904546080,CALCIUM 500 MG (AS CARBONATE)-VITAMIN D3 5 MCG (200 UNIT) TABLET,0.09,0.07,0.01,0.08,119
NDC,00904552261,DOXAZOSIN 1 MG TABLET,5.09,3.82,0.06,4.58,119
NDC,00904572514,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP (REPACKAGING),21.3,15.98,0.26,19.17,119
NDC,00904582360,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,0.08,0.06,0.01,0.07,119
NDC,00904584416,PARABEN-CETYL ALCOHOL-STEARYL ALCOHOL-PROPY GLYCOL-SLS TOPICAL CLEANER,17.03,12.77,0.2,15.33,119
NDC,00904585361,IBUPROFEN 400 MG TABLET,0.41,0.31,0.01,0.37,119
NDC,00904585461,IBUPROFEN 600 MG TABLET,0.51,0.38,0.01,0.46,119
NDC,00904585561,IBUPROFEN 800 MG TABLET,0.45,0.34,0.01,0.4,119
NDC,00904589161,PRAVASTATIN 10 MG TABLET,2.36,1.77,0.03,2.12,119
NDC,00904608461,CITALOPRAM 10 MG TABLET,0.34,0.25,0.01,0.31,119
NDC,00904617261,CARBAMAZEPINE 200 MG TABLET,5.38,4.03,0.06,4.84,119
NDC,00904629061,ATORVASTATIN 10 MG TABLET,1.48,1.11,0.02,1.33,119
NDC,00904629161,ATORVASTATIN 20 MG TABLET,1.81,1.36,0.02,1.63,119
NDC,00904629261,ATORVASTATIN 40 MG TABLET,1.91,1.43,0.02,1.72,119
NDC,00904629304,ATORVASTATIN 80 MG TABLET,2.6,1.95,0.03,2.34,119
NDC,00904630161,CARVEDILOL 6.25 MG TABLET,0.56,0.42,0.01,0.5,119
NDC,00904630521,PHENOL 1.4 % MUCOSAL AEROSOL SPRAY,14.87,11.15,0.18,13.38,119
NDC,00904636961,AMLODIPINE 2.5 MG TABLET,0.83,0.63,0.01,0.75,119
NDC,00904637061,AMLODIPINE 5 MG TABLET,0.47,0.36,0.01,0.42,119
NDC,00904637461,ROPINIROLE 1 MG TABLET,3.4,2.55,0.04,3.06,119
NDC,00904640761,"BISACODYL 5 MG TABLET,DELAYED RELEASE",0.16,0.12,0.01,0.14,119
NDC,00904642661,ESCITALOPRAM 10 MG TABLET,0.92,0.69,0.01,0.83,119
NDC,00904647461,"PANTOPRAZOLE 40 MG TABLET,DELAYED RELEASE",1.8,1.35,0.02,1.62,119
NDC,00904650161,FLUCONAZOLE 200 MG TABLET,12.23,9.18,0.15,11.01,119
NDC,00904650361,CELECOXIB 200 MG CAPSULE,11.96,8.97,0.14,10.76,119
NDC,00904650561,MEMANTINE 5 MG TABLET,2.59,1.94,0.03,2.33,119
NDC,00904657261,ALLOPURINOL 300 MG TABLET,4.04,3.03,0.05,3.64,119
NDC,00904661961,ISOSORBIDE DINITRATE 10 MG TABLET,3.66,2.74,0.04,3.29,119
NDC,00904662361,"TACROLIMUS 0.5 MG CAPSULE, IMMEDIATE-RELEASE",6.3,4.72,0.08,5.67,119
NDC,00904662461,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",54.0,40.5,0.65,48.6,119
NDC,00904662735,CARBAMIDE PEROXIDE 6.5 % EAR DROPS,11.34,8.5,0.14,10.21,119
NDC,00904663561,BUPROPION HCL 75 MG TABLET,7.25,5.44,0.09,6.52,119
NDC,00904663861,QUETIAPINE 25 MG TABLET,1.74,1.3,0.02,1.57,119
NDC,00904664061,QUETIAPINE 100 MG TABLET,2.82,2.11,0.03,2.54,119
NDC,00904666561,GABAPENTIN 100 MG CAPSULE,0.7,0.53,0.01,0.63,119
NDC,00904666661,GABAPENTIN 300 MG CAPSULE,0.98,0.73,0.01,0.88,119
NDC,00904666761,GABAPENTIN 400 MG CAPSULE,1.23,0.92,0.01,1.11,119
NDC,00904671839,"GUAIFENESIN ER 600 MG TABLET, EXTENDED RELEASE 12 HR",5.34,4.0,0.06,4.81,119
NDC,00904672080,ACETAMINOPHEN 500 MG TABLET,0.1,0.08,0.01,0.09,119
NDC,00904673061,ACETAMINOPHEN 500 MG TABLET,0.22,0.17,0.01,0.2,119
NDC,00904675180,"ASPIRIN 81 MG TABLET,DELAYED RELEASE",0.05,0.04,0.01,0.05,119
NDC,00904675415,"PSEUDOEPHEDRINE ER 120 MG TABLET,EXTENDED RELEASE",2.34,1.76,0.03,2.11,119
NDC,00904677361,ACETAMINOPHEN 325 MG TABLET,0.32,0.24,0.01,0.29,119
NDC,00904679480,ASPIRIN 81 MG CHEWABLE TABLET,0.05,0.04,0.01,0.05,119
NDC,00904679761,LISINOPRIL 5 MG TABLET,0.39,0.29,0.01,0.35,119
NDC,00904679961,LISINOPRIL 20 MG TABLET,0.41,0.31,0.01,0.37,119
NDC,00904692361,PREDNISONE 10 MG TABLET,0.93,0.7,0.01,0.84,119
NDC,00904692461,SERTRALINE 25 MG TABLET,2.09,1.57,0.03,1.88,119
NDC,00904695061,LEVOTHYROXINE 50 MCG TABLET,2.81,2.11,0.03,2.53,119
NDC,00904699161,PREGABALIN 25 MG CAPSULE,4.65,3.49,0.06,4.19,119
NDC,00904699261,PREGABALIN 50 MG CAPSULE,4.52,3.39,0.05,4.07,119
NDC,00904700261,PREGABALIN 150 MG CAPSULE,5.7,4.28,0.07,5.13,119
NDC,00904700761,LAMOTRIGINE 25 MG TABLET,1.02,0.76,0.01,0.92,119
NDC,00904700861,LAMOTRIGINE 100 MG TABLET,0.83,0.63,0.01,0.75,119
NDC,00904704361,"DULOXETINE 20 MG CAPSULE,DELAYED RELEASE",9.62,7.22,0.12,8.66,119
NDC,00904704461,"DULOXETINE 30 MG CAPSULE,DELAYED RELEASE",8.62,6.46,0.1,7.76,119
NDC,00904704561,"DULOXETINE 60 MG CAPSULE,DELAYED RELEASE",8.62,6.46,0.1,7.76,119
NDC,00904704861,LOSARTAN 50 MG TABLET,4.05,3.04,0.05,3.64,119
NDC,00904705361,DOXEPIN 25 MG CAPSULE,4.81,3.61,0.06,4.33,119
NDC,00904708461,"BUPROPION HCL XL 150 MG 24 HR TABLET, EXTENDED RELEASE",11.12,8.34,0.13,10.01,119
NDC,00904712761,PREDNISONE 20 MG TABLET,1.01,0.76,0.01,0.91,119
NDC,00904715404,BUPRENORPHINE HCL 2 MG SUBLINGUAL TABLET,14.04,10.53,0.17,12.64,119
NDC,00904716261,METFORMIN 500 MG TABLET,0.38,0.29,0.01,0.34,119
NDC,00904716861,URSODIOL 300 MG CAPSULE,26.36,19.77,0.32,23.72,119
NDC,00904718361,DOCUSATE SODIUM 100 MG CAPSULE,0.29,0.22,0.01,0.26,119
NDC,00904718761,ATENOLOL 25 MG TABLET,1.18,0.88,0.01,1.06,119
NDC,00904719361,FAMOTIDINE 20 MG TABLET,0.45,0.34,0.01,0.4,119
NDC,00904720546,BISMUTH SUBSALICYLATE 262 MG CHEWABLE TABLET,0.46,0.34,0.01,0.41,119
NDC,00904720660,SIMETHICONE 80 MG CHEWABLE TABLET,0.18,0.14,0.01,0.16,119
NDC,00904721104,DANTROLENE 25 MG CAPSULE,9.49,7.11,0.11,8.54,119
NDC,00904723761,DIPHENHYDRAMINE 25 MG CAPSULE,0.25,0.18,0.01,0.22,119
NDC,00904723860,"OMEGA-3 300 MG-DHA 120 MG-EPA 180 MG-FISH OIL 1,000 MG CAPSULE",0.28,0.21,0.01,0.25,119
NDC,00904724468,LACOSAMIDE 50 MG TABLET,7.39,5.54,0.09,6.65,119
NDC,00904725261,SENNOSIDES 8.6 MG TABLET,0.25,0.18,0.01,0.22,119
NDC,00904725761,CARBIDOPA 25 MG-LEVODOPA 100 MG TABLET,1.13,0.85,0.01,1.02,119
NDC,00904727641,"NYSTATIN 100,000 UNIT/ML ORAL SUSPENSION",5.07,3.8,0.06,4.56,119
NDC,00904728361,TORSEMIDE 20 MG TABLET,2.34,1.76,0.03,2.11,119
NDC,00904730561,CARVEDILOL 3.125 MG TABLET,0.55,0.41,0.01,0.5,119
NDC,00904730761,CARVEDILOL 12.5 MG TABLET,0.58,0.44,0.01,0.52,119
NDC,00904734920,PYRETHRINS 0.33 %-PIPERONYL BUTOXIDE 4 % SHAMPOO,49.56,37.17,0.59,44.6,119
NDC,00904735006,AZITHROMYCIN 250 MG TABLET,7.41,5.56,0.09,6.67,119
NDC,00904740361,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG TABLET",1.11,0.83,0.01,1.0,119
NDC,00904741844,MAGNESIUM CITRATE ORAL SOLUTION,17.76,13.32,0.21,15.98,119
NDC,00904742730,OXYMETAZOLINE 0.05 % NASAL SPRAY,13.5,10.12,0.16,12.15,119
NDC,00904747066,SUCRALFATE 100 MG/ML ORAL SUSPENSION,49.62,37.21,0.6,44.66,119
NDC,00904759161,FERROUS SULFATE 325 MG (65 MG IRON) TABLET,0.17,0.13,0.01,0.15,119
NDC,00904772861,CLONAZEPAM 1 MG TABLET,3.13,2.35,0.04,2.82,119
NDC,00904775127,LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM,24.52,18.39,0.29,22.07,119
NDC,00904791461,IBUPROFEN 200 MG TABLET,0.4,0.3,0.01,0.36,119
NDC,00942064103,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,39.0,29.25,0.47,35.1,119
NDC,00942064104,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 730 MG/100 ML SOLN,60.0,45.0,0.72,54.0,119
NDC,00944265603,"IMMUNE GLOB,GAMMA(IGG) 5 GRAM-GLY-GLUC-IGA 0 TO 50 MCG/ML IV SOLUTION",3128.07,2346.05,37.54,2815.26,119
NDC,00944270004,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",2859.24,2144.43,34.31,2573.32,119
NDC,00944270005,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",5718.48,4288.86,68.62,5146.63,119
NDC,00944270006,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",11436.96,8577.72,137.24,10293.26,119
NDC,00944270007,"IMMUNE GLOB,GAMMA (IGG) 10 %-GLY-IGA OVER 50 MCG/ML INJECTION SOLUTION",17155.43,12866.57,205.87,15439.89,119
NDC,00990707526,POTASSIUM CHLORIDE 20 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,16.2,12.15,0.19,14.58,119
NDC,00990707726,POTASSIUM CHLORIDE 40 MEQ/100ML IN STERILE WATER INTRAVENOUS PIGGYBACK,34.2,25.65,0.41,30.78,119
NDC,00990771513,MANNITOL 20 % INTRAVENOUS SOLUTION,114.0,85.5,1.37,102.6,119
NDC,00990793002,DEXTROSE 10 % IN WATER (D10W) INTRAVENOUS SOLUTION,31.5,23.62,0.38,28.35,119
NDC,00990793002,DEXTROSE 10% IN WATER (D10W) IV BOLUS (UW),31.5,23.62,0.38,28.35,119
NDC,00990796709,ELECTROLYTE-R INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,00990798361,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,31.5,23.62,0.38,28.35,119
NDC,00990798420,SODIUM CHLORIDE 0.9 % INTRAVENOUS SOLUTION,20.55,15.41,0.25,18.5,119
NDC,00990925739,POTASSIUM CHLORIDE 20 MEQ/L IN 0.45 % SODIUM CHLORIDE INTRAVENOUS SOLN,42.0,31.5,0.5,37.8,119
NDC,08888-0542-01,ETHANOL 95% INJECTABLE SOLUTION 50 ML COMPOUNDED,2878.2,2158.65,34.54,2590.38,119
NDC,08888004203,CEFTRIAXONE 1000 MG IN SWFI 10 ML IV PUSH,91.38,68.54,1.1,82.24,119
NDC,08888004204,CEFTRIAXONE 2000 MG IN SWFI 20 ML (100 MG/ML) NEO/PEDS IVPB,42.24,31.68,0.51,38.02,119
NDC,08888004204,CEFTRIAXONE 2000 MG IN SWFI 20 ML IV PUSH,42.24,31.68,0.51,38.02,119
NDC,08888043803,CEFAZOLIN 2 GRAM/20 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,35.16,26.37,0.42,31.64,119
NDC,08888043804,CEFAZOLIN 3 GRAM/30 ML IN SODIUM CHLORIDE INTRAVENOUS SYRINGE,19.98,14.98,0.24,17.98,119
NDC,08888044603,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,11.34,8.5,0.14,10.21,119
NDC,08888045106,"CALCIUM 500 MG/5 ML (AS CALCIUM CARB 1,250 MG/5 ML) ORAL SUSPENSION",0.54,0.4,0.01,0.49,119
NDC,08888045204,DOCUSATE SODIUM 50 MG/5 ML ORAL LIQUID,0.42,0.32,0.01,0.38,119
NDC,08888046004,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG-10 MCG/ML ORAL DROPS (REPACKAGING),0.49,0.37,0.01,0.44,119
NDC,08888046005,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG-10 MCG/ML ORAL DROPS (REPACKAGING),0.98,0.74,0.01,0.88,119
NDC,08888046006,PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,0.98,0.74,0.01,0.88,119
NDC,08888046007,PEDIATRIC MULTIVITAMIN NO.189-FERROUS SULFATE 11 MG/ML ORAL DROPS,0.98,0.74,0.01,0.88,119
NDC,08888046102,MELATONIN 1 MG/ML ORAL LIQUID SYRINGE,0.53,0.4,0.01,0.48,119
NDC,08888046302,CETIRIZINE 1 MG/ML ORAL SOLUTION,1.59,1.19,0.02,1.43,119
NDC,08888046402,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,42.42,31.82,0.51,38.18,119
NDC,08888046506,POTASSIUM CHLORIDE 20 MEQ/15 ML ORAL LIQUID,35.19,26.39,0.42,31.67,119
NDC,08888046602,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,1.26,0.94,0.02,1.13,119
NDC,08888046802,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,18.84,14.13,0.23,16.96,119
NDC,08888046901,VANCOMYCIN 1.25 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,120.0,90.0,1.44,108.0,119
NDC,08888046902,VANCOMYCIN 1.5 GRAM/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,169.5,127.12,2.03,152.55,119
NDC,08888047002,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,66.0,49.5,0.79,59.4,119
NDC,08888047701,LIDOCAINE-MAALOX-BENADRYL SOLUTION,94.86,71.14,1.14,85.37,119
NDC,08888047801,VANCOMYCIN 25 MG/ML ORAL SOLUTION COMPOUND,3.78,2.84,0.05,3.4,119
NDC,08888048201,LEVETIRACETAM 100 MG/ML ORAL SOLUTION,3.03,2.27,0.04,2.73,119
NDC,08888048304,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL GEL,95.99,72.0,1.15,86.39,119
NDC,08888048501,DEXTROSE 40 % ORAL GEL,1.01,0.76,0.01,0.91,119
NDC,08888048901,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH (REPACKAGING),0.54,0.4,0.01,0.49,119
NDC,08888049802,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL SOLUTION 50 ML,33.6,25.2,0.4,30.24,119
NDC,08888051202,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,36.3,27.22,0.44,32.67,119
NDC,08888051302,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,17.25,12.94,0.21,15.52,119
NDC,08888052101,LAMIVUDINE 10 MG/ML ORAL SOLUTION,29.97,22.48,0.36,26.97,119
NDC,08888052401,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,7.13,5.35,0.09,6.42,119
NDC,08888052501,SPIRONOLACTONE 12.5 MG (1/2 OF 25 MG) TABLET,0.54,0.4,0.01,0.49,119
NDC,08888052502,SPIRONOLACTONE 25 MG/5 ML ORAL SUSPENSION,109.83,82.37,1.32,98.85,119
NDC,08888052601,TACROLIMUS 1 MG/ML ORAL SUSPENSION COMPOUND,27.02,20.27,0.32,24.32,119
NDC,08888052701,FINASTERIDE 5 MG/15 ML ORAL SUSPENSION COMPOUNDED,4.5,3.38,0.05,4.05,119
NDC,08888053101,EPINEPHRINE 1 MG/ML (1 ML) ANAPHYLAXIS KIT,60.59,45.44,0.73,54.53,119
NDC,08888053201,GLYCERIN 99.5% RECTAL ENEMA SOLUTION (UW),0.14,0.11,0.01,0.13,119
NDC,08888053301,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,24.0,18.0,0.29,21.6,119
NDC,08888053901,WARFARIN 0.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.12,0.84,0.01,1.01,119
NDC,08888054101,EPHEDRINE (PF) 25 MG/5 ML (5 MG/ML) IN 0.9% SODIUM CHLORIDE IV SYRINGE,155.7,116.78,1.87,140.13,119
NDC,08888054301,DEXTROMETHORPHAN POLISTIREX ER 30 MG/5 ML ORAL SUSP EXT.RELEASE 12HR,2.4,1.8,0.03,2.16,119
NDC,08888054401,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,114.3,85.72,1.37,102.87,119
NDC,08888054901,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,21.21,15.91,0.25,19.09,119
NDC,08888054902,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,42.42,31.82,0.51,38.18,119
NDC,08888055201,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,18.84,14.13,0.23,16.96,119
NDC,08888055401,HYDROCORTISONE 1 % TOPICAL CREAM,5.28,3.96,0.06,4.75,119
NDC,08888055501,SODIUM CITRATE-CITRIC ACID 500 MG-334 MG/5 ML ORAL SOLUTION (REPACKAGING),13.68,10.26,0.16,12.31,119
NDC,08888055801,MISOPROSTOL 800 MCG (4 X 200 MCG) TABLET KIT,23.16,17.37,0.28,20.84,119
NDC,09999-007202,MIDAZOLAM 2 MG/ML ORAL SYRUP,33.06,24.8,0.4,29.75,119
NDC,09999-0766-01,FUROSEMIDE 2 MG/ML IN NS NEO/PEDS CMPD INJECTABLE NEO/PEDS,97.5,73.12,1.17,87.75,119
NDC,09999001006,CLONIDINE 20 MCG/ML ORAL SUSPENSION,120.96,90.72,1.45,108.86,119
NDC,09999001901,METOPROLOL TARTRATE 12.5 MG (1/2 OF 25 MG) TABLET,0.14,0.11,0.01,0.13,119
NDC,09999002206,PHYTONADIONE 1 MG/ML CMPD NEO/PED ORAL SOLUTION,26.28,19.71,0.32,23.65,119
NDC,09999002403,DEXMEDETOMIDINE 200 MCG/50 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,84.3,63.22,1.01,75.87,119
NDC,09999002406,DEXMEDETOMIDINE 12 MCG/3 ML (4 MCG/ML) IN NS IV DRIP SYRINGE,16.11,12.08,0.19,14.5,119
NDC,09999002408,DEXMEDETOMIDINE 100 MCG/25 ML (4 MCG/ML) IN NS SYRINGE (NEO/PED) CMPD,42.15,31.61,0.51,37.94,119
NDC,09999003001,MISOPROSTOL 25 MCG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.0,0.75,0.01,0.9,119
NDC,09999003701,PHENYLEPHRINE 20 MG/100 ML (0.2 MG/ML) IN NS IV DRIP CMPD,225.0,168.75,2.7,202.5,119
NDC,09999004001,EPINEPHRINE 10 MG IN NS QS 100 ML FOR ADS LOAD,501.0,375.75,6.01,450.9,119
NDC,09999004206,MIDAZOLAM (PF) 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLOR IV SYRINGE,34.5,25.88,0.41,31.05,119
NDC,09999004602,CETIRIZINE 1 MG/ML ORAL SOLUTION,1.59,1.19,0.02,1.43,119
NDC,09999005115,POTASSIUM CHLORIDE 20 MEQ/250 ML (80 MEQ/L) IN NS IV (PERIPHERAL LINE),27.62,20.72,0.33,24.86,119
NDC,09999005121,POTASSIUM CHLORIDE 40 MEQ/500 ML (80 MEQ/L) IN NS IVPB (PERIPHERAL LINE),30.0,22.5,0.36,27.0,119
NDC,09999005802,CITALOPRAM 10 MG/5 ML ORAL SOLUTION,36.3,27.22,0.44,32.67,119
NDC,09999005903,FLUOXETINE 20 MG/5 ML (4 MG/ML) ORAL SOLUTION,17.25,12.94,0.21,15.52,119
NDC,09999006906,INSULIN REGULAR HUMAN 0.25 UNIT/ML *DILUTED* INJECTION (NEO) CMPD,11.52,8.64,0.14,10.37,119
NDC,09999007001,MORPHINE SULFATE 0.4 MG/ML ORAL SOLUTION,1.63,1.22,0.02,1.47,119
NDC,09999007109,METHADONE 10 MG/ML ORAL CONCENTRATE,2.34,1.76,0.03,2.11,119
NDC,09999007403,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,215.69,161.77,2.59,194.12,119
NDC,09999007502,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,3.16,2.37,0.04,2.84,119
NDC,09999008201,HYDROMORPHONE 1 MG/ML ORAL LIQUID (REPACKAGING),11.52,8.64,0.14,10.37,119
NDC,09999008219,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,98.1,73.57,1.18,88.29,119
NDC,09999008219,"HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL, ISO-OSM IV PCA SYR",98.1,73.57,1.18,88.29,119
NDC,09999008219,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,98.1,73.57,1.18,88.29,119
NDC,09999008601,AMIODARONE 1.8 MG/ML IN D5W FOR BOLUS DOSE CMPD,28.8,21.6,0.35,25.92,119
NDC,09999008701,HYDROCODONE 10 MG-CHLORPHENIRAMINE 8 MG/5 ML ORAL SUSP EXTEND.REL 12HR,14.73,11.05,0.18,13.26,119
NDC,09999008825,MORPHINE 20 MG/20 ML (1 MG/ML) IN NS IV DRIP (NEO/PED),43.08,32.31,0.52,38.77,119
NDC,09999008828,MORPHINE 250 MG/50 ML (5 MG/ML) IN NS HIGH DOSE PCA,135.0,101.25,1.62,121.5,119
NDC,09999008831,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,84.0,63.0,1.01,75.6,119
NDC,09999009003,FENTANYL 300 MCG/30 ML (10 MCG/ML) IN D5W IV DRIP NEO/PED,90.0,67.5,1.08,81.0,119
NDC,09999009004,"FENTANYL 1,500 MCG/30 ML (50 MCG/ML) IV DRIP NEO/PED CMPD",95.4,71.55,1.14,85.86,119
NDC,09999009011,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV DRIP,199.8,149.85,2.4,179.82,119
NDC,09999009011,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,199.8,149.85,2.4,179.82,119
NDC,09999009012,"FENTANYL (PF) 2,500 MCG/50 ML (50 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE",130.5,97.88,1.57,117.45,119
NDC,09999009012,"FENTANYL 2,500 MCG IN NS 50 ML (50 MCG/ML) DRIP",130.5,97.88,1.57,117.45,119
NDC,09999009501,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH (REPACKAGING),0.54,0.4,0.01,0.49,119
NDC,09999009601,LIDOCAINE-MAALOX-BENADRYL SOLUTION,33.84,25.38,0.41,30.46,119
NDC,09999010102,MORPHINE CONCENTRATE 100 MG/5 ML (20 MG/ML) ORAL SOLUTION,3.3,2.47,0.04,2.97,119
NDC,09999010202,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE 1 GRAM OR LESS),142.8,107.1,1.71,128.52,119
NDC,09999010202,VANCOMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD (UW) (DOSE GREATER THAN 1 GRAM),142.8,107.1,1.71,128.52,119
NDC,09999010207,VANCOMYCIN 2 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,285.0,213.75,3.42,256.5,119
NDC,09999010702,URSODIOL 60 MG/ML ORAL SUSPENSION COMPOUND,173.52,130.14,2.08,156.17,119
NDC,09999011301,LANSOPRAZOLE 3 MG/ML ORAL SUSPENSION COMPOUNDING KIT,2.42,1.81,0.03,2.18,119
NDC,09999011605,METRONIDAZOLE 50 MG/ML ORAL SUSP,144.6,108.45,1.74,130.14,119
NDC,09999012502,OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,90.0,67.5,1.08,81.0,119
NDC,09999013902,AMPICILLIN-SULBACTAM 20 MG AMPICILLIN/ML IN NS IVPB (NEO/PED) CMPD,0.21,0.16,0.01,0.19,119
NDC,09999014001,ACYCLOVIR IN NS (5 MG/ML) IV SOLUTION NEO/PED,1050.0,787.5,12.6,945.0,119
NDC,09999014002,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,22.59,16.94,0.27,20.33,119
NDC,09999015101,CEFTAZIDIME 20 MG/ML IN NS IVPB (NEO/PED) CMPD,828.0,621.0,9.94,745.2,119
NDC,09999015105,CEFTAZIDIME 2.25 MG/ 0.1ML OPHTHALMIC INJECTION,2.12,1.59,0.03,1.91,119
NDC,09999015401,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,0.54,0.4,0.01,0.49,119
NDC,09999015501,GENTAMICIN IN D5W (5 MG/ML) IV SOLUTION (NEO/PEDS) CMPD,7.77,5.83,0.09,6.99,119
NDC,09999015601,HYDROCORTISONE IN NS (1 MG/ML) NEO/PEDS SYRINGE,12.48,9.36,0.15,11.23,119
NDC,09999015603,HYDROCORTISONE 2 MG/ML ORAL SUSPENSION CMPD,27.6,20.7,0.33,24.84,119
NDC,09999015901,ERYTHROMYCIN 5 MG/ML IN NS IVPB (NEO/PED) CMPD,1200.0,900.0,14.4,1080.0,119
NDC,09999016002,FOSPHENYTOIN 25 MG PE/ML IN NS INJECTION NEO/PED CMPD,44.4,33.3,0.53,39.96,119
NDC,09999016204,"PENICILLIN G POTASSIUM/NS 100,000 UNITS/ML (PEDS/NEO/INFANT/NICU)",91.2,68.4,1.09,82.08,119
NDC,09999016302,PIPERACILLIN-TAZOBACTAM 40 MG PIPERACILLIN/ML IN NS IVPB (NEO/PED) CMPD,0.74,0.56,0.01,0.67,119
NDC,09999016402,RIFAMPIN 25MG/ML ORAL SUSPENSION - COMPOUND,90.72,68.04,1.09,81.65,119
NDC,09999016501,MEROPENEM 10 MG/ML IN NS IVPB NEO/PED CMPD,180.0,135.0,2.16,162.0,119
NDC,09999016804,NAFCILLIN 40 MG/ML IN NS IVPB (NEO/PED),2.68,2.01,0.03,2.41,119
NDC,09999017101,ACETAZOLAMIDE 25 MG/ML ORAL SUSPENSION - COMPOUNDED,50.4,37.8,0.6,45.36,119
NDC,09999017301,AZATHIOPRINE 50 MG/ML ORAL SUSPENSION,127.98,95.98,1.54,115.18,119
NDC,09999017702,CYCLOPHOSPHAMIDE 10 MG/ML ORAL SOLUTION - COMPOUND,2727.0,2045.25,32.72,2454.3,119
NDC,09999018204,GANCICLOVIR 10 MG/ML IN NS IVPB (NEO/PED) CMPD,11.98,8.98,0.14,10.78,119
NDC,09999018701,LEVOTHYROXINE SODIUM 25 MCG/ML ORAL SUSPENSION,17.76,13.32,0.21,15.98,119
NDC,09999019101,NIFEDIPINE 4 MG/ML ORAL SUSPENSION CMPD,61.56,46.17,0.74,55.4,119
NDC,09999019803,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,5.89,4.42,0.07,5.3,119
NDC,09999020103,TACROLIMUS 1 MG/ML ORAL SUSPENSION COMPOUND,27.02,20.27,0.32,24.32,119
NDC,09999021301,AZITHROMYCIN IN NS (2 MG/ML) PEDS/NEO,33.0,24.75,0.4,29.7,119
NDC,09999021304,AZITHROMYCIN 500 MG IN NS 250 ML IVPB BATCH,57.0,42.75,0.68,51.3,119
NDC,09999023401,PEDIATRIC MULTIVITAMIN NO.192 250 MCG-50 MG-10 MCG/ML ORAL DROPS (REPACKAGING),0.49,0.37,0.01,0.44,119
NDC,09999023504,SIMETHICONE 0.27 MG/ML CMPD ORAL SUSP,18.0,13.5,0.22,16.2,119
NDC,09999023505,SIMETHICONE 0.27 MG/ML CMPD ORAL SUSP,19.5,14.62,0.23,17.55,119
NDC,09999023506,SIMETHICONE 0.27 MG/ML CMPD ORAL SUSP,36.0,27.0,0.43,32.4,119
NDC,09999024009,OXYCODONE 20 MG/ML ORAL CONCENTRATE,22.0,16.5,0.26,19.8,119
NDC,09999024501,WARFARIN 0.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.12,0.84,0.01,1.01,119
NDC,09999024503,WARFARIN 3.75 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),1.05,0.79,0.01,0.94,119
NDC,09999024808,FENTANYL(PF) 100 MCG/50 ML (2 MCG/ML)-BUPIV 0.125 % NACL EPIDURAL SYRG,83.51,62.63,1.0,75.16,119
NDC,09999026109,ALTEPLASE IN NS 10 MG/30 ML (CHEST TUBE ONLY),4166.37,3124.78,50.0,3749.73,119
NDC,09999026110,ALTEPLASE IN NS 5 MG/15 ML (CHEST TUBE ONLY),1615.95,1211.96,19.39,1454.36,119
NDC,09999026903,DEXAMETHASONE IN D5W (0.4 MG/ML) NEO/PEDS IV,85.74,64.3,1.03,77.17,119
NDC,09999029101,SENNOSIDES 8.8 MG/5 ML ORAL SYRUP,2.28,1.71,0.03,2.05,119
NDC,09999030402,DEXTROSE 5% IN WATER 10 ML FLUSH SYRINGE,0.36,0.27,0.01,0.32,119
NDC,09999031602,LACOSAMIDE 10 MG/ML ORAL SOLUTION,274.2,205.65,3.29,246.78,119
NDC,09999031605,LACOSAMIDE 10 MG/ML ORAL SOLUTION,137.1,102.82,1.65,123.39,119
NDC,09999032302,SODIUM ACETATE 0.154 MEQ/ML (NORMAL) IV BOLUS (NEO/PED) CMPD,35.1,26.33,0.42,31.59,119
NDC,09999035401,MITOMYCIN 0.02% (0.1 MG/0.5 ML) OPHTHALMIC SOLUTION COMPOUNDED,148.26,111.2,1.78,133.43,119
NDC,09999036501,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,4.44,3.33,0.05,4.0,119
NDC,09999037503,GLYCERIN 99.5% RECTAL ENEMA SOLUTION (UW),0.07,0.05,0.01,0.06,119
NDC,09999037506,GLYCERIN 25 ML IN 500 ML NS ENEMA,28.35,21.26,0.34,25.52,119
NDC,09999037508,GLYCERIN 50 ML IN 1000 ML NS ENEMA,25.2,18.9,0.3,22.68,119
NDC,09999038867,INV NIPOCALIMAB/PLACEBO 30 MG/ML INJECTION,0.01,0.01,0.01,0.01,119
NDC,09999038868,INV BI1291583/PLACEBO 2.5 MG TABLET,0.01,0.01,0.01,0.01,119
NDC,09999039201,HYDROCODONE 7.5 MG-ACETAMINOPHEN 325 MG/15 ML ORAL SOLUTION,22.14,16.6,0.27,19.93,119
NDC,09999042204,NITROGLYCERIN 100 MCG/ML FOR INJECTION (COMPOUND UW),4.92,3.69,0.06,4.43,119
NDC,09999042902,PANTOPRAZOLE 80 MG IN NS 100 ML IV DRIP BATCHED,63.0,47.25,0.76,56.7,119
NDC,09999043303,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,59.7,44.78,0.72,53.73,119
NDC,09999043401,FOLIC ACID 1 MG/ML ORAL SUSPENSION - COMPOUNDED,73.44,55.08,0.88,66.1,119
NDC,09999044501,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,11.44,8.58,0.14,10.3,119
NDC,09999045301,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,24.0,18.0,0.29,21.6,119
NDC,09999047701,HIV POST-EXPOSURE KIT STARTER PACK,81.0,60.75,0.97,72.9,119
NDC,09999049401,MEXILETINE 10 MG/ML ORAL SUSPENSION - COMPOUNDED,61.92,46.44,0.74,55.73,119
NDC,09999052409,DEXTROSE 10% SPN WITHOUT HEPARIN (DEXTROSE 10% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,202.5,151.88,2.43,182.25,119
NDC,09999052415,DEXTROSE 5% SPN WITHOUT HEPARIN (DEXTROSE 5% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,213.0,159.75,2.56,191.7,119
NDC,09999052416,DEXTROSE 12.5% SPN WITHOUT HEPARIN (DEXTROSE 12.5% WITH CALCIUM GLUCONATE 18.6 MEQ/L AND PREMASOL 3%) 250 ML BAG,199.5,149.62,2.39,179.55,119
NDC,09999053004,ROPIVACAIN 0.2% 50 ML NERVE BLOCK SYRINGE,33.6,25.2,0.4,30.24,119
NDC,09999053004,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL SOLUTION 50 ML,33.6,25.2,0.4,30.24,119
NDC,09999053702,POTASSIUM CHLORIDE 0.4 MEQ/ML IN SW IVPB NEO/PED (CENTRAL LINE ONLY) (UW),0.34,0.26,0.01,0.31,119
NDC,09999055701,GABAPENTIN 250 MG/5 ML ORAL SOLUTION,7.13,5.35,0.09,6.42,119
NDC,09999056101,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,6.34,4.76,0.08,5.71,119
NDC,09999056203,VANCOMYCIN 1.75 GRAM/500 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS,48.0,36.0,0.58,43.2,119
NDC,09999056205,VANCOMYCIN 750 MG/250 ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,66.0,49.5,0.79,59.4,119
NDC,09999056601,"LIDOCAINE 0.75%-EPINEPHRINE 1:4,000-BSS 0.5 ML CMPD SYRINGE (OR ONLY)",10.64,7.98,0.13,9.58,119
NDC,09999057501,BUMETANIDE 0.25 MG/ML ORAL SOLUTION (FROM INJECTION) (UW),0.2,0.15,0.01,0.18,119
NDC,09999057903,"EPOPROSTENOL 90,000 NG/30 ML (3,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",49.68,37.26,0.6,44.71,119
NDC,09999057904,"EPOPROSTENOL 750,000 NG/50 ML (15,000 NG/ML) IN NS IV DRIP (NEO/PED) CMPD",144.0,108.0,1.73,129.6,119
NDC,09999058901,ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION,430.26,322.7,5.16,387.23,119
NDC,09999061901,MOXIFLOXACIN 1.5 MG/0.3 ML INTRACAMERAL INJECTION (OR ONLY),32.67,24.5,0.39,29.4,119
NDC,09999062201,"HEPARIN (PORCINE) 15,000 UNIT/500 ML IN 0.9% SODIUM CHLORIDE",33.0,24.75,0.4,29.7,119
NDC,09999062202,"HEPARIN (PORCINE) 12,500 UNIT/250 ML IN NS (OR ONLY)",225.0,168.75,2.7,202.5,119
NDC,09999063501,"HEPARIN/ELECTROLYTE SOLUTION (PLASMA-LYTE R) 1,000 UNITS/1,000 ML",102.0,76.5,1.22,91.8,119
NDC,09999063701,"HEPARIN 20,000 UNITS IN NS 500 ML IRRIGATION (OR ONLY) CMPD",6060.0,4545.0,72.72,5454.0,119
NDC,09999065102,PHENTOLAMINE 5 MG INJECTION SOLUTION,1742.17,1306.63,20.91,1567.95,119
NDC,09999067301,"BUPIVACAINE (PF) 0.125 %(1,250 MCG/ML)IN 0.9% SODIUM CHLORIDE EPIDURAL",118.2,88.65,1.42,106.38,119
NDC,09999067801,"LACTULOSE/NS 200 G/1,000 ML ENEMA COMPOUNDED",48.0,36.0,0.58,43.2,119
NDC,09999067802,"LACTULOSE/STERILE WATER 200 G/1,000 ML ENEMA COMPOUNDED",42.0,31.5,0.5,37.8,119
NDC,09999069101,DOXYCYCLINE 500 MG IN 20 ML NS (25 MG/ML) FOR SCLEROTHERAPY,800.64,600.48,9.61,720.58,119
NDC,09999070101,POTASSIUM & SODIUM PHOSPHATE 640 MG-1120 MG-1000 MG/300 ML (PHOS-NAK) COMPOUNDED ORAL SUSPENSION,1.8,1.35,0.02,1.62,119
NDC,09999072801,COPPER CHLORIDE 50 MCG/ML INTRAVENOUS SOLUTION (CMPD),97.44,73.08,1.17,87.7,119
NDC,09999072901,SELENIUM 8 MCG/ML INTRAVENOUS SOLUTION (CMPD),1371.9,1028.93,16.46,1234.71,119
NDC,09999073101,EPINEPHRINE HCL 50 MCG/5 ML(10 MCG/ML) IN 0.9 % SOD CHLOR IV SYRINGE,53.88,40.41,0.65,48.49,119
NDC,09999073201,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,458.1,343.58,5.5,412.29,119
NDC,09999074602,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),300.0,225.0,3.6,270.0,119
NDC,09999075101,KETAMINE IN NS 500 MG/250 ML IV DRIP,58.5,43.88,0.7,52.65,119
NDC,09999075102,KETAMINE 10 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,2494.5,1870.88,29.93,2245.05,119
NDC,09999075201,KETAMINE IN NS 200 MG/100 ML IV DRIP,36.6,27.45,0.44,32.94,119
NDC,09999076501,CAFFEINE CITRATE 10 MG/ML IN D5W IVPB (NEO/PED) CMPD,72.0,54.0,0.86,64.8,119
NDC,09999076702,BRIVARACETAM 10 MG/ML ORAL SOLUTION,287.4,215.55,3.45,258.66,119
NDC,09999076901,"HEPARIN 20,000 UNITS IN 20 ML (1,000 UNIT/ML) SYRINGE FOR CRRT",40.44,30.33,0.49,36.4,119
NDC,09999077102,FOSAPREPITANT 150 MG IN 250ML NS (0.6 MG/ML) IVPB CMPD,690.62,517.97,8.29,621.56,119
NDC,09999079301,POTASSIUM PHOSPHATE 0.05 MMOL/ML IN NS (PERIPHERAL) IVPB (NEO/PED) CMPD,0.13,0.1,0.01,0.12,119
NDC,09999079302,POTASSIUM PHOSPHATE 0.12 MMOL/ML IN NS (CENTRAL LINE ONLY) IVPB (NEO/PED) CMPD,31.5,23.62,0.38,28.35,119
NDC,09999079901,CENOBAMATE 12.5 MG (1/4 OF 50 MG) TABLET,59.0,44.25,0.71,53.1,119
NDC,09999079902,CENOBAMATE 25 MG (1/2 OF 50 MG) TABLET,88.5,66.38,1.06,79.65,119
NDC,09999080001,REMDESIVIR 1.25 MG/ML IN NS IVPB (NEO/PED) CMPD,2698.24,2023.68,32.38,2428.42,119
NDC,09999081501,TBO-FILGRASTIM 30 MCG/ML IN D5W IVPB (NEO/PED) CMPD,820.9,615.67,9.85,738.81,119
NDC,09999082901,VORICONAZOLE 4 MG/ML IN NS IVPB (NEO/PED) CMPD,1479.6,1109.7,17.76,1331.64,119
NDC,09999083901,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,21268.5,15951.38,255.22,19141.65,119
NDC,09999083901,TENECTEPLASE 50 MG KIT FOR ISCHEMIC STROKE (UW),21268.5,15951.38,255.22,19141.65,119
NDC,09999084101,POVIDONE-IODINE 5 % EYE SOLUTION,3.41,2.56,0.04,3.07,119
NDC,09999084201,LIDOCAINE HCL 2 % MUCOSAL SOLUTION,9.9,7.43,0.12,8.91,119
NDC,09999084601,HYDROMORPHONE (PF) 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLN,502.5,376.88,6.03,452.25,119
NDC,09999084705,INV PKN605/PLACEBO ORAL TABLET,0.01,0.01,0.01,0.01,119
NDC,09999084801,OXCARBAZEPINE 300 MG/5 ML (60 MG/ML) ORAL SUSPENSION,13.2,9.9,0.16,11.88,119
NDC,09999085801,LEVOCARNITINE 25 MG/ML INTRAVENOUS SOLUTION (CMPD),225.12,168.84,2.7,202.61,119
NDC,09999086201,MORPHINE 10 MG/5 ML ORAL SOLUTION,1.38,1.03,0.02,1.24,119
NDC,10006070012,PYRIDOXINE (VITAMIN B6) 50 MG TABLET,0.1,0.08,0.01,0.09,119
NDC,10019005561,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",777.0,582.75,9.32,699.3,119
NDC,10019065164,SEVOFLURANE 99.97 % INHALATION LIQUID,1075.0,806.25,12.9,967.5,119
NDC,10019067010,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",777.0,582.75,9.32,699.3,119
NDC,10019067210,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
NDC,10019092501,IFOSFAMIDE 1 GRAM INTRAVENOUS SOLUTION,120.32,90.24,1.44,108.29,119
NDC,10019092602,IFOSFAMIDE 3 GRAM INTRAVENOUS SOLUTION,327.73,245.8,3.93,294.96,119
NDC,10019095301,MESNA 100 MG/ML INTRAVENOUS SOLUTION,106.25,79.69,1.28,95.62,119
NDC,10019095362,MESNA 100 MG/ML INTRAVENOUS SOLUTION,106.25,79.69,1.28,95.62,119
NDC,10119000252,SODIUM BORATE-BORIC ACID-SODIUM CHLORIDE-WATER EYE WASH SOLN,16.99,12.74,0.2,15.29,119
NDC,10122051001,PORACTANT ALFA 120 MG/1.5 ML INTRATRACHEAL SUSPENSION,2300.01,1725.01,27.6,2070.01,119
NDC,10122051003,PORACTANT ALFA 240 MG/3 ML INTRATRACHEAL SUSPENSION,4535.34,3401.51,54.42,4081.81,119
NDC,10122061001,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,528.9,396.67,6.35,476.01,119
NDC,10122061010,CLEVIDIPINE 25 MG/50 ML INTRAVENOUS EMULSION,528.9,396.67,6.35,476.01,119
NDC,10122061101,CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMULSION,1057.8,793.35,12.69,952.02,119
NDC,10122061110,CLEVIDIPINE 50 MG/100 ML INTRAVENOUS EMULSION,1057.8,793.35,12.69,952.02,119
NDC,10122062001,CANGRELOR 50 MG INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
NDC,10135060571,LAMIVUDINE 10 MG/ML ORAL SOLUTION,681.12,510.84,8.17,613.01,119
NDC,10310028313,BENZOCAINE 20 %-MENTHOL 0.26 %-ZINC CHLORIDE 0.15 % MUCOSAL GEL,35.27,26.45,0.42,31.74,119
NDC,10511300102,HEXAMINOLEVULINATE 100 MG INTRAVESICAL SOLUTION,2846.0,2134.5,34.15,2561.4,119
NDC,10572001201,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",522.5,391.88,6.27,470.25,119
NDC,10702000310,PROMETHAZINE 25 MG TABLET,0.29,0.22,0.01,0.26,119
NDC,10702015016,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,238.39,178.79,2.86,214.55,119
NDC,10858008100,RADIOPAQUE PVC MARKERS-BARIUM SULFATE 24 MARKERS CAPSULE,83.7,62.78,1.0,75.33,119
NDC,10939056833,"BACITRACIN ZINC 500 UNIT-POLYMYXIN B 10,000 UNIT/GRAM TOPICAL OINTMENT",9.71,7.28,0.12,8.74,119
NDC,11527014055,OXYMETAZOLINE 0.05 % NASAL SPRAY,0.18,0.14,0.01,0.16,119
NDC,11534016503,FOLIC ACID 1 MG TABLET,0.13,0.09,0.01,0.12,119
NDC,11701002223,UREA 10 %-ALPHA HYDROXY ACIDS 4 % TOPICAL CREAM,33.86,25.39,0.41,30.47,119
NDC,11701005033,ZINC OXIDE-PETROLATUM 20 %-51 % TOPICAL PASTE,40.9,30.67,0.49,36.81,119
NDC,11701006723,MICONAZOLE NITRATE 2 % TOPICAL OINTMENT,38.99,29.24,0.47,35.09,119
NDC,11980017405,"PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION",721.8,541.35,8.66,649.62,119
NDC,11980021105,"FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION",757.89,568.42,9.09,682.1,119
NDC,11994000100,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 INTRAVENOUS SYRINGE,490.26,367.7,5.88,441.23,119
NDC,11994000120,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.7,5.88,441.23,119
NDC,11994000152,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.69,5.88,441.23,119
NDC,11994000155,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,490.26,367.69,5.88,441.23,119
NDC,11994000320,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,403.9,302.92,4.85,363.51,119
NDC,11994000602,KIT FOR PREPARATION OF TC-99M-BICISATE 0.9 MG INTRAVENOUS SOLUTION,13528.74,10146.56,162.34,12175.87,119
NDC,11994001101,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,769.31,576.98,9.23,692.38,119
NDC,11994001116,PERFLUTREN LIPID MICROSPHERES 1.1 MG/ML INTRAVENOUS SUSPENSION,741.08,555.81,8.89,666.97,119
NDC,11994009001,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,12.28,9.21,0.15,11.05,119
NDC,11994009003,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,24528.34,18396.26,294.34,22075.51,119
NDC,11994009004,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,26486.16,19864.62,317.83,23837.54,119
NDC,11994009005,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,28518.46,21388.84,342.22,25666.61,119
NDC,11994009006,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,32211.24,24158.43,386.53,28990.12,119
NDC,11994009007,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,37736.86,28302.65,452.84,33963.17,119
NDC,11994009009,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,45921.4,34441.05,551.06,41329.26,119
NDC,11994009010,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,53991.44,40493.58,647.9,48592.3,119
NDC,11994009011,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,66409.53,49807.14,796.91,59768.58,119
NDC,11994009012,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,81683.55,61262.67,980.2,73515.2,119
NDC,11994009036,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,202.5,151.88,2.43,182.25,119
NDC,11994009073,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,18393.65,13795.24,220.72,16554.29,119
NDC,11994009092,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,18741.29,14055.97,224.9,16867.16,119
NDC,11994009101,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,22254.62,16690.97,267.06,20029.16,119
NDC,11994009103,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,26000.04,19500.03,312.0,23400.04,119
NDC,11994009104,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,28075.33,21056.5,336.9,25267.8,119
NDC,11994009105,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,30229.55,22672.16,362.75,27206.6,119
NDC,11994009106,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,34143.91,25607.93,409.73,30729.52,119
NDC,11994009107,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,40001.07,30000.8,480.01,36000.96,119
NDC,11994009109,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,48676.69,36507.52,584.12,43809.02,119
NDC,11994009110,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,57230.93,42923.2,686.77,51507.84,119
NDC,11994009111,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,70394.1,52795.58,844.73,63354.69,119
NDC,11994009112,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,86584.55,64938.41,1039.01,77926.1,119
NDC,11994009136,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,15452.69,11589.52,185.43,13907.42,119
NDC,11994009173,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
NDC,11994009192,SODIUM PERTECHNETATE TC-99M INTRAVENOUS SOLUTION,19865.75,14899.32,238.39,17879.18,119
NDC,11994012106,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,3422.06,2566.54,41.06,3079.85,119
NDC,11994012108,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,4384.42,3288.32,52.61,3945.98,119
NDC,11994012113,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,6576.21,4932.16,78.91,5918.59,119
NDC,11994012119,GALLIUM-67 CITRATE 74 MBQ/ML (2 MCI/ML) INTRAVENOUS SOLUTION,9864.59,7398.44,118.38,8878.13,119
NDC,11994012711,XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) GAS FOR INHALATION,1316.74,987.55,15.8,1185.07,119
NDC,11994012715,XENON-133 IN CARBON DIOXIDE 370 MBQ (10 MCI) GAS FOR INHALATION,979.59,734.69,11.76,881.63,119
NDC,11994012821,XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) GAS FOR INHALATION,2135.12,1601.34,25.62,1921.61,119
NDC,11994012825,XENON-133 IN CARBON DIOXIDE 740 MBQ (20 MCI) GAS FOR INHALATION,1994.92,1496.19,23.94,1795.43,119
NDC,12546062749,MENTHOL 5.8 MG LOZENGES,0.24,0.18,0.01,0.22,119
NDC,12870000101,SILVER NITRATE APPLICATORS 75 %-25 % TOPICAL STICK,453.0,339.75,5.44,407.7,119
NDC,13107000130,MIRTAZAPINE 7.5 MG TABLET,6.5,4.87,0.08,5.85,119
NDC,13107000334,MIRTAZAPINE 30 MG TABLET,2.25,1.69,0.03,2.02,119
NDC,13107003134,MIRTAZAPINE 15 MG TABLET,1.78,1.34,0.02,1.6,119
NDC,13107010701,HYDROMORPHONE 2 MG TABLET,0.88,0.66,0.01,0.79,119
NDC,13517010030,DIAZOXIDE 50 MG/ML ORAL SUSPENSION,1800.0,1350.0,21.6,1620.0,119
NDC,13533031801,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,2613.12,1959.84,31.36,2351.81,119
NDC,13533031803,RABIES IMMUNE GLOBULIN (PF) 300 UNIT/ML INTRAMUSCULAR SOLUTION,7839.33,5879.49,94.07,7055.4,119
NDC,13533060612,ANTITHROMBIN III (HUMAN) 500 (+/-) UNIT INTRAVENOUS SOLUTION,18.95,14.22,0.23,17.06,119
NDC,13533063402,TETANUS IMMUNE GLOBULIN (PF) 250 UNIT/ML INTRAMUSCULAR SYRINGE,2492.81,1869.61,29.91,2243.53,119
NDC,13533063603,HEPATITIS B IMMUNE GLOBULIN 110 UNIT/0.5 ML INTRAMUSCULAR SYRINGE,367.07,275.3,4.4,330.36,119
NDC,13533070501,"ALPHA-1-PROTEINASE INHIBITOR (HUMAN) 1,000 MG (+/-)/20 ML IV SOLUTION",1508.38,1131.29,18.1,1357.54,119
NDC,13533080020,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),2390.75,1793.06,28.69,2151.68,119
NDC,13533080020,IMMUNE GLOBU G 5 GRAM/50 ML(10 %)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,2390.75,1793.06,28.69,2151.68,119
NDC,13533080024,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),9563.0,7172.25,114.76,8606.7,119
NDC,13533080024,IMMUNE GLOB G 20 GRAM/200 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,9563.0,7172.25,114.76,8606.7,119
NDC,13533080040,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),19126.0,14344.5,229.51,17213.4,119
NDC,13533080040,IMMUNE GLOB G 40 GRAM/400 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,19126.0,14344.5,229.51,17213.4,119
NDC,13533080071,IMMUN GLOB G (10%)-GLY-IGA OVER 50 MCG/ML INJ SOLN (W),4781.5,3586.12,57.38,4303.35,119
NDC,13533080071,IMMUNE GLOB G 10 GRAM/100 ML(10%)-GLY-IGA AVE 46 MCG/ML INJECTION SOLN,4781.5,3586.12,57.38,4303.35,119
NDC,13668010401,"ISOSORBIDE MONONITRATE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",0.72,0.54,0.01,0.65,119
NDC,13668010501,"ISOSORBIDE MONONITRATE ER 60 MG TABLET,EXTENDED RELEASE 24 HR",0.78,0.58,0.01,0.7,119
NDC,13668018990,"TOLTERODINE ER 2 MG CAPSULE,EXTENDED RELEASE 24 HR",6.0,4.5,0.07,5.4,119
NDC,13668027101,CARBAMAZEPINE 100 MG CHEWABLE TABLET,3.16,2.37,0.04,2.84,119
NDC,13668034030,"LAMOTRIGINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",9.12,6.84,0.11,8.21,119
NDC,13668048201,MINOCYCLINE 50 MG CAPSULE,1.38,1.03,0.02,1.24,119
NDC,13668048450,MINOCYCLINE 100 MG CAPSULE,2.76,2.07,0.03,2.48,119
NDC,13668058630,"ERYTHROMYCIN 250 MG TABLET,DELAYED RELEASE",29.93,22.45,0.36,26.94,119
NDC,13925052201,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,599.67,449.76,7.2,539.7,119
NDC,14537081775,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,112.5,84.38,1.35,101.25,119
NDC,14537096775,DEXTROSE 2.45 GRAM-SOD CITRATE 2.2 GRAM-CITRIC AC 800 MG/100 ML SOLN,55.5,41.62,0.67,49.95,119
NDC,14789012205,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,1224.25,918.19,14.69,1101.82,119
NDC,14789012207,FLUORESCEIN 500 MG/5 ML (10 %) INTRAVENOUS SOLUTION,1224.25,918.19,14.69,1101.82,119
NDC,14789012705,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,78.75,59.06,0.94,70.88,119
NDC,14789012707,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,78.75,59.06,0.94,70.88,119
NDC,14789090007,PROCAINAMIDE 500 MG/ML INJECTION SOLUTION,2304.0,1728.0,27.65,2073.6,119
NDC,15054004301,IRINOTECAN LIPOSOMAL 4.3 MG/ML INTRAVENOUS,8270.48,6202.86,99.25,7443.43,119
NDC,15054106004,LANREOTIDE 60 MG/0.2 ML SUBCUTANEOUS SYRINGE (UW),13764.97,10323.73,165.18,12388.47,119
NDC,15054109004,LANREOTIDE 90 MG/0.3 ML SUBCUTANEOUS SYRINGE (UW),18332.19,13749.14,219.99,16498.97,119
NDC,15054112004,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE (UW),21619.68,16214.76,259.44,19457.71,119
NDC,16500008806,PEDIATRIC MULTIVITAMIN WITH IRON AND OTHER MINERALS CHEWABLE TABLET,0.7,0.53,0.01,0.63,119
NDC,16500059918,PEDIATRIC MULTIVITAMIN NO.227-FERROUS SULFATE 10 MG CHEWABLE TABLET,0.63,0.47,0.01,0.57,119
NDC,16571020110,"DICLOFENAC SODIUM 75 MG TABLET,DELAYED RELEASE",1.62,1.22,0.02,1.46,119
NDC,16571020210,"DICLOFENAC SODIUM 50 MG TABLET,DELAYED RELEASE",1.47,1.1,0.02,1.32,119
NDC,16571066701,PHENOBARBITAL 64.8 MG TABLET,4.02,3.01,0.05,3.62,119
NDC,16571067101,PHENOBARBITAL 16.2 MG TABLET,2.55,1.91,0.03,2.3,119
NDC,16571067401,PHENOBARBITAL 60 MG TABLET,2.64,1.98,0.03,2.38,119
NDC,16571077909,DONEPEZIL 10 MG TABLET,0.7,0.53,0.01,0.63,119
NDC,16571081320,CALCIUM ACETATE(PHOSPHATE BINDERS) 667 MG CAPSULE,1.5,1.12,0.02,1.35,119
NDC,16714000901,ISOSORBIDE DINITRATE 20 MG TABLET,5.27,3.95,0.06,4.74,119
NDC,16714001001,ISOSORBIDE DINITRATE 30 MG TABLET,6.26,4.69,0.08,5.63,119
NDC,16714002701,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,62.56,46.92,0.75,56.3,119
NDC,16714003001,CLOBETASOL 0.05 % SHAMPOO,768.89,576.67,9.23,692.0,119
NDC,16714003402,LEVETIRACETAM 250 MG TABLET,1.61,1.21,0.02,1.45,119
NDC,16714003502,LEVETIRACETAM 500 MG TABLET,2.18,1.63,0.03,1.96,119
NDC,16714004801,CHLORPROMAZINE 25 MG TABLET,23.41,17.56,0.28,21.07,119
NDC,16714005210,CLOPIDOGREL 75 MG TABLET,1.45,1.08,0.02,1.3,119
NDC,16714006301,"CARBAMAZEPINE ER 100 MG TABLET,EXTENDED RELEASE,12 HR",5.5,4.12,0.07,4.95,119
NDC,16714006401,"CARBAMAZEPINE ER 200 MG TABLET,EXTENDED RELEASE,12 HR",7.81,5.86,0.09,7.03,119
NDC,16714007204,BACLOFEN 20 MG TABLET,1.61,1.21,0.02,1.45,119
NDC,16714007701,TADALAFIL 20 MG TABLET,10.64,7.98,0.13,9.58,119
NDC,16714008110,HYDROXYZINE HCL 10 MG TABLET,0.64,0.48,0.01,0.58,119
NDC,16714008310,HYDROXYZINE HCL 50 MG TABLET,1.11,0.83,0.01,1.0,119
NDC,16714010105,GEMFIBROZIL 600 MG TABLET,0.71,0.53,0.01,0.64,119
NDC,16714011001,HYDROXYCHLOROQUINE 200 MG TABLET,7.54,5.65,0.09,6.79,119
NDC,16714011601,RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
NDC,16714011701,RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
NDC,16714011902,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,314.68,236.01,3.78,283.21,119
NDC,16714011903,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,314.68,236.01,3.78,283.21,119
NDC,16714013001,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,51.0,38.25,0.61,45.9,119
NDC,16714013025,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,51.0,38.25,0.61,45.9,119
NDC,16714013101,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,107.82,80.87,1.29,97.04,119
NDC,16714013701,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",367.41,275.56,4.41,330.67,119
NDC,16714014001,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,271.8,203.85,3.26,244.62,119
NDC,16714014101,ARIPIPRAZOLE 2 MG TABLET,7.2,5.4,0.09,6.48,119
NDC,16714015701,PROGESTERONE MICRONIZED 100 MG CAPSULE,3.02,2.27,0.04,2.72,119
NDC,16714016601,LIOTHYRONINE 5 MCG TABLET,4.63,3.47,0.06,4.17,119
NDC,16714016701,LIOTHYRONINE 25 MCG TABLET,6.0,4.5,0.07,5.4,119
NDC,16714017201,TIZANIDINE 4 MG TABLET,0.95,0.71,0.01,0.86,119
NDC,16714018101,PAROXETINE 10 MG TABLET,1.03,0.77,0.01,0.93,119
NDC,16714018203,PAROXETINE 20 MG TABLET,0.83,0.62,0.01,0.75,119
NDC,16714018405,PAROXETINE 40 MG TABLET,1.21,0.9,0.01,1.09,119
NDC,16714018701,SIROLIMUS 0.5 MG TABLET,34.82,26.11,0.42,31.34,119
NDC,16714019001,"GUANFACINE ER 1 MG TABLET,EXTENDED RELEASE 24 HR",3.3,2.47,0.04,2.97,119
NDC,16714019901,VORICONAZOLE 200 MG TABLET,47.05,35.29,0.56,42.34,119
NDC,16714020010,ONDANSETRON 4 MG DISINTEGRATING TABLET,3.36,2.52,0.04,3.02,119
NDC,16714021301,RALOXIFENE 60 MG TABLET,9.3,6.98,0.11,8.37,119
NDC,16714023501,PENICILLIN V POTASSIUM 500 MG TABLET,3.67,2.75,0.04,3.3,119
NDC,16714024501,"MESALAMINE 1,000 MG RECTAL SUPPOSITORY",60.0,45.0,0.72,54.0,119
NDC,16714024601,CLINDAMYCIN 1 % LOTION,608.04,456.03,7.3,547.24,119
NDC,16714024801,FOSAPREPITANT 150 MG/5 ML (30 MG/ML) INTRAVENOUS SOLUTION (UW),250.44,187.83,3.01,225.4,119
NDC,16714025701,AMITRIPTYLINE 10 MG TABLET,0.67,0.5,0.01,0.6,119
NDC,16714026101,AMITRIPTYLINE 100 MG TABLET,5.3,3.98,0.06,4.77,119
NDC,16714026701,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL OINTMENT,29.61,22.21,0.36,26.65,119
NDC,16714027601,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,24.3,18.23,0.29,21.87,119
NDC,16714029202,AMOXICILLIN 200 MG-POTASSIUM CLAVULANATE 28.5 MG/5 ML ORAL SUSPENSION,55.35,41.51,0.66,49.82,119
NDC,16714029303,AMOXICILLIN 400 MG-POTASSIUM CLAVULANATE 57 MG/5 ML ORAL SUSPENSION,117.0,87.75,1.4,105.3,119
NDC,16714029601,AMOXICILLIN 500 MG-POTASSIUM CLAVULANATE 125 MG TABLET,3.88,2.91,0.05,3.49,119
NDC,16714029701,AMOXICILLIN 875 MG-POTASSIUM CLAVULANATE 125 MG TABLET,5.44,4.08,0.07,4.9,119
NDC,16714029801,AMOXICILLIN 250 MG CAPSULE,0.31,0.23,0.01,0.28,119
NDC,16714029904,AMOXICILLIN 500 MG CAPSULE,0.88,0.66,0.01,0.79,119
NDC,16714034501,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,6802.56,5101.92,81.63,6122.3,119
NDC,16714040102,CEFUROXIME AXETIL 500 MG TABLET,18.93,14.2,0.23,17.04,119
NDC,16714048302,CLINDAMYCIN 75 MG/5 ML ORAL SOLUTION,284.4,213.3,3.41,255.96,119
NDC,16714048401,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",2.28,1.71,0.03,2.05,119
NDC,16714048501,"DIVALPROEX ER 500 MG TABLET,EXTENDED RELEASE 24 HR",3.37,2.52,0.04,3.03,119
NDC,16714049602,CLOTRIMAZOLE-BETAMETHASONE 1 %-0.05 % TOPICAL CREAM,237.87,178.4,2.85,214.08,119
NDC,16714052601,IPRATROPIUM BROMIDE 21 MCG (0.03 %) NASAL SPRAY,217.44,163.08,2.61,195.7,119
NDC,16714052901,BISOPROLOL FUMARATE 5 MG TABLET,3.73,2.79,0.04,3.36,119
NDC,16714053401,EMTRICITABINE 200 MG-TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,6.37,4.77,0.08,5.73,119
NDC,16714053701,LEVETIRACETAM 750 MG TABLET,2.67,2.0,0.03,2.4,119
NDC,16714055301,"DILTIAZEM ER 60 MG CAPSULE,EXTENDED RELEASE 12 HR",16.6,12.45,0.2,14.94,119
NDC,16714055401,"DILTIAZEM ER 90 MG CAPSULE,EXTENDED RELEASE 12 HR",18.97,14.22,0.23,17.07,119
NDC,16714055701,METRONIDAZOLE 0.75 % (37.5 MG/5 GRAM) VAGINAL GEL,692.58,519.44,8.31,623.32,119
NDC,16714055801,PRAVASTATIN 10 MG TABLET,1.52,1.14,0.02,1.37,119
NDC,16714059001,DIGOXIN 125 MCG (0.125 MG) TABLET,7.11,5.33,0.09,6.4,119
NDC,16714059101,DIGOXIN 250 MCG (0.25 MG) TABLET,7.11,5.33,0.09,6.4,119
NDC,16714060102,SERTRALINE 20 MG/ML ORAL CONCENTRATE,335.52,251.64,4.03,301.97,119
NDC,16714061304,SERTRALINE 100 MG TABLET,0.7,0.52,0.01,0.63,119
NDC,16714062101,ZOLPIDEM 5 MG TABLET,0.35,0.26,0.01,0.32,119
NDC,16714062601,"LAMOTRIGINE ER 200 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
NDC,16714063101,ALENDRONATE 10 MG TABLET,2.0,1.5,0.02,1.8,119
NDC,16714063201,ALENDRONATE 35 MG TABLET,7.79,5.84,0.09,7.01,119
NDC,16714063301,ALENDRONATE 70 MG TABLET,6.75,5.06,0.08,6.08,119
NDC,16714064301,MOXIFLOXACIN 0.5 % EYE DROPS,229.64,172.23,2.76,206.68,119
NDC,16714066201,GABAPENTIN 300 MG CAPSULE,0.77,0.58,0.01,0.69,119
NDC,16714067102,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,424.2,318.15,5.09,381.78,119
NDC,16714068201,SIMVASTATIN 10 MG TABLET,0.57,0.43,0.01,0.51,119
NDC,16714068303,SIMVASTATIN 20 MG TABLET,0.53,0.4,0.01,0.48,119
NDC,16714068402,SIMVASTATIN 40 MG TABLET,0.82,0.61,0.01,0.74,119
NDC,16714069101,FLUCONAZOLE 100 MG TABLET,6.65,4.99,0.08,5.98,119
NDC,16714069210,FLUCONAZOLE 150 MG TABLET,16.49,12.37,0.2,14.84,119
NDC,16714069401,FLUCONAZOLE 50 MG TABLET,4.71,3.53,0.06,4.24,119
NDC,16714069601,FLUCONAZOLE 40 MG/ML ORAL SUSPENSION,342.3,256.73,4.11,308.07,119
NDC,16714069703,VALACYCLOVIR 1 GRAM TABLET,7.7,5.77,0.09,6.93,119
NDC,16714069803,VALACYCLOVIR 500 MG TABLET,4.45,3.34,0.05,4.0,119
NDC,16714071701,ENTECAVIR 0.5 MG TABLET,57.19,42.89,0.69,51.47,119
NDC,16714072002,FLUOXETINE 10 MG CAPSULE,0.49,0.36,0.01,0.44,119
NDC,16714072103,FLUOXETINE 20 MG CAPSULE,0.23,0.18,0.01,0.21,119
NDC,16714072901,DESONIDE 0.05 % TOPICAL CREAM,216.45,162.34,2.6,194.8,119
NDC,16714074302,ITRACONAZOLE 100 MG CAPSULE,28.13,21.1,0.34,25.32,119
NDC,16714075501,ATOMOXETINE 10 MG CAPSULE,23.54,17.65,0.28,21.19,119
NDC,16714075601,ATOMOXETINE 18 MG CAPSULE,22.73,17.05,0.27,20.46,119
NDC,16714077101,RASAGILINE 1 MG TABLET,61.33,45.99,0.74,55.2,119
NDC,16714078204,CLOBETASOL 0.05 % TOPICAL OINTMENT,1249.92,937.44,15.0,1124.93,119
NDC,16714079501,TERBINAFINE HCL 250 MG TABLET,1.6,1.2,0.02,1.44,119
NDC,16714079601,SUMATRIPTAN 25 MG TABLET,10.63,7.97,0.13,9.57,119
NDC,16714079701,SUMATRIPTAN 50 MG TABLET,10.63,7.97,0.13,9.57,119
NDC,16714079801,SUMATRIPTAN 100 MG TABLET,10.63,7.97,0.13,9.57,119
NDC,16714079904,CETIRIZINE 10 MG TABLET,0.55,0.41,0.01,0.5,119
NDC,16714080901,LEVONORGESTREL 1.5 MG TABLET,121.23,90.92,1.45,109.11,119
NDC,16714081302,EZETIMIBE 10 MG TABLET,1.91,1.44,0.02,1.72,119
NDC,16714081401,SEVELAMER CARBONATE 800 MG TABLET,12.59,9.44,0.15,11.33,119
NDC,16714082001,TENOFOVIR DISOPROXIL FUMARATE 300 MG TABLET,13.51,10.13,0.16,12.16,119
NDC,16714083001,"MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE",28.78,21.58,0.35,25.9,119
NDC,16714083601,ZIPRASIDONE 40 MG CAPSULE,5.11,3.83,0.06,4.6,119
NDC,16714086701,"PALIPERIDONE ER 3 MG TABLET,EXTENDED RELEASE 24 HR",113.17,84.87,1.36,101.85,119
NDC,16714087801,LIDOCAINE 5 % TOPICAL OINTMENT,387.43,290.57,4.65,348.69,119
NDC,16714088701,CLOBAZAM 10 MG TABLET,10.51,7.88,0.13,9.46,119
NDC,16714089701,PERMETHRIN 5 % TOPICAL CREAM,594.0,445.5,7.13,534.6,119
NDC,16714095001,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,4.16,3.12,0.05,3.74,119
NDC,16714097302,PHYTONADIONE (VITAMIN K1) 5 MG TABLET,168.8,126.6,2.03,151.92,119
NDC,16714098502,TRIAMCINOLONE ACETONIDE 0.025 % TOPICAL CREAM,42.72,32.04,0.51,38.45,119
NDC,16714098601,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,20.61,15.46,0.25,18.55,119
NDC,16714098604,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,130.75,98.06,1.57,117.68,119
NDC,16714098801,ROSUVASTATIN 5 MG TABLET,1.23,0.92,0.01,1.11,119
NDC,16714098901,ROSUVASTATIN 10 MG TABLET,1.21,0.9,0.01,1.09,119
NDC,16714099602,BETAMETHASONE DIPROPIONATE 0.05 % TOPICAL CREAM,435.24,326.43,5.22,391.72,119
NDC,16729002310,BICALUTAMIDE 50 MG TABLET,4.55,3.41,0.05,4.1,119
NDC,16729013600,CLONAZEPAM 0.5 MG TABLET,0.16,0.12,0.01,0.14,119
NDC,16729028838,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,137.7,103.28,1.65,123.93,119
NDC,16729029512,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,201.96,151.47,2.42,181.76,119
NDC,16729029805,ONDANSETRON HCL 2 MG/ML INTRAVENOUS SOLUTION,33.0,24.75,0.4,29.7,119
NDC,16729045415,LEVOTHYROXINE 137 MCG TABLET,0.86,0.65,0.01,0.77,119
NDC,16729047901,METHYLPHENIDATE 10 MG TABLET,1.67,1.25,0.02,1.5,119
NDC,16784011761,BACITRACIN ZINC 500 UNIT/GRAM TOPICAL OINTMENT,102.0,76.5,1.22,91.8,119
NDC,16864068003,BENZOCAINE 20 %-MENTHOL 0.5 % TOPICAL AEROSOL,33.15,24.86,0.4,29.84,119
NDC,17156002101,INDIUM IN-111 OXYQUINOLINE 1 MCI/ML (37 MBQ/ML)(1 ML) INTRAVENOUS SOLN,13196.36,9897.27,158.36,11876.72,119
NDC,17156002205,KIT FOR PREPARATION OF TC-99M-EXAMETAZIME 0.5 MG INTRAVENOUS SOLUTION,5641.15,4230.87,67.69,5077.04,119
NDC,17156006710,FLUTEMETAMOL F-18 5 MCI (185 MBQ) INTRAVENOUS SOLUTION,90288.0,67716.0,1083.46,81259.2,119
NDC,17156006730,FLUTEMETAMOL F-18 5 MCI (185 MBQ) INTRAVENOUS SOLUTION,270864.0,203148.0,3250.37,243777.6,119
NDC,17156021001,IOFLUPANE I 123 5 MCI/2.5 ML (185 MBQ/2.5 ML) INTRAVENOUS SOLUTION,3790.85,2843.14,45.49,3411.76,119
NDC,17156023501,IOBENGUANE SULFATE I-123 10 MCI/5 ML (370 MBQ/5 ML) INTRAVENOUS SOLN,3022.86,2267.15,36.27,2720.57,119
NDC,17156025108,PENTETATE INDIUM DISODIUM IN-111 1.5 MCI/1.5 ML INTRATHECAL SOLUTION,4574.02,3430.52,54.89,4116.62,119
NDC,17156052501,KIT FOR PREPARATION TC-99M-SUCCIMER 1 MG INTRAVENOUS SOLUTION,2301.77,1726.33,27.62,2071.59,119
NDC,17238090011,FLUORESCEIN 1 MG EYE STRIPS,1.26,0.94,0.02,1.13,119
NDC,17238090099,FLUORESCEIN 1 MG EYE STRIPS,1.26,0.94,0.02,1.13,119
NDC,17433987600,DOCUSATE SODIUM 283 MG/5 ML ENEMA,11.19,8.39,0.13,10.07,119
NDC,17518006004,POVIDONE-IODINE 5 % KIT,60.0,45.0,0.72,54.0,119
NDC,17772012301,"OXCARBAZEPINE ER 600 MG TABLET,EXTENDED RELEASE 24 HR",103.35,77.51,1.24,93.02,119
NDC,18657011702,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",231.57,173.68,2.78,208.41,119
NDC,18657011704,"HYALURONIDASE, HUMAN RECOMBINANT 150 UNIT/ML INJECTION SOLUTION",231.57,173.68,2.78,208.41,119
NDC,19515090441,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,39.48,29.61,0.47,35.53,119
NDC,20555003300,"CHOLECALCIFEROL (VITAMIN D3) 25 MCG (1,000 UNIT) TABLET",0.23,0.18,0.01,0.21,119
NDC,20555003601,MELATONIN 3 MG TABLET,0.85,0.63,0.01,0.76,119
NDC,20555003901,MELATONIN 5 MG TABLET,1.29,0.97,0.02,1.16,119
NDC,20555004000,ZINC SULFATE 50 MG ZINC (220 MG) CAPSULE,1.11,0.83,0.01,1.0,119
NDC,21922000407,DESONIDE 0.05 % TOPICAL OINTMENT,240.12,180.09,2.88,216.11,119
NDC,21922001704,CLOBETASOL 0.05 % TOPICAL OINTMENT,29.97,22.48,0.36,26.97,119
NDC,21922001707,CLOBETASOL 0.05 % TOPICAL OINTMENT,119.88,89.91,1.44,107.89,119
NDC,23155007001,METHIMAZOLE 5 MG TABLET,0.9,0.68,0.01,0.81,119
NDC,23155019201,BUPROPION HCL 100 MG TABLET,2.22,1.66,0.03,2.0,119
NDC,23155024041,METOCLOPRAMIDE 5 MG/ML INJECTION SOLUTION,13.2,9.9,0.16,11.88,119
NDC,23155029031,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,45.0,33.75,0.54,40.5,119
NDC,23155029041,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,45.0,33.75,0.54,40.5,119
NDC,23155031331,ACETAZOLAMIDE 500 MG SOLUTION FOR INJECTION,178.65,133.99,2.14,160.78,119
NDC,23155048601,VERAPAMIL 120 MG TABLET,0.53,0.4,0.01,0.48,119
NDC,23155048901,DESMOPRESSIN 0.1 MG TABLET,6.29,4.72,0.08,5.66,119
NDC,23155051211,NIMODIPINE 30 MG CAPSULE,7.2,5.4,0.09,6.48,119
NDC,23155059431,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,725.02,543.76,8.7,652.52,119
NDC,23155060601,GLYCOPYRROLATE 1 MG TABLET,0.71,0.54,0.01,0.64,119
NDC,23155066131,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,630.0,472.5,7.56,567.0,119
NDC,23155066142,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,630.0,472.5,7.56,567.0,119
NDC,23155074831,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,405.46,304.09,4.87,364.91,119
NDC,23155074841,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,405.46,304.09,4.87,364.91,119
NDC,23155078531,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,33.1,24.82,0.4,29.79,119
NDC,23155078541,AMIKACIN 500 MG/2 ML INJECTION SOLUTION,33.1,24.82,0.4,29.79,119
NDC,23155082373,CABERGOLINE 0.5 MG TABLET,12.19,9.14,0.15,10.97,119
NDC,23155084851,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,2714.88,2036.16,32.58,2443.39,119
NDC,23155087503,LETROZOLE 2.5 MG TABLET,1.8,1.35,0.02,1.62,119
NDC,24201001020,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,5022.58,3766.93,60.27,4520.32,119
NDC,24201001050,PENTOBARBITAL SODIUM 50 MG/ML INJECTION SOLUTION,10156.5,7617.38,121.88,9140.85,119
NDC,24201010001,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",65.4,49.05,0.78,58.86,119
NDC,24201010001,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION (REPACKAGED)",65.4,49.05,0.78,58.86,119
NDC,24201010024,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION (REPACKAGED)",65.4,49.05,0.78,58.86,119
NDC,24201020105,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,346.5,259.88,4.16,311.85,119
NDC,24208038762,VIT A 300 MCG-C 200 MG-E 27 MG-LUTEIN 2 MG AND MINERALS TABLET,0.45,0.34,0.01,0.4,119
NDC,24208041110,BRIMONIDINE 0.2 % EYE DROPS,163.5,122.62,1.96,147.15,119
NDC,24208045705,DICLOFENAC 0.1 % EYE DROPS,84.0,63.0,1.01,75.6,119
NDC,24208048510,DORZOLAMIDE 2 % EYE DROPS,203.94,152.95,2.45,183.55,119
NDC,24208053535,GANCICLOVIR 0.15 % EYE GEL,1980.05,1485.04,23.76,1782.04,119
NDC,24208053920,ACETYLCHOLINE CHLORIDE 1 % (10 MG/ML) INTRAOCULAR KIT,397.91,298.43,4.77,358.12,119
NDC,24208055555,"BACITRACIN-POLYMYXIN B 500 UNIT-10,000 UNIT/GRAM EYE OINTMENT",137.53,103.15,1.65,123.78,119
NDC,24208063110,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG/ML-10,000 UNIT/ML-1 % EAR SOLUTION",503.4,377.55,6.04,453.06,119
NDC,24208063562,"NEOMYCIN-POLYMYXIN-HYDROCORT 3.5 MG-10,000 UNIT/ML-1 % EAR DROPS,SUSP",503.4,377.55,6.04,453.06,119
NDC,24208072002,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % EYE DROPS,300.0,225.0,3.6,270.0,119
NDC,24208073006,PROPARACAINE 0.5 % EYE DROPS,210.51,157.88,2.53,189.46,119
NDC,24208073501,CYCLOPENTOLATE 1 % EYE DROPS,72.6,54.45,0.87,65.34,119
NDC,24208079062,"NEOMYCIN 1.75 MG-POLYMYXIN 10,000 UNIT-GRAMICIDIN 0.025MG/ML EYE DROPS",306.3,229.73,3.68,275.67,119
NDC,24208091019,ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT,59.59,44.69,0.72,53.63,119
NDC,24338023030,NIMODIPINE 30 MG/5 ML ORAL SYRINGE (FOR ORAL USE ONLY),294.03,220.52,3.53,264.63,119
NDC,24338026010,NIMODIPINE 60 MG/10 ML ORAL SYRINGE (FOR ORAL USE ONLY),588.06,441.04,7.06,529.25,119
NDC,24338026012,NIMODIPINE 60 MG/10 ML ORAL SYRINGE (FOR ORAL USE ONLY),588.06,441.04,7.06,529.25,119
NDC,24357030001,POTASSIUM ALUM (BULK) POWDER,499.98,374.98,6.0,449.98,119
NDC,24357030030,POTASSIUM ALUM (BULK) POWDER,430.02,322.52,5.16,387.02,119
NDC,24510005010,TAPENTADOL 50 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,24571010206,BICARBONATE HEMODIALYSIS SOLN WITHOUT CALCIUM 8 POT 2 MEQ-MAG 1 MEQ/L,210.0,157.5,2.52,189.0,119
NDC,24571010306,BICARBONATE HEMODIALYSIS SOLUTION NO.2 K 2 MEQ-CA 3.5 MEQ-MG 1 MEQ/L,210.0,157.5,2.52,189.0,119
NDC,24571010506,BICARBONATE HEMODIALYSIS SOLUTION NO.9 K 4 MEQ-CA 2.5 MEQ-MG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
NDC,24571010806,BICARBONATE DIALYSIS SOLN 11 (NO POTASSIUM) CALC 2.5 MEQ-MAG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
NDC,24571011106,BICARB HEMODIALYSIS SOLN WITHOUT CALCIUM NO 16 POT 4 MEQ-MAG 1.5 MEQ/L,210.0,157.5,2.52,189.0,119
NDC,24979000406,DONEPEZIL 23 MG TABLET,13.6,10.2,0.16,12.24,119
NDC,24979019801,GUANFACINE 1 MG TABLET,2.7,2.03,0.03,2.43,119
NDC,24979020101,DICYCLOMINE 10 MG CAPSULE,0.96,0.72,0.01,0.86,119
NDC,25021011020,CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
NDC,25021011487,CIPROFLOXACIN 400 MG/200 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,42.0,31.5,0.5,37.8,119
NDC,25021013182,METRONIDAZOLE 500 MG/100 ML IN SODIUM CHLOR(ISO) INTRAVENOUS PIGGYBACK,13.8,10.35,0.17,12.42,119
NDC,25021013281,LEVOFLOXACIN 250 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,42.0,31.5,0.5,37.8,119
NDC,25021013282,LEVOFLOXACIN 500 MG/100 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,34.8,26.1,0.42,31.32,119
NDC,25021013410,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),8.5,6.38,0.1,7.65,119
NDC,25021018066,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,12.44,9.33,0.15,11.2,119
NDC,25021018466,FLUCONAZOLE 200 MG/100 ML IN SOD. CHLORIDE (ISO) INTRAVENOUS PIGGYBACK,24.0,18.0,0.29,21.6,119
NDC,25021018467,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,26.4,19.8,0.32,23.76,119
NDC,25021018487,FLUCONAZOLE 400 MG/200 ML IN SOD. CHLORIDE(ISO) INTRAVENOUS PIGGYBACK,84.0,63.0,1.01,75.6,119
NDC,25021019920,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,90.0,67.5,1.08,81.0,119
NDC,25021020401,VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION,81.88,61.41,0.98,73.69,119
NDC,25021020405,VINORELBINE 50 MG/5 ML INTRAVENOUS SOLUTION,294.75,221.06,3.54,265.28,119
NDC,25021020751,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,565.25,423.94,6.78,508.72,119
NDC,25021025020,MITOMYCIN 5 MG INTRAVENOUS SOLUTION,692.35,519.26,8.31,623.12,119
NDC,25021025350,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,119.0,89.25,1.43,107.1,119
NDC,25021025550,"PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS",255.0,191.25,3.06,229.5,119
NDC,25021026210,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,131.0,98.25,1.57,117.9,119
NDC,25021030266,AMIODARONE 150 MG/3 ML INTRAVENOUS SYRINGE,77.99,58.5,0.94,70.19,119
NDC,25021030520,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,119
NDC,25021030566,CHLOROTHIAZIDE SODIUM 500 MG INTRAVENOUS SOLUTION,142.56,106.92,1.71,128.3,119
NDC,25021030884,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",990.0,742.5,11.88,891.0,119
NDC,25021030982,"ESMOLOL 2,000 MG/100 ML (20 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
NDC,25021032104,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,13.66,10.24,0.16,12.29,119
NDC,25021032110,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,16.44,12.33,0.2,14.8,119
NDC,25021041882,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",123.0,92.25,1.48,110.7,119
NDC,25021061110,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,51.0,38.25,0.61,45.9,119
NDC,25021067376,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,35.71,26.78,0.43,32.14,119
NDC,25021067377,LIDOCAINE 2 % MUCOSAL JELLY IN APPLICATOR,38.08,28.56,0.46,34.27,119
NDC,25021079002,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,31.8,23.85,0.38,28.62,119
NDC,25021081230,ACETYLCYSTEINE 200 MG/ML (20 %) INTRAVENOUS SOLUTION,599.94,449.96,7.2,539.95,119
NDC,25021081430,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,65.5,49.12,0.79,58.95,119
NDC,25021081630,LEUCOVORIN CALCIUM 350 MG SOLUTION FOR INJECTION,213.32,159.99,2.56,191.99,119
NDC,25021082682,ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK,765.0,573.75,9.18,688.5,119
NDC,25021083082,ZOLEDRONIC ACID 5 MG/100 ML IN MANNITOL 5 %-WATER INTRAVENOUS PIGGYBCK,1487.5,1115.62,17.85,1338.75,119
NDC,25208000201,TIROFIBAN 5 MG/100 ML (50 MCG/ML)-0.9 % SODIUM CHLORIDE INTRAVENOUS,552.0,414.0,6.62,496.8,119
NDC,25682000101,ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION,18564.43,13923.32,222.77,16707.99,119
NDC,27241004910,ENTACAPONE 200 MG TABLET,3.6,2.7,0.04,3.24,119
NDC,27241013909,OSELTAMIVIR 6 MG/ML ORAL SUSPENSION,180.0,135.0,2.16,162.0,119
NDC,27241017529,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,1800.29,1350.22,21.6,1620.26,119
NDC,27241030501,"OXCARBAZEPINE ER 300 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
NDC,27808003301,THEOPHYLLINE 80 MG/15 ML ORAL SOLUTION,448.4,336.3,5.38,403.56,119
NDC,27808008601,HYDROCODONE 10 MG-CHLORPHENIRAMINE 8 MG/5 ML ORAL SUSP EXTEND.REL 12HR,338.79,254.09,4.07,304.91,119
NDC,27808008602,HYDROCODONE 10 MG-CHLORPHENIRAMINE 8 MG/5 ML ORAL SUSP EXTEND.REL 12HR,1367.92,1025.94,16.42,1231.13,119
NDC,27808023402,DOXYCYCLINE HYCLATE 100 MG TABLET,1.2,0.9,0.01,1.08,119
NDC,29033003001,"ACETAZOLAMIDE ER 500 MG CAPSULE,EXTENDED RELEASE",7.5,5.62,0.09,6.75,119
NDC,29300011105,LAMOTRIGINE 25 MG TABLET,0.34,0.26,0.01,0.31,119
NDC,29300013001,HYDROCHLOROTHIAZIDE 12.5 MG CAPSULE,0.6,0.45,0.01,0.54,119
NDC,29300013901,"DIVALPROEX 250 MG TABLET,DELAYED RELEASE",1.06,0.79,0.01,0.95,119
NDC,29300023916,TOLTERODINE 1 MG TABLET,5.0,3.75,0.06,4.5,119
NDC,29300039619,AMLODIPINE 2.5 MG TABLET,0.22,0.16,0.01,0.2,119
NDC,29300039810,AMLODIPINE 10 MG TABLET,0.26,0.2,0.01,0.23,119
NDC,29300041001,ATENOLOL 25 MG TABLET,0.27,0.2,0.01,0.24,119
NDC,29300042901,ZONISAMIDE 50 MG CAPSULE,1.1,0.83,0.01,0.99,119
NDC,30698091115,CALCITRIOL 1 MCG/ML ORAL SOLUTION,965.92,724.44,11.59,869.33,119
NDC,31722001490,DROXIDOPA 100 MG CAPSULE,6.67,5.0,0.08,6.0,119
NDC,31722005360,IVABRADINE 5 MG TABLET,48.28,36.21,0.58,43.45,119
NDC,31722013631,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,719.71,539.78,8.64,647.74,119
NDC,31722014101,CAPTOPRIL 12.5 MG TABLET,4.8,3.6,0.06,4.32,119
NDC,31722015130,VALSARTAN 40 MG TABLET,1.59,1.19,0.02,1.43,119
NDC,31722015390,VALSARTAN 160 MG TABLET,2.38,1.78,0.03,2.14,119
NDC,31722018601,"DEXTROAMPHETAMINE-AMPHETAMINE ER 10 MG 24HR CAPSULE,EXTEND RELEASE",4.2,3.15,0.05,3.78,119
NDC,31722030801,OLANZAPINE 10 MG INTRAMUSCULAR SOLUTION,90.0,67.5,1.08,81.0,119
NDC,31722041214,TEMOZOLOMIDE 20 MG CAPSULE,36.78,27.58,0.44,33.1,119
NDC,31722041314,TEMOZOLOMIDE 100 MG CAPSULE,112.44,84.33,1.35,101.2,119
NDC,31722054201,INDOMETHACIN 25 MG CAPSULE,1.15,0.86,0.01,1.03,119
NDC,31722054301,INDOMETHACIN 50 MG CAPSULE,1.34,1.0,0.02,1.21,119
NDC,31722056560,"INDOMETHACIN ER 75 MG CAPSULE,EXTENDED RELEASE",7.5,5.62,0.09,6.75,119
NDC,31722062330,ROFLUMILAST 500 MCG TABLET,3.6,2.7,0.04,3.24,119
NDC,31722063031,OSELTAMIVIR 30 MG CAPSULE,15.6,11.7,0.19,14.04,119
NDC,31722065832,"DIMETHYL FUMARATE 240 MG CAPSULE,DELAYED RELEASE",11.25,8.44,0.14,10.12,119
NDC,31722068147,ACYCLOVIR 200 MG/5 ML ORAL SUSPENSION,479.62,359.72,5.76,431.66,119
NDC,31722068301,TRIENTINE 250 MG CAPSULE,42.0,31.5,0.5,37.8,119
NDC,31722070090,LOSARTAN 25 MG TABLET,0.84,0.63,0.01,0.76,119
NDC,31722072150,LEVOFLOXACIN 250 MG TABLET,2.02,1.51,0.02,1.82,119
NDC,31722072250,LEVOFLOXACIN 500 MG TABLET,2.32,1.74,0.03,2.09,119
NDC,31722072320,LEVOFLOXACIN 750 MG TABLET,4.33,3.25,0.05,3.9,119
NDC,31722077705,ACYCLOVIR 400 MG TABLET,0.76,0.57,0.01,0.68,119
NDC,31722082111,TETRABENAZINE 12.5 MG TABLET,8.03,6.03,0.1,7.23,119
NDC,31722083260,VALGANCICLOVIR 450 MG TABLET,25.0,18.75,0.3,22.5,119
NDC,31722083330,ENTECAVIR 0.5 MG TABLET,8.0,6.0,0.1,7.2,119
NDC,31722093847,CHERRY FLAVOR (BULK) ORAL LIQUID,82.3,61.73,0.99,74.07,119
NDC,32551093835,CHLORHEXIDINE GLUCONATE 4 % TOPICAL LIQUID,22.66,16.99,0.27,20.39,119
NDC,33342007015,OLANZAPINE 10 MG TABLET,1.22,0.91,0.01,1.1,119
NDC,33342008909,RIVASTIGMINE 1.5 MG CAPSULE,2.0,1.5,0.02,1.8,119
NDC,33342009009,RIVASTIGMINE 3 MG CAPSULE,2.0,1.5,0.02,1.8,119
NDC,33342009709,TOLTERODINE 1 MG TABLET,2.44,1.83,0.03,2.2,119
NDC,33342010207,MONTELUKAST 10 MG TABLET,0.39,0.29,0.01,0.35,119
NDC,33342025866,OSELTAMIVIR 75 MG CAPSULE,15.0,11.25,0.18,13.5,119
NDC,33342029907,ESZOPICLONE 1 MG TABLET,3.47,2.61,0.04,3.12,119
NDC,33342033315,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,26.01,19.51,0.31,23.41,119
NDC,33342040535,LIDOCAINE 5 % TOPICAL OINTMENT,59.96,44.97,0.72,53.96,119
NDC,35573043330,KETOCONAZOLE 200 MG TABLET,6.31,4.73,0.08,5.68,119
NDC,36000003310,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,7.8,5.85,0.09,7.02,119
NDC,36000028225,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,6.48,4.86,0.08,5.83,119
NDC,36000028325,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,6.65,4.99,0.08,5.98,119
NDC,36000028425,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,10.68,8.01,0.13,9.61,119
NDC,36000030660,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION",57.0,42.75,0.68,51.3,119
NDC,36000030660,"ACETAMINOPHEN 1,000 MG/100 ML (10 MG/ML) INTRAVENOUS SOLUTION (REPACKAGED)",57.0,42.75,0.68,51.3,119
NDC,36000030801,NALOXONE 0.4 MG/ML INJECTION SOLUTION,30.0,22.5,0.36,27.0,119
NDC,36000030810,NALOXONE 0.4 MG/ML INJECTION SOLUTION,30.0,22.5,0.36,27.0,119
NDC,37000029417,BIFIDOBACTERIUM INFANTIS 4 MG CAPSULE,4.43,3.32,0.05,3.99,119
NDC,37257248101,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,31.87,23.9,0.38,28.68,119
NDC,39328006325,SODIUM HYPOCHLORITE 0.25 % SOLUTION,42.57,31.93,0.51,38.31,119
NDC,39328012912,HYDROCORTISONE ACETATE 30 MG RECTAL SUPPOSITORY,35.5,26.62,0.43,31.95,119
NDC,39328055750,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,64.5,48.38,0.77,58.05,119
NDC,39822041206,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,311.25,233.44,3.74,280.12,119
NDC,39822105505,AMPHOTERICIN B 50 MG SOLUTION FOR INJECTION,157.2,117.9,1.89,141.48,119
NDC,39822110001,FOLIC ACID 5 MG/ML INJECTION SOLUTION,210.0,157.5,2.52,189.0,119
NDC,39822303002,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,373.5,280.12,4.48,336.15,119
NDC,39822420005,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,45.0,33.75,0.54,40.5,119
NDC,40028051130,FLUDEOXYGLUCOSE F-18 20 MCI TO 200 MCI/ML INTRAVENOUS SOLUTION,477.25,357.94,5.73,429.52,119
NDC,40093010287,SELENIUM 200 MCG TABLET,0.28,0.21,0.01,0.25,119
NDC,40565012249,CADEXOMER IODINE 0.9 % TOPICAL GEL,513.12,384.84,6.16,461.81,119
NDC,41100059419,CLOTRIMAZOLE 1 % TOPICAL CREAM,65.88,49.41,0.79,59.29,119
NDC,41167000609,DOXYLAMINE SUCCINATE 25 MG TABLET,1.4,1.05,0.02,1.26,119
NDC,41616093240,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,76.5,57.38,0.92,68.85,119
NDC,41616093244,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,76.5,57.38,0.92,68.85,119
NDC,42023010501,METHOHEXITAL 500 MG SOLUTION FOR INJECTION,402.47,301.85,4.83,362.22,119
NDC,42023011602,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,84.0,63.0,1.01,75.6,119
NDC,42023011925,TRIMETHOBENZAMIDE 100 MG/ML INTRAMUSCULAR SOLUTION,272.82,204.61,3.27,245.54,119
NDC,42023012306,DANTROLENE 20 MG INTRAVENOUS SOLUTION,367.86,275.89,4.41,331.07,119
NDC,42023015901,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,67.32,50.49,0.81,60.59,119
NDC,42023015925,EPINEPHRINE 1 MG/ML (1 ML) INJECTION SOLUTION,67.32,50.49,0.81,60.59,119
NDC,42023016801,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,1503.36,1127.52,18.04,1353.02,119
NDC,42023016899,EPINEPHRINE 1 MG/ML INJECTION SOLUTION,1503.36,1127.52,18.04,1353.02,119
NDC,42023017901,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,61.29,45.97,0.74,55.16,119
NDC,42023017905,BUPRENORPHINE HCL 0.3 MG/ML INJECTION SOLUTION,61.29,45.97,0.74,55.16,119
NDC,42023018201,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1523.75,1142.81,18.28,1371.38,119
NDC,42023018901,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,36.18,27.14,0.43,32.56,119
NDC,42023018910,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,36.18,27.14,0.43,32.56,119
NDC,42023020501,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,11553.39,8665.04,138.64,10398.05,119
NDC,42023023001,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,620.84,465.63,7.45,558.76,119
NDC,42023023010,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,620.84,465.63,7.45,558.76,119
NDC,42192033901,HYOSCYAMINE 0.125 MG SUBLINGUAL TABLET,2.7,2.03,0.03,2.43,119
NDC,42192060806,GABAPENTIN 300 MG/6 ML (6 ML) ORAL SOLUTION,22.46,16.85,0.27,20.21,119
NDC,42291007760,CLOBETASOL 0.05 % TOPICAL OINTMENT,51.84,38.88,0.62,46.66,119
NDC,42291041260,DOFETILIDE 250 MCG CAPSULE,1.93,1.45,0.02,1.74,119
NDC,42291041360,DOFETILIDE 500 MCG CAPSULE,1.96,1.47,0.02,1.76,119
NDC,42291056090,MIDODRINE 2.5 MG TABLET,0.7,0.52,0.01,0.63,119
NDC,42291092301,URSODIOL 300 MG CAPSULE,2.88,2.16,0.03,2.59,119
NDC,42367052125,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,7392.46,5544.35,88.71,6653.21,119
NDC,42494041501,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,117.81,88.36,1.41,106.03,119
NDC,42494041525,PHENOBARBITAL SODIUM 65 MG/ML INJECTION SOLUTION,117.81,88.36,1.41,106.03,119
NDC,42494041601,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,281.99,211.49,3.38,253.79,119
NDC,42494041625,PHENOBARBITAL SODIUM 130 MG/ML INJECTION SOLUTION,281.99,211.49,3.38,253.79,119
NDC,42571013027,TRAVOPROST 0.004 % EYE DROPS,572.16,429.12,6.87,514.94,119
NDC,42571013252,CROMOLYN 100 MG/5 ML ORAL CONCENTRATE,12.51,9.38,0.15,11.26,119
NDC,42571027560,"DALFAMPRIDINE ER 10 MG TABLET,EXTENDED RELEASE,12 HR",6.0,4.5,0.07,5.4,119
NDC,42658000801,DACTINOMYCIN 0.5 MG INTRAVENOUS SOLUTION,1423.0,1067.25,17.08,1280.7,119
NDC,42799080601,IVERMECTIN 3 MG TABLET,24.85,18.63,0.3,22.36,119
NDC,42799081501,PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION (REPACKAGING),238.9,179.17,2.87,215.01,119
NDC,42806010201,ETHAMBUTOL 400 MG TABLET,7.6,5.7,0.09,6.84,119
NDC,42806015134,AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION,90.0,67.5,1.08,81.0,119
NDC,42806026695,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,6.0,4.5,0.07,5.4,119
NDC,42806026698,CHOLESTYRAMINE (WITH SUGAR) 4 GRAM POWDER FOR SUSP IN A PACKET,6.0,4.5,0.07,5.4,119
NDC,42806035830,LEUCOVORIN CALCIUM 5 MG TABLET,8.09,6.07,0.1,7.28,119
NDC,42806051330,QUINIDINE SULFATE 200 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,42806054909,DUTASTERIDE 0.5 MG CAPSULE,1.97,1.48,0.02,1.77,119
NDC,42806055212,OMEGA-3 ACID ETHYL ESTERS 1 GRAM CAPSULE,1.25,0.94,0.02,1.12,119
NDC,42806071401,BENZONATATE 100 MG CAPSULE,0.9,0.68,0.01,0.81,119
NDC,42806075760,SULFADIAZINE 500 MG TABLET,72.13,54.1,0.87,64.92,119
NDC,42806080130,RIFAMPIN 150 MG CAPSULE,19.99,14.99,0.24,17.99,119
NDC,42858000110,OXYCODONE 5 MG TABLET,2.7,2.03,0.03,2.43,119
NDC,42858030101,HYDROMORPHONE 2 MG TABLET,1.43,1.07,0.02,1.29,119
NDC,42858030125,HYDROMORPHONE 2 MG TABLET,1.0,0.75,0.01,0.9,119
NDC,42858030225,HYDROMORPHONE 4 MG TABLET,1.31,0.99,0.02,1.18,119
NDC,42858050203,BUPRENORPHINE HCL 8 MG SUBLINGUAL TABLET,4.8,3.6,0.06,4.32,119
NDC,42858051501,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",27.53,20.65,0.33,24.78,119
NDC,42858075040,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,225.0,168.75,2.7,202.5,119
NDC,43066001610,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,480.0,360.0,5.76,432.0,119
NDC,43066015010,"AMIODARONE 150 MG/100 ML (1.5 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",208.2,156.15,2.5,187.38,119
NDC,43066036020,"AMIODARONE 360 MG/200 ML (1.8 MG/ML) IN DEXTROSE, ISO-OSMOTIC IV",277.2,207.9,3.33,249.48,119
NDC,43066055712,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,480.0,360.0,5.76,432.0,119
NDC,43066099324,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,64.2,48.15,0.77,57.78,119
NDC,43066099524,CLINDAMYCIN 18 MG/ML IN D5W IVPB NEO/PED,78.3,58.72,0.94,70.47,119
NDC,43066099524,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,78.3,58.72,0.94,70.47,119
NDC,43066099701,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,43066099710,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,30.0,22.5,0.36,27.0,119
NDC,43386002602,FLUOCINONIDE 0.05 % TOPICAL SOLUTION,120.0,90.0,1.44,108.0,119
NDC,43528000301,HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE,598.08,448.56,7.18,538.27,119
NDC,43528000305,HEPATITIS B VACCINE 20 MCG/0.5 ML-ADJUVANT CPG 1018 (PF) IM SYRINGE,598.08,448.56,7.18,538.27,119
NDC,43547033906,RISPERIDONE 0.25 MG TABLET,1.0,0.75,0.01,0.9,119
NDC,43547034106,RISPERIDONE 1 MG TABLET,1.2,0.9,0.01,1.08,119
NDC,43547034206,RISPERIDONE 2 MG TABLET,1.3,0.98,0.02,1.17,119
NDC,43547034506,"LEVETIRACETAM ER 500 MG TABLET,EXTENDED RELEASE 24 HR",2.5,1.88,0.03,2.25,119
NDC,43547034606,"LEVETIRACETAM ER 750 MG TABLET,EXTENDED RELEASE 24 HR",3.5,2.62,0.04,3.15,119
NDC,43547035311,LISINOPRIL 10 MG TABLET,0.26,0.19,0.01,0.23,119
NDC,43547063901,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,16.32,12.24,0.2,14.69,119
NDC,43547063925,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,16.32,12.24,0.2,14.69,119
NDC,43547064001,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,32.64,24.48,0.39,29.38,119
NDC,43547064025,GLYCOPYRROLATE 0.2 MG/ML INJECTION SOLUTION,32.64,24.48,0.39,29.38,119
NDC,43598021040,SILVER SULFADIAZINE 1 % TOPICAL CREAM,316.8,237.6,3.8,285.12,119
NDC,43598021055,SILVER SULFADIAZINE 1 % TOPICAL CREAM,74.4,55.8,0.89,66.96,119
NDC,43598021085,SILVER SULFADIAZINE 1 % TOPICAL CREAM,132.6,99.45,1.59,119.34,119
NDC,43598039467,TETRABENAZINE 12.5 MG TABLET,47.09,35.32,0.57,42.38,119
NDC,43598040511,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,192.45,144.34,2.31,173.2,119
NDC,43598040516,PHYTONADIONE (VITAMIN K1) 10 MG/ML INJECTION SOLUTION,192.45,144.34,2.31,173.2,119
NDC,43598044671,NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH,10.28,7.71,0.12,9.25,119
NDC,43598044771,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,10.28,7.71,0.12,9.25,119
NDC,43598044871,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,9.62,7.21,0.12,8.66,119
NDC,43598045202,ALBENDAZOLE 200 MG TABLET,180.0,135.0,2.16,162.0,119
NDC,43598048624,NICOTINE (POLACRILEX) 2 MG BUCCAL LOZENGE,2.32,1.74,0.03,2.09,119
NDC,43598054850,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,84.0,63.0,1.01,75.6,119
NDC,43598063652,"LEVETIRACETAM 1,000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK",180.0,135.0,2.16,162.0,119
NDC,43598064911,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,4755.9,3566.92,57.07,4280.31,119
NDC,43598069858,CARBOPROST TROMETHAMINE 250 MCG/ML INTRAMUSCULAR SOLUTION,1224.92,918.69,14.7,1102.43,119
NDC,43598072525,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,69.3,51.97,0.83,62.37,119
NDC,43598075752,"LEVETIRACETAM 1,000 MG/100 ML IN SODIUM CHLORIDE(ISO-OSM) IV PIGGYBACK",180.0,135.0,2.16,162.0,119
NDC,43900097647,GUAR GUM ORAL PACKET,2.86,2.15,0.03,2.57,119
NDC,44206025105,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",540.0,405.0,6.48,486.0,119
NDC,44206025110,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",1080.0,810.0,12.96,972.0,119
NDC,44206025190,"ALBUMIN, HUMAN 25 % INTRAVENOUS SOLUTION",540.0,405.0,6.48,486.0,119
NDC,44206030001,"RHO(D) IMMUNE GLOBULIN 1,500 UNIT (300 MCG)/2 ML INJECTION SYRINGE",706.12,529.59,8.47,635.51,119
NDC,44206031025,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",540.0,405.0,6.48,486.0,119
NDC,44206031050,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",1080.0,810.0,12.96,972.0,119
NDC,44206043605,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",3083.08,2312.31,37.0,2774.77,119
NDC,44206043710,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",6166.17,4624.63,73.99,5549.55,119
NDC,44206043820,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",12332.34,9249.26,147.99,11099.11,119
NDC,44206043940,"IMMUNE GLOB,GAMM(IGG) 10 %-PRO-IGA 0 TO 50 MCG/ML INTRAVENOUS SOLUTION",24664.68,18498.51,295.98,22198.21,119
NDC,44567010010,AMPICILLIN 250 MG SOLUTION FOR INJECTION,9.56,7.17,0.11,8.6,119
NDC,44567023525,CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION,19.12,14.34,0.23,17.21,119
NDC,44567023610,CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
NDC,44567024525,CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION,59.7,44.78,0.72,53.73,119
NDC,44567043724,LEVOFLOXACIN 750 MG/150 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,78.3,58.72,0.94,70.47,119
NDC,44567045001,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",558.0,418.5,6.7,502.2,119
NDC,44567045010,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",558.0,418.5,6.7,502.2,119
NDC,44567064101,NOREPINEPHRINE BITARTRATE 8 MG/250 ML (32 MCG/ML) IN 0.9 % NACL IV,294.0,220.5,3.53,264.6,119
NDC,44677010202,MODIFIED LANOLIN 100 % TOPICAL CREAM,13.27,9.95,0.16,11.94,119
NDC,45548014105,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,410.85,308.14,4.93,369.77,119
NDC,45548014110,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,410.85,308.14,4.93,369.77,119
NDC,45567003001,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,1632.0,1224.0,19.58,1468.8,119
NDC,45567004001,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,180.0,135.0,2.16,162.0,119
NDC,45567004002,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,180.0,135.0,2.16,162.0,119
NDC,45567006001,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,225.0,168.75,2.7,202.5,119
NDC,45567006002,KIT PREPARATION OF TC-99M-SODIUM PYROPHOSPHATE 12 MG IV SOLUTION,345.65,259.24,4.15,311.08,119
NDC,45567045501,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,311.25,233.44,3.74,280.12,119
NDC,45567045502,KIT FOR THE PREPARATION OF TC-99M-MEBROFENIN 45 MG IV SOLUTION,311.25,233.44,3.74,280.12,119
NDC,45567055501,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,1359.36,1019.52,16.31,1223.42,119
NDC,45567055502,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,1359.36,1019.52,16.31,1223.42,119
NDC,45567065501,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,2016.0,1512.0,24.19,1814.4,119
NDC,45802004635,GENTAMICIN 0.1 % TOPICAL OINTMENT,236.97,177.73,2.84,213.27,119
NDC,45802004835,"NYSTATIN 100,000 UNIT/GRAM TOPICAL OINTMENT",83.97,62.98,1.01,75.57,119
NDC,45802005505,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,201.58,151.18,2.42,181.42,119
NDC,45802005535,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,27.09,20.32,0.33,24.38,119
NDC,45802005536,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL OINTMENT,61.44,46.08,0.74,55.3,119
NDC,45802005635,GENTAMICIN 0.1 % TOPICAL CREAM,236.97,177.73,2.84,213.27,119
NDC,45802006436,TRIAMCINOLONE ACETONIDE 0.1 % TOPICAL CREAM,47.52,35.64,0.57,42.77,119
NDC,45802009735,ESTRADIOL 0.01% (0.1 MG/GRAM) VAGINAL CREAM,431.97,323.98,5.18,388.77,119
NDC,45802014464,HYDROCORTISONE-PRAMOXINE 1 %-1 % RECTAL CREAM,727.92,545.94,8.74,655.13,119
NDC,45802018816,PHENYLEPHRINE 0.25 %-MINERAL OIL 14 %-PETROLATM 74.9 % RECTAL OINTMENT,15.73,11.8,0.19,14.16,119
NDC,45802021001,NITROGLYCERIN 400 MCG/SPRAY TRANSLINGUAL,841.78,631.34,10.1,757.6,119
NDC,45802027603,HYDROCORTISONE 1 % TOPICAL OINTMENT,12.6,9.45,0.15,11.34,119
NDC,45802035803,DIPHENHYDRAMINE-ZINC ACETATE 2 %-0.1 % TOPICAL CREAM,12.94,9.7,0.16,11.65,119
NDC,45802046564,KETOCONAZOLE 2 % SHAMPOO,132.48,99.36,1.59,119.23,119
NDC,45802049071,NAPROXEN SODIUM 220 MG TABLET,0.38,0.29,0.01,0.34,119
NDC,45802056201,CLINDAMYCIN PHOSPHATE 1 % TOPICAL SOLUTION,144.72,108.54,1.74,130.25,119
NDC,45802057800,NALOXONE 4 MG/ACTUATION NASAL SPRAY,180.0,135.0,2.16,162.0,119
NDC,45802057884,NALOXONE 4 MG/ACTUATION NASAL SPRAY,180.0,135.0,2.16,162.0,119
NDC,45802073000,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,1.67,1.26,0.02,1.5,119
NDC,45802073030,ACETAMINOPHEN 650 MG RECTAL SUPPOSITORY,2.12,1.59,0.03,1.91,119
NDC,45802075800,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,58.49,43.87,0.7,52.64,119
NDC,45802075830,PROMETHAZINE 12.5 MG RECTAL SUPPOSITORY,58.49,43.87,0.7,52.64,119
NDC,45802075930,PROMETHAZINE 25 MG RECTAL SUPPOSITORY,58.49,43.87,0.7,52.64,119
NDC,45802086802,POLYETHYLENE GLYCOL 3350 17 GRAM/DOSE ORAL POWDER,44.27,33.2,0.53,39.84,119
NDC,45802095301,DICLOFENAC 1 % TOPICAL GEL,73.8,55.35,0.89,66.42,119
NDC,45802096126,CLOBETASOL 0.05 % SHAMPOO,450.29,337.72,5.4,405.26,119
NDC,45963043965,LACTULOSE 10 GRAM/15 ML ORAL SOLUTION,85.14,63.86,1.02,76.63,119
NDC,45963073360,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,595.0,446.25,7.14,535.5,119
NDC,46017001840,CAFFEINE 200 MG TABLET,0.82,0.62,0.01,0.74,119
NDC,46287000660,SODIUM POLYSTYRENE SULFONATE 15 GRAM-SORBITOL 20 GRAM/60 ML ORAL SUSP,148.68,111.51,1.78,133.81,119
NDC,46287050030,SORBITOL 70 % SOLUTION,16.74,12.56,0.2,15.07,119
NDC,47335023683,AMBRISENTAN 5 MG TABLET,172.8,129.6,2.07,155.52,119
NDC,47335023783,AMBRISENTAN 10 MG TABLET,172.8,129.6,2.07,155.52,119
NDC,47335093240,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,76.5,57.38,0.92,68.85,119
NDC,47335093244,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,76.5,57.38,0.92,68.85,119
NDC,47781035503,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,13.36,10.02,0.16,12.02,119
NDC,47781035511,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM,13.36,10.02,0.16,12.02,119
NDC,47781035703,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,16.9,12.68,0.2,15.21,119
NDC,47781035711,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL FILM,16.9,12.68,0.2,15.21,119
NDC,47781042311,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,73.09,54.82,0.88,65.78,119
NDC,47781042347,FENTANYL 12 MCG/HR TRANSDERMAL PATCH,73.09,54.82,0.88,65.78,119
NDC,47781042411,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,42.78,32.08,0.51,38.5,119
NDC,47781042447,FENTANYL 25 MCG/HR TRANSDERMAL PATCH,42.78,32.08,0.51,38.5,119
NDC,47781042611,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
NDC,47781042647,FENTANYL 50 MCG/HR TRANSDERMAL PATCH,60.0,45.0,0.72,54.0,119
NDC,47781042711,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,90.09,67.57,1.08,81.08,119
NDC,47781042747,FENTANYL 75 MCG/HR TRANSDERMAL PATCH,90.09,67.57,1.08,81.08,119
NDC,47781042811,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,124.01,93.01,1.49,111.61,119
NDC,47781042847,FENTANYL 100 MCG/HR TRANSDERMAL PATCH,124.01,93.01,1.49,111.61,119
NDC,47783010101,ECALLANTIDE 10 MG/ML (1 ML) SUBCUTANEOUS SOLUTION,58549.48,43912.11,702.59,52694.53,119
NDC,48433020230,MINERAL OIL ORAL,9.9,7.43,0.12,8.91,119
NDC,48433021501,SODIUM CHLORIDE 234 MG/ML (4 MEQ/ML) ORAL SOLUTION,312.18,234.14,3.75,280.96,119
NDC,48433023015,IODINE STRONG (LUGOLS) 5 % ORAL SOLUTION,193.54,145.15,2.32,174.19,119
NDC,48582080220,SALIVA SUBSTITUTE COMBO NO.9 MOUTHWASH,19.91,14.93,0.24,17.92,119
NDC,48783011208,FERRIC SUBSULFATE 0.2 GRAM TO 0.22 GRAM/ML TOPICAL SOLN AND APPLICATOR,91.54,68.65,1.1,82.39,119
NDC,48815100101,SODIUM IODIDE-123 3.7 MBQ (100 MICROCI) CAPSULE,2299.01,1724.26,27.59,2069.11,119
NDC,48815100201,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE,829.83,622.38,9.96,746.85,119
NDC,48815100205,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE,179.96,134.97,2.16,161.96,119
NDC,48985000150,NICOTINE 14 MG/24 HR DAILY TRANSDERMAL PATCH,10.67,8.0,0.13,9.6,119
NDC,48985000153,NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH,9.62,7.21,0.12,8.66,119
NDC,49100036374,LACTOBACILLUS RHAMNOSUS GG 15 BILLION CELL SPRINKLE CAPSULE,3.28,2.46,0.04,2.95,119
NDC,49281012588,FLU VACCINE TS2025-26(65YR UP)(PF)180 MCG/0.5 ML INTRAMUSCULAR SYRINGE,156.84,117.63,1.88,141.16,119
NDC,49281021588,TETANUS AND DIPHTHERIA TOX (PF) 5 LF UNIT-2 LF UNIT/0.5 ML IM SYRINGE,169.11,126.83,2.03,152.2,119
NDC,49281054503,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN,60.0,45.0,0.72,54.0,119
NDC,49281054758,HAEMOPHILUS B POLYSACCHARID CONJ-TETANUS TOX(PF) 10 MCG/0.5 ML IM SOLN,60.0,45.0,0.72,54.0,119
NDC,49281057415,NIRSEVIMAB-ALIP 100 MG/ML INTRAMUSCULAR SYRINGE,1995.84,1496.88,23.95,1796.26,119
NDC,49281057500,NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,1920.0,1440.0,23.04,1728.0,119
NDC,49281057515,NIRSEVIMAB-ALIP 50 MG/0.5 ML INTRAMUSCULAR SYRINGE,2052.13,1539.1,24.63,1846.92,119
NDC,49348015529,TOLNAFTATE 1 % TOPICAL CREAM,13.14,9.86,0.16,11.83,119
NDC,49348064573,"MICONAZOLE NITRATE 4 % (200 MG)-2 % (9 GRAM)VAGINAL,PREFILL APPL,CREAM",1116.0,837.0,13.39,1004.4,119
NDC,49348068972,MICONAZOLE NITRATE 2 % TOPICAL CREAM,13.14,9.86,0.16,11.83,119
NDC,49401010101,BELIMUMAB 120 MG INTRAVENOUS SOLUTION,1806.5,1354.87,21.68,1625.85,119
NDC,49401010201,BELIMUMAB 400 MG INTRAVENOUS SOLUTION,5815.0,4361.25,69.78,5233.5,119
NDC,49502010202,"EPINEPHRINE 0.3 MG/0.3 ML INJECTION, AUTO-INJECTOR",622.5,466.88,7.47,560.25,119
NDC,49502090001,SELEGILINE 6 MG/24 HR TRANSDERMAL 24 HOUR PATCH,296.72,222.54,3.56,267.05,119
NDC,49591053251,CYTOMEGALOVIRUS IMMUNE GLOBULIN 50 MG/ML INTRAVENOUS SOLUTION,5753.68,4315.26,69.04,5178.31,119
NDC,49609010101,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,852.48,639.36,10.23,767.23,119
NDC,49609010102,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,852.48,639.36,10.23,767.23,119
NDC,49702020548,LAMIVUDINE 10 MG/ML ORAL SOLUTION,665.28,498.96,7.98,598.75,119
NDC,49702021301,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,124.1,93.07,1.49,111.69,119
NDC,49702021326,ZIDOVUDINE 10 MG/ML INTRAVENOUS SOLUTION,124.1,93.07,1.49,111.69,119
NDC,49702022813,DOLUTEGRAVIR 50 MG TABLET,321.65,241.23,3.86,289.48,119
NDC,49702026423,"CABOTEGRAVIR ER 600 MG/3 ML (200 MG/ML) IM SUSPENSION,EXTENDED RELEASE",14853.06,11139.8,178.24,13367.75,119
NDC,49884004901,"DEXMETHYLPHENIDATE ER 10 MG CAPSULE,EXTENDED RELEASE BIPHASIC50-50",6.35,4.76,0.08,5.72,119
NDC,49884015676,VARENICLINE TARTRATE 1 MG TABLET,5.89,4.42,0.07,5.3,119
NDC,49884015852,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.25 MG TABLET,44.51,33.39,0.53,40.06,119
NDC,49884016111,CALCITONIN (SALMON) 200 UNIT/ACTUATION NASAL SPRAY,222.0,166.5,2.66,199.8,119
NDC,49884023183,PRAZIQUANTEL 600 MG TABLET,275.68,206.76,3.31,248.11,119
NDC,49884025601,MINOXIDIL 2.5 MG TABLET,1.26,0.94,0.02,1.13,119
NDC,49884025701,MINOXIDIL 10 MG TABLET,2.76,2.07,0.03,2.48,119
NDC,49884076852,TOLVAPTAN 15 MG TABLET,249.0,186.75,2.99,224.1,119
NDC,50090258601,WARFARIN 2.5 MG TABLET,3.77,2.83,0.05,3.39,119
NDC,50111032703,HYDRALAZINE 25 MG TABLET,0.89,0.67,0.01,0.8,119
NDC,50111032801,HYDRALAZINE 50 MG TABLET,1.24,0.93,0.01,1.12,119
NDC,50190014123,SODIUM CHLORIDE 7% FOR NEBULIZATION (BIO BALANCED),3.79,2.84,0.05,3.41,119
NDC,50228010901,CARISOPRODOL 350 MG TABLET,0.72,0.54,0.01,0.65,119
NDC,50228017405,"BUPROPION HCL SR 100 MG TABLET,12 HR SUSTAINED-RELEASE",0.26,0.2,0.01,0.23,119
NDC,50228038060,"QUETIAPINE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",0.5,0.37,0.01,0.45,119
NDC,50228038160,"QUETIAPINE ER 150 MG TABLET,EXTENDED RELEASE 24 HR",0.7,0.53,0.01,0.63,119
NDC,50228038460,"QUETIAPINE ER 400 MG TABLET,EXTENDED RELEASE 24 HR",1.2,0.9,0.01,1.08,119
NDC,50228043301,NAPROXEN SODIUM 550 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,50228045901,CARBIDOPA 25 MG-LEVODOPA 250 MG TABLET,0.7,0.53,0.01,0.63,119
NDC,50228046001,"CARBIDOPA ER 25 MG-LEVODOPA 100 MG TABLET,EXTENDED RELEASE",2.03,1.52,0.02,1.83,119
NDC,50228046101,"CARBIDOPA ER 50 MG-LEVODOPA 200 MG TABLET,EXTENDED RELEASE",3.78,2.84,0.05,3.4,119
NDC,50228046501,NABUMETONE 500 MG TABLET,0.69,0.52,0.01,0.62,119
NDC,50228046601,NABUMETONE 750 MG TABLET,0.74,0.55,0.01,0.67,119
NDC,50228048201,DILTIAZEM 60 MG TABLET,0.42,0.32,0.01,0.38,119
NDC,50242003706,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,28376.63,21282.47,340.52,25538.97,119
NDC,50242004164,ALTEPLASE 2 MG INTRA-CATHETER SOLUTION,768.46,576.34,9.22,691.61,119
NDC,50242004413,ALTEPLASE 50 MG INTRAVENOUS SOLUTION,18260.83,13695.62,219.13,16434.75,119
NDC,50242005121,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",2863.19,2147.39,34.36,2576.87,119
NDC,50242005306,"RITUXIMAB 10 MG/ML CONCENTRATE,INTRAVENOUS",14315.94,10736.95,171.79,12884.35,119
NDC,50242006001,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,2428.68,1821.51,29.14,2185.81,119
NDC,50242006101,BEVACIZUMAB 25 MG/ML INTRAVENOUS SOLUTION,9714.7,7286.02,116.58,8743.23,119
NDC,50242007001,"OBINUTUZUMAB 1,000 MG/40 ML INTRAVENOUS SOLUTION",24511.8,18383.85,294.14,22060.62,119
NDC,50242008701,ADO-TRASTUZUMAB EMTANSINE 160 MG INTRAVENOUS SOLUTION,16424.49,12318.37,197.09,14782.04,119
NDC,50242008801,ADO-TRASTUZUMAB EMTANSINE 100 MG INTRAVENOUS SOLUTION,10965.5,8224.12,131.59,9868.95,119
NDC,50242010039,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,562.5,421.88,6.75,506.25,119
NDC,50242010040,DORNASE ALFA 1 MG/ML SOLUTION FOR INHALATION,562.5,421.88,6.75,506.25,119
NDC,50242010301,POLATUZUMAB VEDOTIN-PIIQ 30 MG INTRAVENOUS SOLUTION,10961.49,8221.11,131.54,9865.34,119
NDC,50242010501,POLATUZUMAB VEDOTIN-PIIQ 140 MG INTRAVENOUS SOLUTION,42080.4,31560.3,504.96,37872.36,119
NDC,50242012047,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,28376.63,21282.47,340.52,25538.97,119
NDC,50242012047,TENECTEPLASE 50 MG KIT FOR ISCHEMIC STROKE (UW),28376.63,21282.47,340.52,25538.97,119
NDC,50242013201,TRASTUZUMAB 150 MG INTRAVENOUS SOLUTION,4283.32,3212.49,51.4,3854.99,119
NDC,50242013501,TOCILIZUMAB 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1618.71,1214.03,19.42,1456.84,119
NDC,50242013601,TOCILIZUMAB 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,4046.81,3035.1,48.56,3642.13,119
NDC,50242013701,TOCILIZUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,8093.61,6070.21,97.12,7284.25,119
NDC,50242014501,PERTUZUMAB 420 MG/14 ML (30 MG/ML) INTRAVENOUS SOLUTION,19411.12,14558.34,232.93,17470.01,119
NDC,50242015001,OCRELIZUMAB 30 MG/ML INTRAVENOUS SOLUTION,56731.68,42548.76,680.78,51058.51,119
NDC,50242017601,TENECTEPLASE 50 MG INTRAVENOUS SOLUTION,28376.63,21282.47,340.52,25538.97,119
NDC,50242021401,OMALIZUMAB 75 MG/0.5 ML SUBCUTANEOUS SYRINGE,1946.1,1459.58,23.35,1751.49,119
NDC,50242021501,OMALIZUMAB 150 MG/ML SUBCUTANEOUS SYRINGE,3892.21,2919.15,46.71,3502.99,119
NDC,50242024501,"PERTUZUMAB 1,200 MG-TRASTUZUMAB 600 MG-HYALURON-ZZXF/15 ML SUBCUT SOLN",39606.46,29704.84,475.28,35645.81,119
NDC,50242026001,PERTUZUMAB 600 MG-TRASTUZUMAB 600 MG-HYALURONID-ZZXF/10 ML SUBCUT SOLN,26403.25,19802.44,316.84,23762.92,119
NDC,50242091701,"ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION",32022.68,24017.01,384.27,28820.41,119
NDC,50242091801,ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION,22415.88,16811.91,268.99,20174.29,119
NDC,50268004911,ABACAVIR 300 MG TABLET,40.09,30.07,0.48,36.08,119
NDC,50268006911,AMANTADINE HCL 100 MG CAPSULE,11.98,8.98,0.14,10.78,119
NDC,50268008911,ARIPIPRAZOLE 10 MG TABLET,3.73,2.8,0.04,3.36,119
NDC,50268013111,BUMETANIDE 1 MG TABLET,6.0,4.5,0.07,5.4,119
NDC,50268013211,BUMETANIDE 2 MG TABLET,10.29,7.72,0.12,9.26,119
NDC,50268019011,CYCLOBENZAPRINE 5 MG TABLET,4.1,3.07,0.05,3.69,119
NDC,50268025911,"DIVALPROEX ER 250 MG TABLET,EXTENDED RELEASE 24 HR",2.36,1.77,0.03,2.12,119
NDC,50268032111,FLECAINIDE 100 MG TABLET,5.36,4.02,0.06,4.82,119
NDC,50268033011,FLUDROCORTISONE 0.1 MG TABLET,2.85,2.14,0.03,2.56,119
NDC,50268033611,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,22.29,16.72,0.27,20.06,119
NDC,50268033624,FERROUS SULFATE 300 MG (60 MG IRON)/5 ML ORAL LIQUID,22.29,16.72,0.27,20.06,119
NDC,50268041111,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,9.98,7.48,0.12,8.98,119
NDC,50268041124,HYDROCORTISONE ACETATE 25 MG RECTAL SUPPOSITORY,8.55,6.41,0.1,7.7,119
NDC,50268054111,"METOPROLOL SUCCINATE ER 50 MG TABLET,EXTENDED RELEASE 24 HR",2.71,2.03,0.03,2.44,119
NDC,50268062111,ONDANSETRON HCL 4 MG TABLET,3.03,2.27,0.04,2.73,119
NDC,50268066211,PROPRANOLOL 10 MG TABLET,1.57,1.18,0.02,1.41,119
NDC,50268066311,PROPRANOLOL 20 MG TABLET,2.57,1.93,0.03,2.31,119
NDC,50268068411,PROCHLORPERAZINE MALEATE 5 MG TABLET,6.64,4.98,0.08,5.98,119
NDC,50268068711,PRIMIDONE 250 MG TABLET,3.91,2.93,0.05,3.52,119
NDC,50268071711,SILDENAFIL (PULMONARY HYPERTENSION) 20 MG TABLET,4.45,3.33,0.05,4.0,119
NDC,50268072811,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG TABLET,1.8,1.35,0.02,1.62,119
NDC,50268073811,TADALAFIL 5 MG TABLET,6.44,4.83,0.08,5.8,119
NDC,50268074411,ROPINIROLE 2 MG TABLET,2.76,2.07,0.03,2.48,119
NDC,50268074511,SUCRALFATE 100 MG/ML ORAL SUSPENSION,47.16,35.37,0.57,42.44,119
NDC,50268075511,TORSEMIDE 10 MG TABLET,1.84,1.38,0.02,1.66,119
NDC,50268075711,TORSEMIDE 100 MG TABLET,2.46,1.84,0.03,2.21,119
NDC,50268075911,TIZANIDINE 2 MG TABLET,5.22,3.92,0.06,4.7,119
NDC,50268085111,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,1.01,0.76,0.01,0.91,119
NDC,50268085115,THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET,1.01,0.76,0.01,0.91,119
NDC,50268086311,CHOLECALCIFEROL (VITAMIN D3) 10 MCG (400 UNIT) TABLET,1.4,1.05,0.02,1.26,119
NDC,50268086511,"CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) TABLET",1.48,1.11,0.02,1.33,119
NDC,50268086515,"CHOLECALCIFEROL (VITAMIN D3) 50 MCG (2,000 UNIT) TABLET",1.48,1.11,0.02,1.33,119
NDC,50289325001,GLYCERIN-WITCH HAZEL 12.5 %-50 % TOPICAL PADS,15.36,11.52,0.18,13.82,119
NDC,50419020801,"RADIUM RA 223 DICHLOR 1,100 KBQ/ML (30 MICROCURIE/ML) INTRAVENOUS SOLN",102892.62,77169.46,1234.71,92603.36,119
NDC,50419025191,RIOCIGUAT 1 MG TABLET,650.64,487.98,7.81,585.58,119
NDC,50419025291,RIOCIGUAT 1.5 MG TABLET,650.64,487.98,7.81,585.58,119
NDC,50419025491,RIOCIGUAT 2.5 MG TABLET,650.64,487.98,7.81,585.58,119
NDC,50419032005,GADOXETATE 0.25 MMOL/ML (181.43 MG/ML) INTRAVENOUS SOLUTION,464.92,348.69,5.58,418.43,119
NDC,50419032511,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,373.5,280.12,4.48,336.15,119
NDC,50419032512,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,498.0,373.5,5.98,448.2,119
NDC,50419032513,GADOBUTROL 15 MMOL/15 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,747.0,560.25,8.96,672.3,119
NDC,50419032514,GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,1494.0,1120.5,17.93,1344.6,119
NDC,50419032515,GADOBUTROL 1 MMOL/ML (604.72 MG/ML) INTRAVENOUS SOLUTION,3237.0,2427.75,38.84,2913.3,119
NDC,50419032527,GADOBUTROL 7.5 MMOL/7.5 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,403.52,302.64,4.84,363.17,119
NDC,50419032528,GADOBUTROL 10 MMOL/10 ML (1 MMOL/ML) INTRAVENOUS SYRINGE,534.0,400.5,6.41,480.6,119
NDC,50419032537,GADOBUTROL 2 MMOL/2 ML (1 MMOL/ML) INTRAVENOUS SOLUTION,99.6,74.7,1.2,89.64,119
NDC,50419042201,LEVONORGESTREL 14 MCG/24 HR (UP TO 3 YRS) 13.5 MG INTRAUTERINE DEVICE,3840.0,2880.0,46.08,3456.0,119
NDC,50419042301,LEVONORGESTREL 21 MCG/24 HR (UP TO 8 YEARS) 52 MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
NDC,50419042401,LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE,4481.98,3361.49,53.78,4033.78,119
NDC,50458056301,PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE,6374.29,4780.72,76.49,5736.86,119
NDC,50458056401,PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE,9561.21,7170.9,114.73,8605.09,119
NDC,50458057701,RIVAROXABAN 2.5 MG TABLET,56.96,42.72,0.68,51.26,119
NDC,50458057801,RIVAROXABAN 15 MG TABLET,85.44,64.08,1.03,76.9,119
NDC,50458057901,RIVAROXABAN 20 MG TABLET,85.44,64.08,1.03,76.9,119
NDC,50458058001,RIVAROXABAN 10 MG TABLET,85.44,64.08,1.03,76.9,119
NDC,50474047066,BRIVARACETAM 25 MG TABLET,110.48,82.86,1.33,99.43,119
NDC,50474057066,BRIVARACETAM 50 MG TABLET,110.48,82.86,1.33,99.43,119
NDC,50474070062,CERTOLIZUMAB PEGOL 400 MG (200 MG X 2 VIALS) SUBCUTANEOUS KIT,15436.53,11577.4,185.24,13892.88,119
NDC,50474087015,BRIVARACETAM 10 MG/ML ORAL SOLUTION,8838.0,6628.5,106.06,7954.2,119
NDC,50474097075,BRIVARACETAM 50 MG/5 ML INTRAVENOUS SOLUTION,300.0,225.0,3.6,270.0,119
NDC,50484001030,COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 250 UNIT/GRAM TOPICAL OINTMENT,1800.0,1350.0,21.6,1620.0,119
NDC,50486055032,BENZOCAINE 10 % MUCOSAL GEL,32.09,24.07,0.39,28.88,119
NDC,50580045711,ACETAMINOPHEN 500 MG TABLET,0.34,0.25,0.01,0.31,119
NDC,50580045770,ACETAMINOPHEN 500 MG TABLET,0.26,0.2,0.01,0.23,119
NDC,50580053604,PSEUDOEPHEDRINE 15 MG/5 ML ORAL LIQUID,34.69,26.02,0.42,31.22,119
NDC,50632001001,"RABIES VACCINE, PURIFIED CHICKEN EMBRYO CELL (PF) 2.5 UNIT IM SUSP",1668.9,1251.68,20.03,1502.01,119
NDC,50633012011,DIGOXIN IMMUNE FAB 40 MG INTRAVENOUS SOLUTION,17649.27,13236.95,211.79,15884.34,119
NDC,50633031011,HYDROXOCOBALAMIN 5 GRAM INTRAVENOUS SOLUTION,3832.32,2874.24,45.99,3449.09,119
NDC,50742011301,DESIPRAMINE 25 MG TABLET,0.9,0.68,0.01,0.81,119
NDC,50742024990,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",1.3,0.98,0.02,1.17,119
NDC,50742025090,"DILTIAZEM CD 240 MG CAPSULE,EXTENDED RELEASE 24 HR",1.43,1.08,0.02,1.29,119
NDC,50742026003,"NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR",1.05,0.79,0.01,0.94,119
NDC,50742037201,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,187.3,140.48,2.25,168.57,119
NDC,50742037204,BUPRENORPHINE 5 MCG/HOUR WEEKLY TRANSDERMAL PATCH,187.3,140.48,2.25,168.57,119
NDC,50742037501,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,373.75,280.31,4.49,336.38,119
NDC,50742037504,BUPRENORPHINE 15 MCG/HOUR WEEKLY TRANSDERMAL PATCH,373.75,280.31,4.49,336.38,119
NDC,50742050501,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,57.0,42.75,0.68,51.3,119
NDC,50742050524,SCOPOLAMINE 1 MG OVER 3 DAYS TRANSDERMAL PATCH,1425.02,1068.77,17.1,1282.52,119
NDC,50742061701,"METOPROLOL SUCCINATE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",0.89,0.67,0.01,0.8,119
NDC,50742064601,TRIAZOLAM 0.25 MG TABLET,4.5,3.38,0.05,4.05,119
NDC,50881000560,RUXOLITINIB 5 MG TABLET,1126.4,844.8,13.52,1013.76,119
NDC,50881001060,RUXOLITINIB 10 MG TABLET,1126.4,844.8,13.52,1013.76,119
NDC,51079010301,SPIRONOLACTONE 25 MG TABLET,1.08,0.81,0.01,0.97,119
NDC,51079016401,VORICONAZOLE 50 MG TABLET,51.19,38.39,0.61,46.07,119
NDC,51079025501,METOPROLOL TARTRATE 25 MG TABLET,0.57,0.43,0.01,0.51,119
NDC,51079028401,DIAZEPAM 2 MG TABLET,0.38,0.29,0.01,0.34,119
NDC,51079028501,DIAZEPAM 5 MG TABLET,0.4,0.3,0.01,0.36,119
NDC,51079028520,DIAZEPAM 5 MG TABLET,0.4,0.3,0.01,0.36,119
NDC,51079044201,LEVOTHYROXINE 100 MCG TABLET,3.38,2.54,0.04,3.04,119
NDC,51079044401,LEVOTHYROXINE 25 MCG TABLET,2.63,1.98,0.03,2.37,119
NDC,51079045301,MIDODRINE 5 MG TABLET,6.84,5.13,0.08,6.16,119
NDC,51079057201,TRIFLUOPERAZINE 1 MG TABLET,6.71,5.04,0.08,6.04,119
NDC,51079059701,CETIRIZINE 10 MG TABLET,0.88,0.66,0.01,0.79,119
NDC,51079063001,PRAZOSIN 1 MG CAPSULE,9.06,6.8,0.11,8.15,119
NDC,51079073401,HALOPERIDOL 1 MG TABLET,2.46,1.84,0.03,2.21,119
NDC,51079081801,"TACROLIMUS 1 MG CAPSULE, IMMEDIATE-RELEASE",6.9,5.18,0.08,6.21,119
NDC,51079088601,METOCLOPRAMIDE 5 MG TABLET,4.52,3.39,0.05,4.07,119
NDC,51079092101,CLOZAPINE 25 MG TABLET,3.9,2.92,0.05,3.51,119
NDC,51079092201,CLOZAPINE 100 MG TABLET,9.9,7.43,0.12,8.91,119
NDC,51079096001,BUSPIRONE 15 MG TABLET,2.72,2.04,0.03,2.45,119
NDC,51079098501,BUSPIRONE 5 MG TABLET,0.61,0.45,0.01,0.55,119
NDC,51079098601,BUSPIRONE 10 MG TABLET,0.83,0.62,0.01,0.75,119
NDC,51144000301,TISOTUMAB VEDOTIN-TFTV 40 MG INTRAVENOUS SOLUTION,18327.48,13745.61,219.93,16494.73,119
NDC,51144002001,ENFORTUMAB VEDOTIN-EJFV 20 MG INTRAVENOUS SOLUTION,7720.54,5790.4,92.65,6948.49,119
NDC,51144003001,ENFORTUMAB VEDOTIN-EJFV 30 MG INTRAVENOUS SOLUTION,11580.8,8685.6,138.97,10422.72,119
NDC,51144005001,BRENTUXIMAB VEDOTIN 50 MG INTRAVENOUS SOLUTION,27584.2,20688.15,331.01,24825.78,119
NDC,51167033101,ELEXACAFTOR 100 MG-TEZACAF 50MG-IVACAF 75MG(D)/IVACAF 150MG(N) TABLETS,1213.53,910.15,14.56,1092.18,119
NDC,51167044601,ELEXACAF 100 MG-TEZACAF 50 MG-IVACAF 75 MG(D)/IVACAF 75 MG(N) GRAN PK,1820.3,1365.22,21.84,1638.27,119
NDC,51167054834,SUZETRIGINE 50 MG TABLET,69.75,52.31,0.84,62.78,119
NDC,51224001220,PHENTOLAMINE 5 MG INJECTION SOLUTION,1612.03,1209.02,19.34,1450.83,119
NDC,51525011501,"HYOSCYAMINE ER 0.375 MG TABLET,EXTENDED RELEASE,12 HR",4.74,3.56,0.06,4.27,119
NDC,51672130301,ECONAZOLE NITRATE 1 % TOPICAL CREAM,150.21,112.66,1.8,135.19,119
NDC,51672137001,MUPIROCIN CALCIUM 2 % TOPICAL CREAM,450.0,337.5,5.4,405.0,119
NDC,51672138601,FLUOCINONIDE 0.05 % TOPICAL CREAM,90.0,67.5,1.08,81.0,119
NDC,51672140004,CLINDAMYCIN 1 % LOTION,360.0,270.0,4.32,324.0,119
NDC,51672200306,CLOTRIMAZOLE 1 % VAGINAL CREAM,24.3,18.23,0.29,21.87,119
NDC,51672201002,HYDROCORTISONE 0.5 % TOPICAL CREAM,19.77,14.83,0.24,17.79,119
NDC,51672201302,HYDROCORTISONE-ALOE VERA 1 % TOPICAL CREAM,19.77,14.83,0.24,17.79,119
NDC,51672203506,MICONAZOLE NITRATE 2 % VAGINAL CREAM,48.33,36.25,0.58,43.5,119
NDC,51672211400,ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,119
NDC,51672211402,ACETAMINOPHEN 80 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,119
NDC,51672211500,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,119
NDC,51672211502,ACETAMINOPHEN 120 MG RECTAL SUPPOSITORY,5.6,4.2,0.07,5.04,119
NDC,51672211600,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,6.1,4.58,0.07,5.49,119
NDC,51672211602,ACETAMINOPHEN 325 MG RECTAL SUPPOSITORY,6.1,4.58,0.07,5.49,119
NDC,51672400101,NORTRIPTYLINE 10 MG CAPSULE,1.18,0.88,0.01,1.06,119
NDC,51672401105,CLOMIPRAMINE 25 MG CAPSULE,2.0,1.5,0.02,1.8,119
NDC,51672402801,WARFARIN 2 MG TABLET,1.37,1.03,0.02,1.23,119
NDC,51672403001,WARFARIN 3 MG TABLET,1.42,1.06,0.02,1.28,119
NDC,51672403801,ENALAPRIL MALEATE 5 MG TABLET,1.26,0.94,0.02,1.13,119
NDC,51672404201,CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET,5.97,4.48,0.07,5.37,119
NDC,51672406901,PHENYTOIN 125 MG/5 ML ORAL SUSPENSION,143.62,107.72,1.72,129.26,119
NDC,51672414601,PHENYTOIN 50 MG CHEWABLE TABLET,2.53,1.89,0.03,2.28,119
NDC,51672423501,FLUPHENAZINE 5 MG TABLET,8.69,6.52,0.1,7.82,119
NDC,51754010801,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",126.0,94.5,1.51,113.4,119
NDC,51754050103,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) ORAL SOLUTION,72.0,54.0,0.86,64.8,119
NDC,51754200104,POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,32.4,24.3,0.39,29.16,119
NDC,51754420001,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,69.3,51.97,0.83,62.37,119
NDC,51754420004,EPHEDRINE SULFATE 50 MG/ML INTRAVENOUS SOLUTION,69.3,51.97,0.83,62.37,119
NDC,51754425001,EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,74.1,55.58,0.89,66.69,119
NDC,51754425003,EPHEDRINE SULFATE 25 MG/5 ML (5 MG/ML) INTRAVENOUS SYRINGE,74.1,55.58,0.89,66.69,119
NDC,51754500101,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,52.5,39.38,0.63,47.25,119
NDC,51759020813,ECULIZUMAB-AAGH 300 MG/30 ML INTRAVENOUS SOLUTION,13914.88,10436.16,166.98,12523.39,119
NDC,51862048601,TRIMETHOPRIM 100 MG TABLET,11.18,8.38,0.13,10.06,119
NDC,51991029305,OXCARBAZEPINE 300 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,51991038099,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.5 MG TABLET,50.0,37.5,0.6,45.0,119
NDC,51991087733,EPLERENONE 25 MG TABLET,8.39,6.3,0.1,7.55,119
NDC,51991090601,TETRACYCLINE 250 MG CAPSULE,9.99,7.49,0.12,8.99,119
NDC,52015008001,FIDAXOMICIN 200 MG TABLET,956.31,717.24,11.48,860.68,119
NDC,52268001201,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",715.79,536.84,8.59,644.21,119
NDC,52268010001,PEG 3350-ELECTROLYTES 236 GRAM-22.74 GRAM-6.74 GRAM-5.86 GRAM SOLUTION,144.0,108.0,1.73,129.6,119
NDC,52427080390,"GABAPENTIN ER 300 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
NDC,52652500101,AMLODIPINE BENZOATE 1 MG/ML ORAL SUSPENSION,3521.7,2641.27,42.26,3169.53,119
NDC,52652800101,ZONISAMIDE 100 MG/5 ML ORAL SUSPENSION,2309.4,1732.05,27.71,2078.46,119
NDC,52817023530,RAMELTEON 8 MG TABLET,6.79,5.09,0.08,6.11,119
NDC,52817033050,CYCLOBENZAPRINE 5 MG TABLET,0.16,0.12,0.01,0.14,119
NDC,52817033200,CYCLOBENZAPRINE 10 MG TABLET,0.1,0.07,0.01,0.09,119
NDC,52817036100,METOPROLOL TARTRATE 50 MG TABLET,0.13,0.09,0.01,0.12,119
NDC,52817083004,LEVOCARNITINE (WITH SUGAR) 100 MG/ML ORAL SOLUTION,123.19,92.39,1.48,110.87,119
NDC,53746057201,BETHANECHOL CHLORIDE 10 MG TABLET,1.9,1.43,0.02,1.71,119
NDC,53746057301,BETHANECHOL CHLORIDE 25 MG TABLET,2.74,2.05,0.03,2.47,119
NDC,53746064101,FLECAINIDE 50 MG TABLET,2.06,1.55,0.02,1.85,119
NDC,53746064201,FLECAINIDE 100 MG TABLET,3.38,2.53,0.04,3.04,119
NDC,53746074501,PROMETHAZINE 12.5 MG TABLET,0.48,0.36,0.01,0.43,119
NDC,53746083153,"CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION",675.0,506.25,8.1,607.5,119
NDC,54092018981,"MESALAMINE ER 250 MG CAPSULE,EXTENDED RELEASE",18.22,13.66,0.22,16.4,119
NDC,54288010301,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,54288010310,EPINEPHRINE HCL (PF) 1 MG/ML (1 ML) INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,54288010502,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,4129.25,3096.94,49.55,3716.32,119
NDC,54288010515,ETHYL ALCOHOL 99 % INTRA-ARTERIAL SOLUTION,4129.25,3096.94,49.55,3716.32,119
NDC,54288012301,EPINEPHRINE 1 MG/ML NASAL SOLUTION,540.0,405.0,6.48,486.0,119
NDC,54288014201,PAPAVERINE 30 MG/ML INJECTION SOLUTION,146.25,109.69,1.76,131.62,119
NDC,54288014210,PAPAVERINE 30 MG/ML INJECTION SOLUTION,146.25,109.69,1.76,131.62,119
NDC,54482014701,LEVOCARNITINE 200 MG/ML INTRAVENOUS SOLUTION,233.25,174.94,2.8,209.92,119
NDC,54643564601,"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",144.27,108.2,1.73,129.84,119
NDC,54643564700,"MVI, PEDI NO.1 WITH VIT K 80 MG-400 UNIT-200 MCG/5 ML INTRAVENOUS SOLN",1475.7,1106.78,17.71,1328.13,119
NDC,54643564901,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",92.28,69.21,1.11,83.05,119
NDC,54643565002,"MVI,ADULT NO.4 WITH VIT K 3300 UNIT-150 MCG/10 ML INTRAVENOUS SOLUTION",782.4,586.8,9.39,704.16,119
NDC,54828000101,FLORBETABEN F-18 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,12546.0,9409.5,150.55,11291.4,119
NDC,54828000130,FLORBETABEN F-18 8.1 MCI (300 MBQ) INTRAVENOUS SOLUTION,10332.0,7749.0,123.98,9298.8,119
NDC,54838001150,FERROUS SULFATE 15 MG IRON (75 MG)/ML ORAL DROPS,25.2,18.9,0.3,22.68,119
NDC,54838050140,HALOPERIDOL LACTATE 2 MG/ML ORAL CONCENTRATE,169.92,127.44,2.04,152.93,119
NDC,54838051080,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,102.17,76.63,1.23,91.95,119
NDC,54838056670,LAMIVUDINE 10 MG/ML ORAL SOLUTION,498.24,373.68,5.98,448.42,119
NDC,55111022990,PRAVASTATIN 10 MG TABLET,0.73,0.55,0.01,0.66,119
NDC,55111026379,OLANZAPINE 10 MG DISINTEGRATING TABLET,15.25,11.43,0.18,13.72,119
NDC,55111030290,DONEPEZIL 23 MG TABLET,10.89,8.17,0.13,9.8,119
NDC,55111032101,GLIMEPIRIDE 2 MG TABLET,0.4,0.3,0.01,0.36,119
NDC,55111062660,ZAFIRLUKAST 20 MG TABLET,10.81,8.11,0.13,9.73,119
NDC,55111065301,SIROLIMUS 1 MG TABLET,45.01,33.75,0.54,40.51,119
NDC,55111067811,FONDAPARINUX 2.5 MG/0.5 ML SUBCUTANEOUS SOLUTION SYRINGE,103.86,77.9,1.25,93.47,119
NDC,55111067911,FONDAPARINUX 5 MG/0.4 ML SUBCUTANEOUS SOLUTION SYRINGE,225.43,169.07,2.71,202.89,119
NDC,55111068507,ZOLEDRONIC ACID 4 MG/5 ML INTRAVENOUS SOLUTION,245.62,184.22,2.95,221.06,119
NDC,55111069407,PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION,212.5,159.38,2.55,191.25,119
NDC,55135013201,SACITUZUMAB GOVITECAN-HZIY 180 MG INTRAVENOUS SOLUTION,6772.2,5079.15,81.27,6094.98,119
NDC,55150011620,AMPICILLIN-SULBACTAM 1.5 GRAM SOLUTION FOR INJECTION,11.58,8.69,0.14,10.42,119
NDC,55150012030,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,33.0,24.75,0.4,29.7,119
NDC,55150012150,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,39.0,29.25,0.47,35.1,119
NDC,55150012150,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (4 GM PIP NEO/PED)(UW),39.0,29.25,0.47,35.1,119
NDC,55150012316,NAFCILLIN 2 GRAM SOLUTION FOR INJECTION,42.5,31.88,0.51,38.25,119
NDC,55150012409,NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,339.8,254.85,4.08,305.82,119
NDC,55150012499,NAFCILLIN 10 GRAM SOLUTION FOR INJECTION,339.8,254.85,4.08,305.82,119
NDC,55150015410,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,67.5,50.62,0.81,60.75,119
NDC,55150016205,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,17.76,13.32,0.21,15.98,119
NDC,55150016402,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,20.0,15.0,0.24,18.0,119
NDC,55150016710,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,13.74,10.3,0.16,12.37,119
NDC,55150016830,BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION,14.04,10.53,0.17,12.64,119
NDC,55150016910,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,15.78,11.84,0.19,14.2,119
NDC,55150017030,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,15.48,11.61,0.19,13.93,119
NDC,55150017110,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,15.72,11.79,0.19,14.15,119
NDC,55150017230,BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION,27.9,20.92,0.33,25.11,119
NDC,55150017301,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,49.5,37.12,0.59,44.55,119
NDC,55150017305,SUMATRIPTAN 6 MG/0.5 ML SUBCUTANEOUS SOLUTION,49.5,37.12,0.59,44.55,119
NDC,55150018301,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,127.44,95.58,1.53,114.7,119
NDC,55150018310,NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION,127.44,95.58,1.53,114.7,119
NDC,55150019183,IBANDRONATE 3 MG/3 ML INTRAVENOUS SYRINGE,731.4,548.55,8.78,658.26,119
NDC,55150019410,ESMOLOL 100 MG/10 ML (10 MG/ML) INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,119
NDC,55150020720,MEROPENEM 500 MG INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,55150020902,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,43.2,32.4,0.52,38.88,119
NDC,55150023200,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,240.7,180.53,2.89,216.63,119
NDC,55150023300,FONDAPARINUX 10 MG/0.8 ML SUBCUTANEOUS SOLUTION SYRINGE,241.12,180.84,2.89,217.01,119
NDC,55150023501,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,119
NDC,55150023510,VECURONIUM BROMIDE 10 MG INTRAVENOUS SOLUTION,26.4,19.8,0.32,23.76,119
NDC,55150023601,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,55150023602,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,48.6,36.45,0.58,43.74,119
NDC,55150023620,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,55150023621,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,48.6,36.45,0.58,43.74,119
NDC,55150025220,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,21.36,16.02,0.26,19.22,119
NDC,55150027201,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,1637.5,1228.12,19.65,1473.75,119
NDC,55150028209,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,180.0,135.0,2.16,162.0,119
NDC,55150028220,ERTAPENEM 1 GRAM SOLUTION FOR INJECTION,249.0,186.75,2.99,224.1,119
NDC,55150033701,BORTEZOMIB 3.5 MG INJECTION POWDER FOR SOLUTION,137.55,103.16,1.65,123.8,119
NDC,55150033701,BORTEZOMIB 3.5 MG SOLUTION FOR SUBCUTANEOUS INJECTION (UW),137.55,103.16,1.65,123.8,119
NDC,55150036501,AMPHOTERICIN B LIPOSOME 50 MG INTRAVENOUS SUSPENSION,725.02,543.76,8.7,652.52,119
NDC,55150037001,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,311.25,233.44,3.74,280.12,119
NDC,55150037025,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,311.25,233.44,3.74,280.12,119
NDC,55150038601,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,213.18,159.88,2.56,191.86,119
NDC,55150038801,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,1484.96,1113.72,17.82,1336.46,119
NDC,55150042001,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",838.5,628.88,10.06,754.65,119
NDC,55150042010,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",838.5,628.88,10.06,754.65,119
NDC,55150043801,KETAMINE 10 MG/ML INJECTION SOLUTION,115.8,86.85,1.39,104.22,119
NDC,55150043810,KETAMINE 10 MG/ML INJECTION SOLUTION,115.8,86.85,1.39,104.22,119
NDC,55390003910,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,55513002101,DARBEPOETIN ALFA 40 MCG/0.4 ML (NEO WEEKLY) (UW),881.12,660.84,10.57,793.01,119
NDC,55513002101,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,881.12,660.84,10.57,793.01,119
NDC,55513002104,DARBEPOETIN ALFA 40 MCG/0.4 ML (NEO WEEKLY) (UW),881.12,660.84,10.57,793.01,119
NDC,55513002104,DARBEPOETIN ALFA 40 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,881.12,660.84,10.57,793.01,119
NDC,55513002301,DARBEPOETIN ALFA 60 MCG/0.3 ML (NEO WEEKLY) (UW),1276.4,957.3,15.32,1148.76,119
NDC,55513002301,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,1276.4,957.3,15.32,1148.76,119
NDC,55513002304,DARBEPOETIN ALFA 60 MCG/0.3 ML (NEO WEEKLY) (UW),1276.4,957.3,15.32,1148.76,119
NDC,55513002304,DARBEPOETIN ALFA 60 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,1276.4,957.3,15.32,1148.76,119
NDC,55513002501,DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE,2127.34,1595.5,25.53,1914.61,119
NDC,55513002504,DARBEPOETIN ALFA 100 MCG/0.5 ML IN POLYSORBATE INJECTION SYRINGE,2127.34,1595.5,25.53,1914.61,119
NDC,55513002701,DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,3191.01,2393.26,38.29,2871.91,119
NDC,55513002704,DARBEPOETIN ALFA 150 MCG/0.3 ML IN POLYSORBATE INJECTION SYRINGE,3191.01,2393.26,38.29,2871.91,119
NDC,55513002801,DARBEPOETIN ALFA 200 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,4254.68,3191.01,51.06,3829.21,119
NDC,55513005701,DARBEPOETIN ALFA 25 MCG/0.42 ML (NEO WEEKLY) (UW),550.7,413.03,6.61,495.63,119
NDC,55513005701,DARBEPOETIN ALFA 25 MCG/0.42 ML IN POLYSORBATE INJECTION SYRINGE,550.7,413.03,6.61,495.63,119
NDC,55513005704,DARBEPOETIN ALFA 25 MCG/0.42 ML (NEO WEEKLY) (UW),550.7,413.03,6.61,495.63,119
NDC,55513005704,DARBEPOETIN ALFA 25 MCG/0.42 ML IN POLYSORBATE INJECTION SYRINGE,550.7,413.03,6.61,495.63,119
NDC,55513009801,DARBEPOETIN ALFA 10 MCG/0.4 ML (NEO WEEKLY) (UW),235.88,176.91,2.83,212.29,119
NDC,55513009801,DARBEPOETIN ALFA 10 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,235.88,176.91,2.83,212.29,119
NDC,55513009804,DARBEPOETIN ALFA 10 MCG/0.4 ML (NEO WEEKLY) (UW),235.88,176.91,2.83,212.29,119
NDC,55513009804,DARBEPOETIN ALFA 10 MCG/0.4 ML IN POLYSORBATE INJECTION SYRINGE,235.88,176.91,2.83,212.29,119
NDC,55513013201,TRASTUZUMAB-ANNS 420 MG INTRAVENOUS SOLUTION,10466.78,7850.09,125.6,9420.1,119
NDC,55513019001,PEGFILGRASTIM 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,15438.0,11578.5,185.26,13894.2,119
NDC,55513019201,PEGFILGRASTIM 6 MG/0.6 ML (DELIVERABLE) WEARABLE SUBCUTANEOUS INJECTOR,15438.0,11578.5,185.26,13894.2,119
NDC,55513020601,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,2126.34,1594.75,25.52,1913.71,119
NDC,55513020701,BEVACIZUMAB-AWWB 25 MG/ML INTRAVENOUS SOLUTION,8505.26,6378.94,102.06,7654.73,119
NDC,55513022301,ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION,4837.52,3628.14,58.05,4353.77,119
NDC,55513071021,DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE,4909.15,3681.86,58.91,4418.23,119
NDC,55513073001,DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION,9030.11,6772.58,108.36,8127.1,119
NDC,55513095401,PANITUMUMAB 100 MG/5 ML (20 MG/ML) INTRAVENOUS SOLUTION,4910.43,3682.82,58.93,4419.39,119
NDC,55513095601,PANITUMUMAB 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,19641.73,14731.29,235.7,17677.56,119
NDC,55513099802,ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE,3440.76,2580.57,41.29,3096.68,119
NDC,55566280001,"DINOPROSTONE ER 10 MG VAGINAL INSERT,CONTROLLED RELEASE",2012.08,1509.06,24.14,1810.87,119
NDC,55566830301,DEGARELIX 80 MG SUBCUTANEOUS SOLUTION,1390.13,1042.6,16.68,1251.12,119
NDC,55566840301,DEGARELIX 120 MG SUBCUTANEOUS SOLUTION,2168.91,1626.68,26.03,1952.02,119
NDC,55764000711,GELMIX ORAL POWDER PACKET (INF-PED NUTRITION),3.9,2.92,0.05,3.51,119
NDC,57237011490,"ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR",1.67,1.25,0.02,1.5,119
NDC,57237012601,WARFARIN 7.5 MG TABLET,1.39,1.04,0.02,1.25,119
NDC,57237017501,VENLAFAXINE 75 MG TABLET,0.86,0.65,0.01,0.77,119
NDC,57237018090,PRAMIPEXOLE 0.125 MG TABLET,0.67,0.5,0.01,0.6,119
NDC,57237018190,PRAMIPEXOLE 0.25 MG TABLET,0.67,0.5,0.01,0.6,119
NDC,57237027424,LAMIVUDINE 10 MG/ML ORAL SOLUTION,479.52,359.64,5.75,431.57,119
NDC,57894003001,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,3209.75,2407.32,38.52,2888.78,119
NDC,57894005427,USTEKINUMAB 130 MG/26 ML INTRAVENOUS SOLUTION,6169.71,4627.28,74.04,5552.74,119
NDC,57894016001,INFLIXIMAB 100 MG INTRAVENOUS SOLUTION,1351.85,1013.89,16.22,1216.66,119
NDC,57894035001,GOLIMUMAB 12.5 MG/ML INTRAVENOUS SOLUTION,5689.7,4267.28,68.28,5120.73,119
NDC,57894045001,TECLISTAMAB-CQYV 90 MG/ML SUBCUTANEOUS SOLUTION,24997.49,18748.12,299.97,22497.74,119
NDC,57894050101,AMIVANTAMAB-VMJW 50 MG/ML INTRAVENOUS SOLUTION,10377.51,7783.13,124.53,9339.76,119
NDC,57894050301,"DARATUMUMAB 1,800 MG-HYALURONIDASE-FIHJ 30,000 UNIT/15 ML SUBCUT SOLN",28524.39,21393.29,342.29,25671.95,119
NDC,57896030410,SENNOSIDES 8.6 MG-DOCUSATE SODIUM 50 MG TABLET,0.08,0.06,0.01,0.07,119
NDC,57896075201,"VITAMIN E (DL, ACETATE) 180 MG (400 UNIT) CAPSULE",0.4,0.3,0.01,0.36,119
NDC,57896084216,ASCORBIC ACID (VITAMIN C) 500 MG/5 ML ORAL SYRUP,70.95,53.21,0.85,63.86,119
NDC,57896087503,COENZYME Q10 100 MG CAPSULE,0.82,0.61,0.01,0.74,119
NDC,57896090110,ASPIRIN 325 MG TABLET,0.04,0.03,0.01,0.04,119
NDC,57896092110,"ASPIRIN 325 MG TABLET,DELAYED RELEASE",0.07,0.05,0.01,0.06,119
NDC,57970010001,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6564.99,4923.74,78.78,5908.49,119
NDC,58160081043,"DIPH,PERTUS(ACEL),TET PED(PF) 25 LF UNIT-58 MCG-10 LF/0.5ML IM SYRINGE",113.47,85.1,1.36,102.12,119
NDC,58160081143,HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE,414.46,310.85,4.97,373.01,119
NDC,58160081152,HEP B-DP(A)T-POLIO VACC (PF) 10 MCG-25LF-25 MCG-10LF/0.5 ML IM SYRINGE,414.46,310.85,4.97,373.01,119
NDC,58160081543,HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE,543.36,407.52,6.52,489.02,119
NDC,58160081552,HEPATITIS A AND B VIRUS VACCINE(PF)720 ELISA UNIT-20 MCG/ML IM SYRINGE,543.36,407.52,6.52,489.02,119
NDC,58160082043,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,118.28,88.71,1.42,106.45,119
NDC,58160082052,HEPATITIS B VIRUS VACCINE RECOMB (PF) 10 MCG/0.5 ML IM SYRINGE,118.28,88.71,1.42,106.45,119
NDC,58160082143,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,296.68,222.51,3.56,267.01,119
NDC,58160082152,HEPATITIS B VIRUS VACCINE RECOMB (PF) 20 MCG/ML INTRAMUSCULAR SYRINGE,296.68,222.51,3.56,267.01,119
NDC,58160082311,"VARICELLA-ZOSTER GLYCOE VACC-AS01B ADJ(PF) 50 MCG/0.5 ML IM SUSP, KIT",830.0,622.5,9.96,747.0,119
NDC,58160082643,"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",354.42,265.81,4.25,318.98,119
NDC,58160082652,"HEPATITIS A VACCINE (PF) 1,440 ELISA UNIT/ML INTRAMUSCULAR SYRINGE",354.42,265.81,4.25,318.98,119
NDC,58160082803,VARICELLA-ZOSTER GLYCOP E VACCINE (VIAL 2 OF 2) 50 MCG IM SUSPENSION,830.0,622.5,9.96,747.0,119
NDC,58160082903,"ADJUVANT AS01B (PF), COMPONENT VIAL 1 OF 2 INTRAMUSCULAR SUSPENSION",827.55,620.66,9.93,744.8,119
NDC,58160084243,"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",192.96,144.72,2.32,173.66,119
NDC,58160084252,"DIPHTH,PERTUSSIS(ACEL),TETANUS 2.5 LF UNIT-8 MCG-5 LF/0.5ML IM SYRINGE",192.96,144.72,2.32,173.66,119
NDC,58160091241,FLU VACCINE TS 2025-26(6MOS UP)(PF) 45 MCG(15MCG X3)/0.5 ML IM SYRINGE,39.48,29.61,0.47,35.53,119
NDC,58160095509,"MENINGOC VAC A,C,Y,W-135 DIP(PF) 10 MCG-5 MCG/0.5 ML IM KIT (2 VIALS)",688.89,516.67,8.27,620.0,119
NDC,58160095901,"MENINGOCO C,Y,W-135 VACC 1 OF 2(PF) 5 MCG X3/0.5 ML(FINAL) IM SOLUTION",0.01,0.01,0.01,0.01,119
NDC,58160097602,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",907.68,680.76,10.89,816.91,119
NDC,58160097620,"MENINGOCOCCAL B VAC,4-CMP 50 MCG-50 MCG-50 MCG-25 MCG/0.5ML IM SYRINGE",907.68,680.76,10.89,816.91,119
NDC,58292001005,DIPHENHYDRAMINE 12.5 MG/5 ML ORAL LIQUID IN PACKET,6.0,4.5,0.07,5.4,119
NDC,58394063403,COAGULATION FACTOR IX (RECOMB) 500 UNIT INTRAVENOUS SOLUTION,7.4,5.55,0.09,6.66,119
NDC,58394063503,"COAGULATION FACTOR IX (RECOMB) 1,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
NDC,58394063603,"COAGULATION FACTOR IX (RECOMB) 2,000 UNIT INTRAVENOUS SOLUTION",7.4,5.55,0.09,6.66,119
NDC,58468003002,THYROTROPIN ALFA 0.9 MG INTRAMUSCULAR SOLUTION,5434.44,4075.83,65.21,4891.0,119
NDC,58468004001,AGALSIDASE BETA 35 MG INTRAVENOUS SOLUTION,20140.08,15105.06,241.68,18126.07,119
NDC,58468004101,AGALSIDASE BETA 5 MG INTRAVENOUS SOLUTION,3072.88,2304.66,36.87,2765.59,119
NDC,58468008001,ANTI-THYMOCYTE GLOBULIN (RABBIT) 25 MG INTRAVENOUS SOLUTION,3076.86,2307.65,36.92,2769.17,119
NDC,58468020001,ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION,66585.86,49939.4,799.03,59927.27,119
NDC,58657031216,"POTASSIUM CITRATE-CITRIC ACID 1,100 MG-334 MG/5 ML ORAL SOLUTION",374.62,280.96,4.5,337.16,119
NDC,58657060250,LABETALOL 100 MG TABLET,1.08,0.81,0.01,0.97,119
NDC,58657093101,BACLOFEN 10 MG TABLET,2.4,1.8,0.03,2.16,119
NDC,58980041012,GLYCERIN (ADULT) RECTAL SUPPOSITORY,0.98,0.73,0.01,0.88,119
NDC,59011041020,"OXYCODONE ER 10 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",34.9,26.18,0.42,31.41,119
NDC,59011041520,"OXYCODONE ER 15 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",51.34,38.51,0.62,46.21,119
NDC,59011042020,"OXYCODONE ER 20 MG TABLET,CRUSH RESISTANT,EXTENDED RELEASE 12 HR",60.0,45.0,0.72,54.0,119
NDC,59011075104,BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH,319.74,239.8,3.84,287.77,119
NDC,59148001971,"ARIPIPRAZOLE ER 400 MG INTRAMUSCULAR SUSPENSION,EXTENDED RELEASE",7982.85,5987.14,95.79,7184.56,119
NDC,59148003713,BREXPIPRAZOLE 1 MG TABLET,225.0,168.75,2.7,202.5,119
NDC,59148003813,BREXPIPRAZOLE 2 MG TABLET,225.0,168.75,2.7,202.5,119
NDC,59148007280,"ARIPIPRAZOLE ER 400 MG SUSPENSION, EXTENDED REL.INTRAMUSCULAR SYRINGE",7982.85,5987.14,95.79,7184.56,119
NDC,59310030240,BECLOMETHASONE DIPROP 40 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,985.48,739.11,11.83,886.93,119
NDC,59310030480,BECLOMETHASONE DIPROP 80 MCG/ACTUATION HFA BREATH ACTIVATED AEROSOL,1319.86,989.89,15.84,1187.87,119
NDC,59316010312,MENTHOL 4 % TOPICAL GEL,45.92,34.44,0.55,41.33,119
NDC,59338077501,FERUMOXYTOL 510 MG/17 ML (30 MG/ML) INTRAVENOUS SOLUTION,3637.56,2728.17,43.65,3273.8,119
NDC,59365512801,COPPER 380 SQUARE MM INTRAUTERINE DEVICE,4202.91,3152.18,50.43,3782.62,119
NDC,59385002201,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,45.18,33.88,0.54,40.66,119
NDC,59385002260,BUPRENORPHINE HCL 150 MCG BUCCAL FILM,45.16,33.87,0.54,40.64,119
NDC,59385002301,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,60.0,45.0,0.72,54.0,119
NDC,59385002360,BUPRENORPHINE HCL 300 MCG BUCCAL FILM,60.0,45.0,0.72,54.0,119
NDC,59385004130,NALDEMEDINE 0.2 MG TABLET,72.88,54.66,0.87,65.59,119
NDC,59417010110,LISDEXAMFETAMINE 10 MG CAPSULE,60.0,45.0,0.72,54.0,119
NDC,59417010310,LISDEXAMFETAMINE 30 MG CAPSULE,60.0,45.0,0.72,54.0,119
NDC,59417010710,LISDEXAMFETAMINE 70 MG CAPSULE,60.0,45.0,0.72,54.0,119
NDC,59572071101,LUSPATERCEPT-AAMT 25 MG SUBCUTANEOUS SOLUTION,11083.3,8312.47,133.0,9974.97,119
NDC,59630026601,CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION,894.11,670.58,10.73,804.7,119
NDC,59651001890,"NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",2.14,1.6,0.03,1.93,119
NDC,59651008560,DARUNAVIR 600 MG TABLET,6.0,4.5,0.07,5.4,119
NDC,59651008630,DARUNAVIR 800 MG TABLET,12.0,9.0,0.14,10.8,119
NDC,59651024130,IMATINIB 400 MG TABLET,26.0,19.5,0.31,23.4,119
NDC,59651025601,PROPAFENONE 150 MG TABLET,1.4,1.05,0.02,1.26,119
NDC,59651025701,PROPAFENONE 225 MG TABLET,2.3,1.73,0.03,2.07,119
NDC,59651029960,TAMOXIFEN 10 MG TABLET,1.15,0.86,0.01,1.03,119
NDC,59651033201,FLUCYTOSINE 500 MG CAPSULE,90.0,67.5,1.08,81.0,119
NDC,59651042011,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,210.34,157.75,2.52,189.31,119
NDC,59651042201,CEVIMELINE 30 MG CAPSULE,12.72,9.54,0.15,11.45,119
NDC,59651048401,PREDNISONE 1 MG TABLET,0.6,0.45,0.01,0.54,119
NDC,59651048501,PREDNISONE 2.5 MG TABLET,0.73,0.55,0.01,0.66,119
NDC,59651048901,PREDNISONE 50 MG TABLET,1.81,1.35,0.02,1.63,119
NDC,59651049101,PREDNISOLONE 5 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,59651051630,EXEMESTANE 25 MG TABLET,10.0,7.5,0.12,9.0,119
NDC,59651056501,DICLOXACILLIN 250 MG CAPSULE,3.76,2.82,0.05,3.38,119
NDC,59651057590,FENOFIBRATE 54 MG TABLET,1.33,1.0,0.02,1.2,119
NDC,59651072301,CLONAZEPAM 1 MG TABLET,0.25,0.19,0.01,0.22,119
NDC,59676057530,DARUNAVIR 800 MG-COBICISTAT 150 MG TABLET,341.23,255.92,4.09,307.11,119
NDC,59746038306,TERAZOSIN 1 MG CAPSULE,1.08,0.81,0.01,0.97,119
NDC,59746038506,TERAZOSIN 5 MG CAPSULE,1.08,0.81,0.01,0.97,119
NDC,59746038606,TERAZOSIN 10 MG CAPSULE,1.08,0.81,0.01,0.97,119
NDC,59762005901,"ALPRAZOLAM ER 1 MG TABLET,EXTENDED RELEASE 24 HR",4.33,3.24,0.05,3.9,119
NDC,59762007301,HYDROCORTISONE 5 MG TABLET,1.03,0.77,0.01,0.93,119
NDC,59762007401,HYDROCORTISONE 10 MG TABLET,1.72,1.29,0.02,1.55,119
NDC,59762007501,HYDROCORTISONE 20 MG TABLET,3.08,2.31,0.04,2.77,119
NDC,59762010405,"SULFASALAZINE 500 MG TABLET,DELAYED RELEASE",1.71,1.28,0.02,1.54,119
NDC,59762011701,MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE),13.97,10.48,0.17,12.57,119
NDC,59762033302,LATANOPROST 0.005 % EYE DROPS,15.0,11.25,0.18,13.5,119
NDC,59762045001,COLESTIPOL 1 GRAM TABLET,6.31,4.73,0.08,5.68,119
NDC,59762093503,VORICONAZOLE 200 MG/5 ML (40 MG/ML) ORAL SUSPENSION,4500.0,3375.0,54.0,4050.0,119
NDC,59762205801,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,13899.31,10424.48,166.79,12509.38,119
NDC,59762500006,SULFASALAZINE 500 MG TABLET,1.16,0.87,0.01,1.04,119
NDC,59781066678,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,14.18,10.63,0.17,12.76,119
NDC,59781066679,ARGININE 7 GRAM-GLUTAM 7 GRAM-CAHMB 1.5 GRAM-COLLA-MV-MIN ORAL PWD PKT,14.16,10.62,0.17,12.74,119
NDC,60055033430,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,2945.28,2208.96,35.34,2650.75,119
NDC,60219158503,"FLUOROMETHOLONE 0.1 % EYE DROPS,SUSPENSION",348.48,261.36,4.18,313.63,119
NDC,60219174802,ATROPINE 1 % EYE DROPS,161.55,121.16,1.94,145.4,119
NDC,60219174903,ATROPINE 1 % EYE DROPS,262.74,197.06,3.15,236.47,119
NDC,60219265101,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,719.71,539.78,8.64,647.74,119
NDC,60219552209,FENOFIBRATE 160 MG TABLET,2.33,1.75,0.03,2.1,119
NDC,60258000601,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",3.26,2.45,0.04,2.93,119
NDC,60258000615,"POTASSIUM, SODIUM PHOSPHATES 280 MG-160 MG-250 MG ORAL POWDER PACKET",3.26,2.45,0.04,2.93,119
NDC,60258016001,VITAMIN B COMPLEX-VITAMIN C-FOLIC ACID 0.8 MG TABLET,0.41,0.31,0.01,0.37,119
NDC,60267070550,SODIUM THIOSULFATE 12.5 GRAM/50 ML (250 MG/ML) INTRAVENOUS SOLUTION,486.0,364.5,5.83,437.4,119
NDC,60267081200,SODIUM NITRITE-SODIUM THIOSULFATE 300 MG/10 ML-12.5 GRAM/50 ML IV SOLN,671.42,503.56,8.06,604.28,119
NDC,60432045516,HYDROCODONE-HOMATROPINE 5 MG-1.5 MG/5 ML ORAL SOLUTION,420.02,315.02,5.04,378.02,119
NDC,60505003306,"PENTOXIFYLLINE ER 400 MG TABLET,EXTENDED RELEASE",2.54,1.9,0.03,2.29,119
NDC,60505016501,FLUVOXAMINE 50 MG TABLET,3.3,2.47,0.04,2.97,119
NDC,60505056401,BRIMONIDINE 0.15 % EYE DROPS,690.03,517.52,8.28,621.03,119
NDC,60505057701,BRIMONIDINE 0.1 % EYE DROPS,797.98,598.49,9.58,718.18,119
NDC,60505059304,TRAVOPROST 0.004 % EYE DROPS,562.5,421.88,6.75,506.25,119
NDC,60505081500,DESMOPRESSIN 10 MCG/SPRAY (0.1 ML) NASAL SPRAY (NON-REFRIGERATED),554.08,415.56,6.65,498.67,119
NDC,60505082901,"FLUTICASONE PROPIONATE 50 MCG/ACTUATION NASAL SPRAY,SUSPENSION",108.0,81.0,1.3,97.2,119
NDC,60505100301,KETOROLAC 0.5 % EYE DROPS,192.36,144.27,2.31,173.12,119
NDC,60505131603,"PAROXETINE ER 12.5 MG TABLET,EXTENDED RELEASE 24 HR",12.0,9.0,0.14,10.8,119
NDC,60505131703,"PAROXETINE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",12.6,9.45,0.15,11.34,119
NDC,60505265701,TRIAMTERENE 75 MG-HYDROCHLOROTHIAZIDE 50 MG TABLET,1.69,1.27,0.02,1.52,119
NDC,60505280607,"CARBAMAZEPINE ER 200 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",9.82,7.37,0.12,8.84,119
NDC,60505280707,"CARBAMAZEPINE ER 300 MG CAPSULE,EXTENDED RELEASE MPHASE12HR",9.82,7.37,0.12,8.84,119
NDC,60505311000,OLANZAPINE 2.5 MG TABLET,1.18,0.88,0.01,1.06,119
NDC,60505311100,OLANZAPINE 5 MG TABLET,1.39,1.04,0.02,1.25,119
NDC,60505325006,LAMIVUDINE 100 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,60505327503,OLANZAPINE 5 MG DISINTEGRATING TABLET,5.14,3.85,0.06,4.63,119
NDC,60505343803,SELEGILINE 5 MG TABLET,8.83,6.62,0.11,7.95,119
NDC,60505464203,PRASUGREL HCL 5 MG TABLET,4.95,3.71,0.06,4.46,119
NDC,60505612801,IRINOTECAN 100 MG/5 ML INTRAVENOUS SOLUTION,63.75,47.81,0.76,57.38,119
NDC,60505613206,OXALIPLATIN 50 MG/10 ML (5 MG/ML) INTRAVENOUS SOLUTION,85.0,63.75,1.02,76.5,119
NDC,60505613207,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,170.0,127.5,2.04,153.0,119
NDC,60505614500,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,38.25,28.69,0.46,34.43,119
NDC,60505614504,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,22.34,16.75,0.27,20.11,119
NDC,60505614600,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.46,16.1,0.26,19.31,119
NDC,60505614604,CEFEPIME 1 GRAM SOLUTION FOR INJECTION,21.44,16.08,0.26,19.3,119
NDC,60505614700,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,46.28,34.71,0.56,41.65,119
NDC,60505614704,CEFEPIME 2 GRAM SOLUTION FOR INJECTION,46.28,34.71,0.56,41.65,119
NDC,60505615700,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,21.0,15.75,0.25,18.9,119
NDC,60505615704,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,21.0,15.75,0.25,18.9,119
NDC,60505622600,ATROPINE 1 % EYE DROPS,163.66,122.75,1.96,147.29,119
NDC,60505623600,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,60505623606,DEFEROXAMINE 500 MG SOLUTION FOR INJECTION,60.0,45.0,0.72,54.0,119
NDC,60687011211,ANASTROZOLE 1 MG TABLET,5.44,4.08,0.07,4.9,119
NDC,60687011311,CLONIDINE HCL 0.1 MG TABLET,1.82,1.37,0.02,1.64,119
NDC,60687012195,"ACAMPROSATE 333 MG TABLET,DELAYED RELEASE",13.56,10.17,0.16,12.2,119
NDC,60687012211,PREDNISONE 5 MG TABLET,1.01,0.76,0.01,0.91,119
NDC,60687014511,PREDNISONE 20 MG TABLET,1.19,0.89,0.01,1.07,119
NDC,60687015211,CEPHALEXIN 250 MG CAPSULE,1.94,1.46,0.02,1.75,119
NDC,60687017811,PRAVASTATIN 20 MG TABLET,4.22,3.17,0.05,3.8,119
NDC,60687018411,MEMANTINE 10 MG TABLET,4.0,3.0,0.05,3.6,119
NDC,60687020601,"DILTIAZEM CD 180 MG CAPSULE,EXTENDED RELEASE 24 HR",4.84,3.63,0.06,4.36,119
NDC,60687021111,"DIVALPROEX 125 MG TABLET,DELAYED RELEASE",4.47,3.35,0.05,4.02,119
NDC,60687022711,LEUCOVORIN CALCIUM 25 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,60687022911,LOPERAMIDE 2 MG CAPSULE,5.1,3.82,0.06,4.59,119
NDC,60687024211,SERTRALINE 50 MG TABLET,2.35,1.76,0.03,2.12,119
NDC,60687025240,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,81.99,61.49,0.98,73.79,119
NDC,60687025246,ONDANSETRON HCL 4 MG/5 ML ORAL SOLUTION,81.99,61.49,0.98,73.79,119
NDC,60687025611,ROSUVASTATIN 20 MG TABLET,8.4,6.3,0.1,7.56,119
NDC,60687027211,CEFUROXIME AXETIL 250 MG TABLET,22.69,17.02,0.27,20.42,119
NDC,60687029211,DONEPEZIL 5 MG TABLET,0.81,0.61,0.01,0.73,119
NDC,60687030295,NADOLOL 20 MG TABLET,17.51,13.13,0.21,15.76,119
NDC,60687037511,DRONABINOL 2.5 MG CAPSULE,42.46,31.84,0.51,38.21,119
NDC,60687037521,DRONABINOL 2.5 MG CAPSULE,42.46,31.84,0.51,38.21,119
NDC,60687038801,ALPRAZOLAM 0.5 MG TABLET,2.21,1.66,0.03,1.99,119
NDC,60687038811,ALPRAZOLAM 0.5 MG TABLET,2.21,1.66,0.03,1.99,119
NDC,60687040579,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,3.89,2.92,0.05,3.5,119
NDC,60687040583,IPRATROPIUM 0.5 MG-ALBUTEROL 3 MG (2.5 MG BASE)/3 ML NEBULIZATION SOLN,3.89,2.92,0.05,3.5,119
NDC,60687043311,AMITRIPTYLINE 25 MG TABLET,2.58,1.94,0.03,2.32,119
NDC,60687043611,CELECOXIB 100 MG CAPSULE,8.7,6.52,0.1,7.83,119
NDC,60687043811,MYCOPHENOLATE MOFETIL 500 MG TABLET,6.6,4.95,0.08,5.94,119
NDC,60687047511,LEVOTHYROXINE 75 MCG TABLET,3.52,2.64,0.04,3.17,119
NDC,60687049501,PREGABALIN 75 MG CAPSULE,8.08,6.06,0.1,7.27,119
NDC,60687049511,PREGABALIN 75 MG CAPSULE,8.08,6.06,0.1,7.27,119
NDC,60687049711,LEVOTHYROXINE 100 MCG TABLET,3.61,2.71,0.04,3.25,119
NDC,60687050601,PREGABALIN 100 MG CAPSULE,8.08,6.06,0.1,7.27,119
NDC,60687050611,PREGABALIN 100 MG CAPSULE,8.08,6.06,0.1,7.27,119
NDC,60687051911,LEVOTHYROXINE 125 MCG TABLET,4.26,3.2,0.05,3.83,119
NDC,60687054911,"RANOLAZINE ER 500 MG TABLET,EXTENDED RELEASE,12 HR",8.4,6.3,0.1,7.56,119
NDC,60687055011,METRONIDAZOLE 500 MG TABLET,4.5,3.38,0.05,4.05,119
NDC,60687057640,MIDAZOLAM 10 MG/5 ML (2 MG/ML) ORAL SYRUP,36.99,27.74,0.44,33.29,119
NDC,60687057901,HYDROMORPHONE 2 MG TABLET,2.14,1.61,0.03,1.93,119
NDC,60687058001,GABAPENTIN 100 MG CAPSULE,0.75,0.56,0.01,0.68,119
NDC,60687058011,GABAPENTIN 100 MG CAPSULE,0.75,0.56,0.01,0.68,119
NDC,60687058111,PRAMIPEXOLE 0.5 MG TABLET,5.0,3.75,0.06,4.5,119
NDC,60687059211,PRAMIPEXOLE 1 MG TABLET,6.63,4.97,0.08,5.97,119
NDC,60687059311,HYDROCHLOROTHIAZIDE 25 MG TABLET,1.26,0.94,0.02,1.13,119
NDC,60687061911,ACETAZOLAMIDE 250 MG TABLET,20.94,15.71,0.25,18.85,119
NDC,60687064011,"METFORMIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR",3.11,2.34,0.04,2.8,119
NDC,60687065611,LISINOPRIL 2.5 MG TABLET,3.32,2.49,0.04,2.99,119
NDC,60687067211,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,9.76,7.32,0.12,8.78,119
NDC,60687067265,BUTALBITAL-ACETAMINOPHEN-CAFFEINE 50 MG-325 MG-40 MG TABLET,9.76,7.32,0.12,8.78,119
NDC,60687067711,ALLOPURINOL 100 MG TABLET,2.48,1.86,0.03,2.23,119
NDC,60687068101,FOLIC ACID 1 MG TABLET,1.04,0.78,0.01,0.94,119
NDC,60687068111,FOLIC ACID 1 MG TABLET,1.04,0.78,0.01,0.94,119
NDC,60687069411,METHENAMINE HIPPURATE 1 GRAM TABLET,14.78,11.08,0.18,13.3,119
NDC,60687069511,SUCRALFATE 1 GRAM TABLET,2.3,1.73,0.03,2.07,119
NDC,60687071711,DILTIAZEM 30 MG TABLET,2.62,1.97,0.03,2.36,119
NDC,60687072511,"PANTOPRAZOLE 20 MG TABLET,DELAYED RELEASE",1.48,1.11,0.02,1.33,119
NDC,60687074611,MISOPROSTOL 200 MCG TABLET,13.63,10.22,0.16,12.27,119
NDC,60687076411,ICOSAPENT ETHYL 1 GRAM CAPSULE,21.62,16.21,0.26,19.46,119
NDC,60687079501,TRAMADOL 50 MG TABLET,0.88,0.66,0.01,0.79,119
NDC,60687079511,TRAMADOL 50 MG TABLET,0.88,0.66,0.01,0.79,119
NDC,60687080711,CHLORDIAZEPOXIDE 25 MG CAPSULE,3.97,2.98,0.05,3.57,119
NDC,60687083811,ZOLPIDEM 5 MG TABLET,0.91,0.68,0.01,0.82,119
NDC,60758011905,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",264.0,198.0,3.17,237.6,119
NDC,60758080205,TIMOLOL MALEATE 0.25 % EYE DROPS,17.88,13.41,0.21,16.09,119
NDC,60793070102,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1392.28,1044.21,16.71,1253.05,119
NDC,60793070102,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE (UW)",1392.28,1044.21,16.71,1253.05,119
NDC,60793070110,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE",1392.28,1044.21,16.71,1253.05,119
NDC,60793070110,"PENICILLIN G BENZATHINE 1,200,000 UNIT/2 ML INTRAMUSCULAR SYRINGE (UW)",1392.28,1044.21,16.71,1253.05,119
NDC,60977014101,PRALIDOXIME 1 GRAM SOLUTION FOR INJECTION,359.8,269.85,4.32,323.82,119
NDC,61314012605,KETOROLAC 0.5 % EYE DROPS,168.0,126.0,2.02,151.2,119
NDC,61314024063,DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE,4408.95,3306.71,52.91,3968.06,119
NDC,61314031801,FILGRASTIM-SNDZ 300 MCG/0.5 ML INJECTION SYRINGE,780.83,585.62,9.37,702.75,119
NDC,61314032605,FILGRASTIM-SNDZ 480 MCG/0.8 ML INJECTION SYRINGE,1249.34,937.0,14.99,1124.41,119
NDC,61314035502,TROPICAMIDE 1 % EYE DROPS,183.6,137.7,2.2,165.24,119
NDC,61314062810,"POLYMYXIN B SULFATE 10,000 UNIT-TRIMETHOPRIM 1 MG/ML EYE DROPS",62.1,46.58,0.75,55.89,119
NDC,61314063006,"NEOMYCIN-POLYMYXIN-DEXAMETH 3.5 MG/ML-10,000 UNIT/ML-0.1% EYE DROPS",108.0,81.0,1.3,97.2,119
NDC,61314063136,"NEOMYCIN 3.5 MG/G-POLYMYXIN B 10,000 UNIT/G-DEXAMETH 0.1 % EYE OINT",108.0,81.0,1.3,97.2,119
NDC,61314064725,"TOBRAMYCIN 0.3 %-DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",170.68,128.01,2.05,153.61,119
NDC,61314065625,CIPROFLOXACIN 0.3 % EYE DROPS,63.0,47.25,0.76,56.7,119
NDC,61314067225,GATIFLOXACIN 0.5 % EYE DROPS,212.72,159.54,2.55,191.45,119
NDC,61703030538,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,26.97,20.23,0.32,24.27,119
NDC,61703030558,CYTARABINE (PF) 100 MG/5 ML (20 MG/ML) INJECTION SOLUTION,26.97,20.23,0.32,24.27,119
NDC,61703030906,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,58.13,43.6,0.7,52.32,119
NDC,61703030916,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,65.45,49.09,0.79,58.9,119
NDC,61703030925,VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION,72.25,54.19,0.87,65.03,119
NDC,61703030926,VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION,25.2,18.9,0.3,22.68,119
NDC,61703032322,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,285.31,213.98,3.42,256.78,119
NDC,61703033218,BLEOMYCIN 15 UNIT SOLUTION FOR INJECTION,163.75,122.81,1.96,147.38,119
NDC,61703033922,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,98.75,74.06,1.18,88.88,119
NDC,61703033950,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,200.43,150.32,2.41,180.39,119
NDC,61703033956,CARBOPLATIN 10 MG/ML INTRAVENOUS SOLUTION,251.43,188.57,3.02,226.29,119
NDC,61703035009,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,119
NDC,61703035010,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,119
NDC,61703035037,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,119
NDC,61703035038,METHOTREXATE SODIUM 25 MG/ML INJECTION SOLUTION,30.89,23.17,0.37,27.8,119
NDC,61703040841,METHOTREXATE SODIUM (PF) 25 MG/ML INJECTION SOLUTION,156.06,117.04,1.87,140.45,119
NDC,61755000502,AFLIBERCEPT 2 MG/0.05 ML INTRAVITREAL SOLUTION FOR INJECTION,4182.85,3137.14,50.19,3764.57,119
NDC,61755000801,CEMIPLIMAB-RWLC 50 MG/ML INTRAVENOUS SOLUTION,29152.67,21864.5,349.83,26237.4,119
NDC,61874011511,CARIPRAZINE 1.5 MG CAPSULE,225.0,168.75,2.7,202.5,119
NDC,61958200201,EMTRICITABINE 200 MG-TENOFOVIR ALAFENAMIDE FUMARATE 25 MG TABLET,304.65,228.49,3.66,274.18,119
NDC,61958250101,BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET,550.74,413.05,6.61,495.67,119
NDC,61958290102,REMDESIVIR 100 MG INTRAVENOUS POWDER FOR SOLUTION,1706.12,1279.59,20.47,1535.51,119
NDC,62037059790,"DILTIAZEM CD 120 MG CAPSULE,EXTENDED RELEASE 24 HR",2.79,2.09,0.03,2.51,119
NDC,62135043130,DISULFIRAM 250 MG TABLET,58.0,43.5,0.7,52.2,119
NDC,62135052047,OXYBUTYNIN CHLORIDE 5 MG/5 ML ORAL SYRUP,2999.77,2249.82,36.0,2699.79,119
NDC,62135075047,HYDROXYZINE HCL 10 MG/5 ML ORAL SOLUTION,2999.77,2249.82,36.0,2699.79,119
NDC,62144551005,ARTIFICIAL TEARS (HYPROMELLOSE) (PF) 1.7 % EYE DROPS WITH APPLICATOR,150.03,112.52,1.8,135.03,119
NDC,62175031037,"METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR",31.11,23.33,0.37,28.0,119
NDC,62175048537,"VERAPAMIL ER (PM) 100 MG CAPSULE 24HR PELLET CT,EXT.RELEASE",29.26,21.95,0.35,26.33,119
NDC,62332005531,CLONIDINE HCL 0.2 MG TABLET,0.35,0.26,0.01,0.32,119
NDC,62332019810,ASENAPINE 5 MG SUBLINGUAL TABLET,21.61,16.21,0.26,19.45,119
NDC,62332034130,CANDESARTAN 4 MG TABLET,14.38,10.78,0.17,12.94,119
NDC,62332034330,CANDESARTAN 16 MG TABLET,14.38,10.78,0.17,12.94,119
NDC,62332050503,MOXIFLOXACIN 0.5 % EYE DROPS,120.01,90.0,1.44,108.01,119
NDC,62332053231,METOLAZONE 2.5 MG TABLET,3.9,2.92,0.05,3.51,119
NDC,62332053331,METOLAZONE 5 MG TABLET,4.5,3.38,0.05,4.05,119
NDC,62332058204,LIDOCAINE-PRILOCAINE 2.5 %-2.5 % TOPICAL CREAM,49.56,37.17,0.59,44.6,119
NDC,62332061831,CYCLOPHOSPHAMIDE 25 MG CAPSULE,10.1,7.58,0.12,9.09,119
NDC,62332061931,CYCLOPHOSPHAMIDE 50 MG CAPSULE,17.57,13.18,0.21,15.81,119
NDC,62332073531,CHLORPROMAZINE 10 MG TABLET,0.82,0.61,0.01,0.74,119
NDC,62530000011,UREA 15 GRAM ORAL POWDER PACKET,21.75,16.31,0.26,19.58,119
NDC,62559015304,OPIUM TINCTURE 10 MG/ML (MORPHINE) ORAL,2700.31,2025.23,32.4,2430.28,119
NDC,62559015710,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,8.02,6.01,0.1,7.22,119
NDC,62559015717,POLYETHYLENE GLYCOL 3350 17 GRAM ORAL POWDER PACKET,8.02,6.01,0.1,7.22,119
NDC,62559029915,FLUOCINOLONE 0.025 % TOPICAL OINTMENT,169.74,127.3,2.04,152.77,119
NDC,62559039020,VANCOMYCIN 125 MG CAPSULE,15.0,11.25,0.18,13.5,119
NDC,62559072101,TERBUTALINE 2.5 MG TABLET,6.0,4.5,0.07,5.4,119
NDC,62559074001,THYROID (PORK) 15 MG TABLET,3.18,2.39,0.04,2.86,119
NDC,62559082001,MEXILETINE 150 MG CAPSULE,3.8,2.85,0.05,3.42,119
NDC,62559082101,MEXILETINE 200 MG CAPSULE,4.54,3.41,0.05,4.09,119
NDC,62756096983,BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET,3.89,2.92,0.05,3.5,119
NDC,62756097083,BUPRENORPHINE 8 MG-NALOXONE 2 MG SUBLINGUAL TABLET,5.6,4.2,0.07,5.04,119
NDC,62856021501,LECANEMAB-IRMB 100 MG/ML INTRAVENOUS SOLUTION,1951.04,1463.28,23.41,1755.94,119
NDC,62856038901,ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION,4012.86,3009.64,48.15,3611.57,119
NDC,63304045001,"MORPHINE ER 15 MG TABLET,EXTENDED RELEASE",1.81,1.35,0.02,1.63,119
NDC,63304045201,"MORPHINE ER 100 MG TABLET,EXTENDED RELEASE",9.89,7.42,0.12,8.9,119
NDC,63323001001,GENTAMICIN 40 MG/ML INJECTION SOLUTION,27.84,20.88,0.33,25.06,119
NDC,63323001002,GENTAMICIN 40 MG/ML INJECTION SOLUTION,27.84,20.88,0.33,25.06,119
NDC,63323001003,GENTAMICIN 40 MG/ML INJECTION SOLUTION,199.92,149.94,2.4,179.93,119
NDC,63323001020,GENTAMICIN 40 MG/ML INJECTION SOLUTION,199.92,149.94,2.4,179.93,119
NDC,63323001203,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,20.7,15.52,0.25,18.63,119
NDC,63323001207,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,9.0,6.75,0.11,8.1,119
NDC,63323001211,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,20.7,15.52,0.25,18.63,119
NDC,63323001217,OXYTOCIN 10 UNIT/ML INJECTION SOLUTION,9.0,6.75,0.11,8.1,119
NDC,63323001301,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,59.7,44.78,0.72,53.73,119
NDC,63323001302,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,59.7,44.78,0.72,53.73,119
NDC,63323001309,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,41.52,31.14,0.5,37.37,119
NDC,63323001321,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,41.52,31.14,0.5,37.37,119
NDC,63323006401,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,13.62,10.22,0.16,12.26,119
NDC,63323006403,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,13.62,10.22,0.16,12.26,119
NDC,63323006404,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,14.82,11.12,0.18,13.34,119
NDC,63323006411,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,16.92,12.69,0.2,15.23,119
NDC,63323008305,SODIUM BICARBONATE 4.2 % INTRAVENOUS SOLUTION,141.18,105.88,1.69,127.06,119
NDC,63323009301,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,40.32,30.24,0.48,36.29,119
NDC,63323009502,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,92.4,69.3,1.11,83.16,119
NDC,63323009561,SODIUM CHLORIDE 4 MEQ/ML INTRAVENOUS SOLUTION,92.4,69.3,1.11,83.16,119
NDC,63323010161,DOXORUBICIN 2 MG/ML INTRAVENOUS SOLUTION,566.52,424.89,6.8,509.87,119
NDC,63323010351,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,87.55,65.66,1.05,78.8,119
NDC,63323010365,CISPLATIN 1 MG/ML INTRAVENOUS SOLUTION,175.1,131.32,2.1,157.59,119
NDC,63323010425,ETOPOSIDE 20 MG/ML INTRAVENOUS SOLUTION,264.35,198.26,3.17,237.92,119
NDC,63323010601,MAGNESIUM SULFATE 4 GRAM/100 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,48.0,36.0,0.58,43.2,119
NDC,63323010605,MAGNESIUM SULFATE 2 GRAM/50 ML (4 %) IN WATER INTRAVENOUS PIGGYBACK,77.1,57.82,0.93,69.39,119
NDC,63323010615,MAGNESIUM SULFATE 20 GRAM/500 ML (4 %) IN WATER INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,63323011301,PENTAMIDINE 300 MG SOLUTION FOR INJECTION,692.59,519.45,8.31,623.33,119
NDC,63323011700,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,14.54,10.9,0.17,13.09,119
NDC,63323011701,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,29.07,21.8,0.35,26.16,119
NDC,63323011710,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,14.54,10.9,0.17,13.09,119
NDC,63323011720,FLUOROURACIL 1 GRAM/20 ML INTRAVENOUS SOLUTION,29.07,21.8,0.35,26.16,119
NDC,63323011751,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,62.26,46.7,0.75,56.03,119
NDC,63323011761,FLUOROURACIL 5 GRAM/100 ML INTRAVENOUS SOLUTION,124.52,93.39,1.49,112.07,119
NDC,63323012700,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
NDC,63323012710,DACARBAZINE 100 MG INTRAVENOUS SOLUTION,42.5,31.88,0.51,38.25,119
NDC,63323013002,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,118.48,88.86,1.42,106.63,119
NDC,63323013003,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,94.5,70.88,1.13,85.05,119
NDC,63323013011,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,118.48,88.86,1.42,106.63,119
NDC,63323013013,DOXYCYCLINE HYCLATE 100 MG INTRAVENOUS POWDER FOR SOLUTION,77.96,58.47,0.94,70.16,119
NDC,63323016212,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,4.2,3.15,0.05,3.78,119
NDC,63323016223,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,4.2,3.15,0.05,3.78,119
NDC,63323017301,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,37.02,27.76,0.44,33.32,119
NDC,63323017302,GENTAMICIN SULFATE (PEDIATRIC) (PF) 20 MG/2 ML INJECTION SOLUTION,37.02,27.76,0.44,33.32,119
NDC,63323018000,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,97.78,73.34,1.17,88.0,119
NDC,63323018001,PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION,97.78,73.34,1.17,88.0,119
NDC,63323018410,FOLIC ACID 5 MG/ML INJECTION SOLUTION,336.42,252.32,4.04,302.78,119
NDC,63323022901,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,92.88,69.66,1.11,83.59,119
NDC,63323022905,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,92.88,69.66,1.11,83.59,119
NDC,63323022930,PROTAMINE 10 MG/ML INTRAVENOUS SOLUTION,317.4,238.05,3.81,285.66,119
NDC,63323025410,"MINERAL OIL, LIGHT STERILE",119.88,89.91,1.44,107.89,119
NDC,63323026203,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",24.96,18.72,0.3,22.46,119
NDC,63323026206,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",24.96,18.72,0.3,22.46,119
NDC,63323026929,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,36.0,27.0,0.43,32.4,119
NDC,63323026929,PROPOFOL 10 MG/ML IV BOLUS (UW),36.0,27.0,0.43,32.4,119
NDC,63323026930,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,90.0,67.5,1.08,81.0,119
NDC,63323026935,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,180.0,135.0,2.16,162.0,119
NDC,63323026950,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,90.0,67.5,1.08,81.0,119
NDC,63323026950,PROPOFOL 10 MG/ML IV BOLUS (UW),90.0,67.5,1.08,81.0,119
NDC,63323026965,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,180.0,135.0,2.16,162.0,119
NDC,63323026965,PROPOFOL 10 MG/ML IV BOLUS (UW),180.0,135.0,2.16,162.0,119
NDC,63323027810,VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION,228.48,171.36,2.74,205.63,119
NDC,63323028503,ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION,33.12,24.84,0.4,29.81,119
NDC,63323028611,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,135.54,101.66,1.63,121.99,119
NDC,63323028635,ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION,135.54,101.66,1.63,121.99,119
NDC,63323030301,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,346.52,259.89,4.16,311.87,119
NDC,63323030351,TOBRAMYCIN 1.2 GRAM SOLUTION FOR INJECTION,346.52,259.89,4.16,311.87,119
NDC,63323030630,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,131.94,98.96,1.58,118.75,119
NDC,63323031501,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,403.67,302.75,4.84,363.3,119
NDC,63323031510,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,403.67,302.75,4.84,363.3,119
NDC,63323032201,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,134.91,101.18,1.62,121.42,119
NDC,63323032225,IMIPENEM-CILASTATIN 500 MG INTRAVENOUS SOLUTION,134.91,101.18,1.62,121.42,119
NDC,63323032503,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,112.8,84.6,1.35,101.52,119
NDC,63323032509,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,210.0,157.5,2.52,189.0,119
NDC,63323032510,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,112.8,84.6,1.35,101.52,119
NDC,63323032520,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,210.0,157.5,2.52,189.0,119
NDC,63323036001,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,60.12,45.09,0.72,54.11,119
NDC,63323036003,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,162.0,121.5,1.94,145.8,119
NDC,63323036005,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,324.0,243.0,3.89,291.6,119
NDC,63323036019,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,60.12,45.09,0.72,54.11,119
NDC,63323036059,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,162.0,121.5,1.94,145.8,119
NDC,63323036061,CALCIUM GLUCONATE 100 MG/ML (10 %) INTRAVENOUS SOLUTION,324.0,243.0,3.89,291.6,119
NDC,63323037600,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,42.24,31.68,0.51,38.02,119
NDC,63323037601,OCTREOTIDE ACETATE 100 MCG/ML INJECTION SOLUTION,42.24,31.68,0.51,38.02,119
NDC,63323037700,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,162.74,122.05,1.95,146.47,119
NDC,63323037701,OCTREOTIDE ACETATE 500 MCG/ML INJECTION SOLUTION,162.74,122.05,1.95,146.47,119
NDC,63323037905,"OCTREOTIDE ACETATE 1,000 MCG/ML INJECTION SOLUTION",1514.24,1135.68,18.17,1362.82,119
NDC,63323040121,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,89.44,67.08,1.07,80.5,119
NDC,63323040126,AZTREONAM 1 GRAM SOLUTION FOR INJECTION,89.44,67.08,1.07,80.5,119
NDC,63323041701,CISATRACURIUM 2 MG/ML INTRAVENOUS SOLUTION,110.4,82.8,1.32,99.36,119
NDC,63323041801,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1217.25,912.94,14.61,1095.53,119
NDC,63323041820,CISATRACURIUM CONCENTRATE 10 MG/ML (ICU USE ONLY) INTRAVENOUS SOLUTION,1217.25,912.94,14.61,1095.53,119
NDC,63323045200,MORPHINE 2 MG/ML INJECTION SOLUTION,17.22,12.92,0.21,15.5,119
NDC,63323045201,MORPHINE 2 MG/ML INJECTION SOLUTION,17.22,12.92,0.21,15.5,119
NDC,63323046617,BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION,31.44,23.58,0.38,28.3,119
NDC,63323047400,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,35.94,26.96,0.43,32.35,119
NDC,63323047401,HALOPERIDOL LACTATE 5 MG/ML INJECTION SOLUTION,35.94,26.96,0.43,32.35,119
NDC,63323047801,CHLOROPROCAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION,134.28,100.71,1.61,120.85,119
NDC,63323048101,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",48.0,36.0,0.58,43.2,119
NDC,63323048157,"LIDOCAINE-EPINEPHRINE 0.5 %-1:200,000 INJECTION SOLUTION",48.0,36.0,0.58,43.2,119
NDC,63323048203,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.52,22.14,0.35,26.57,119
NDC,63323048205,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",68.4,51.3,0.82,61.56,119
NDC,63323048227,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.52,22.14,0.35,26.57,119
NDC,63323048257,"LIDOCAINE 1 %-EPINEPHRINE 1:100,000 INJECTION SOLUTION",68.4,51.3,0.82,61.56,119
NDC,63323048303,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.88,22.41,0.36,26.89,119
NDC,63323048327,"LIDOCAINE 20 MG/ML (2 %)-EPINEPHRINE 1:100,000 INJECTION SOLUTION",29.88,22.41,0.36,26.89,119
NDC,63323048503,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,34.2,25.65,0.41,30.78,119
NDC,63323048557,LIDOCAINE HCL 10 MG/ML (1 %) INJECTION SOLUTION,34.2,25.65,0.41,30.78,119
NDC,63323048602,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,23.04,17.28,0.28,20.74,119
NDC,63323048627,LIDOCAINE HCL 20 MG/ML (2 %) INJECTION SOLUTION,23.04,17.28,0.28,20.74,119
NDC,63323048707,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",81.0,60.75,0.97,72.9,119
NDC,63323048737,"LIDOCAINE-EPINEPHRINE (PF) 1 %-1:200,000 INJECTION SOLUTION",81.0,60.75,0.97,72.9,119
NDC,63323048927,"LIDOCAINE-EPINEPHRINE (PF) 2 %-1:200,000 INJECTION SOLUTION",123.72,92.79,1.48,111.35,119
NDC,63323049227,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,14.16,10.62,0.17,12.74,119
NDC,63323049504,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,21.54,16.16,0.26,19.39,119
NDC,63323049507,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,21.54,16.16,0.26,19.39,119
NDC,63323050601,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,45.0,33.75,0.54,40.5,119
NDC,63323050701,MEROPENEM 500 MG INTRAVENOUS SOLUTION,18.0,13.5,0.22,16.2,119
NDC,63323050720,MEROPENEM 500 MG INTRAVENOUS SOLUTION,18.0,13.5,0.22,16.2,119
NDC,63323050801,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,35.4,26.55,0.42,31.86,119
NDC,63323050830,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,35.4,26.55,0.42,31.86,119
NDC,63323051701,"HEPARIN (PORCINE) 25,000 UNIT/250 ML IN 0.45 % SODIUM CHLORIDE IV SOLN",40.38,30.28,0.48,36.34,119
NDC,63323052301,HEPARIN (PORCINE) 100 UNIT/ML IN DEXTROSE 5 % IV BOLUS (UW),64.5,48.38,0.77,58.05,119
NDC,63323052301,"HEPARIN (PORCINE) 25,000 UNIT/250 ML (100 UNIT/ML) IN DEXTROSE 5 % IV",64.5,48.38,0.77,58.05,119
NDC,63323053075,SODIUM CHLORIDE 3 % HYPERTONIC INTRAVENOUS INJECTION SOLUTION,24.0,18.0,0.29,21.6,119
NDC,63323053075,SODIUM CHLORIDE 3 % HYPERTONIC IV BOLUS (UW),24.0,18.0,0.29,21.6,119
NDC,63323054003,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",23.22,17.42,0.28,20.9,119
NDC,63323054005,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",43.62,32.71,0.52,39.26,119
NDC,63323054013,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",23.22,17.42,0.28,20.9,119
NDC,63323054015,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",43.62,32.71,0.52,39.26,119
NDC,63323054033,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",42.84,32.13,0.51,38.56,119
NDC,63323054036,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",42.84,32.13,0.51,38.56,119
NDC,63323055963,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,15.5,11.62,0.19,13.95,119
NDC,63323055965,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,16.62,12.46,0.2,14.96,119
NDC,63323055993,ENOXAPARIN 30 MG/0.3 ML SUBCUTANEOUS SYRINGE,16.62,12.46,0.2,14.96,119
NDC,63323056421,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,22.08,16.56,0.26,19.87,119
NDC,63323056497,ENOXAPARIN 40 MG/0.4 ML SUBCUTANEOUS SYRINGE,22.08,16.56,0.26,19.87,119
NDC,63323056698,ENOXAPARIN 60 MG/0.6 ML SUBCUTANEOUS SYRINGE,32.22,24.16,0.39,29.0,119
NDC,63323058421,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,44.4,33.3,0.53,39.96,119
NDC,63323058499,ENOXAPARIN 80 MG/0.8 ML SUBCUTANEOUS SYRINGE,44.4,33.3,0.53,39.96,119
NDC,63323058621,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,55.92,41.94,0.67,50.33,119
NDC,63323058696,ENOXAPARIN 100 MG/ML SUBCUTANEOUS SYRINGE,55.92,41.94,0.67,50.33,119
NDC,63323058921,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,62.82,47.12,0.75,56.54,119
NDC,63323058994,ENOXAPARIN 150 MG/ML SUBCUTANEOUS SYRINGE,62.82,47.12,0.75,56.54,119
NDC,63323059608,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,672.3,504.22,8.07,605.07,119
NDC,63323059616,GLUCAGON HCL 1 MG/ML SOLUTION FOR INJECTION,672.3,504.22,8.07,605.07,119
NDC,63323059930,DEFEROXAMINE 2 GRAM SOLUTION FOR INJECTION,185.4,139.05,2.22,166.86,119
NDC,63323060400,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,63323060401,PROPRANOLOL 1 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,63323061400,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,64.44,48.33,0.77,58.0,119
NDC,63323061401,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,64.44,48.33,0.77,58.0,119
NDC,63323061421,HYDRALAZINE 20 MG/ML INJECTION SOLUTION,21.0,15.75,0.25,18.9,119
NDC,63323064201,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,54.36,40.77,0.65,48.92,119
NDC,63323064220,MAGNESIUM SULFATE 500 MG/ML (50 %) INJECTION SOLUTION,54.36,40.77,0.65,48.92,119
NDC,63323064710,LEVOTHYROXINE 200 MCG INTRAVENOUS POWDER FOR SOLUTION,924.36,693.27,11.09,831.92,119
NDC,63323065123,ADENOSINE 3 MG/ML INTRAVENOUS SYRINGE,155.4,116.55,1.86,139.86,119
NDC,63323065521,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.91,37.43,0.6,44.92,119
NDC,63323065599,ENOXAPARIN 120 MG/0.8 ML SUBCUTANEOUS SYRINGE,49.91,37.43,0.6,44.92,119
NDC,63323066500,TERBUTALINE 1 MG/ML SUBCUTANEOUS SOLUTION,88.65,66.49,1.06,79.79,119
NDC,63323068517,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,1215.03,911.27,14.58,1093.53,119
NDC,63323069504,ACETYLCYSTEINE 100 MG/ML (10 %) SOLUTION,76.63,57.47,0.92,68.97,119
NDC,63323071050,LEUCOVORIN CALCIUM 200 MG SOLUTION FOR INJECTION,75.52,56.64,0.91,67.97,119
NDC,63323072401,REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,533.77,400.33,6.41,480.39,119
NDC,63323072405,REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,533.77,400.33,6.41,480.39,119
NDC,63323072801,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,108.0,81.0,1.3,97.2,119
NDC,63323072810,MICAFUNGIN 50 MG INTRAVENOUS SOLUTION,108.0,81.0,1.3,97.2,119
NDC,63323072901,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,216.0,162.0,2.59,194.4,119
NDC,63323072910,MICAFUNGIN 100 MG INTRAVENOUS SOLUTION,216.0,162.0,2.59,194.4,119
NDC,63323073820,FAMOTIDINE 10 MG/ML INTRAVENOUS SOLUTION,54.0,40.5,0.65,48.6,119
NDC,63323073911,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,5.4,4.05,0.06,4.86,119
NDC,63323073911,FAMOTIDINE (PF) 20 MG/2 ML ORAL SOLUTION (UW),5.4,4.05,0.06,4.86,119
NDC,63323073912,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,5.4,4.05,0.06,4.86,119
NDC,63323075103,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,7.81,5.86,0.09,7.03,119
NDC,63323078220,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,63323078223,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,63323082004,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,156.0,117.0,1.87,140.4,119
NDC,63323082010,FAT EMULSION-SOYBEAN OIL-MCT-OLIVE OIL-FISH OIL 20 % INTRAVENOUS,378.0,283.5,4.54,340.2,119
NDC,63323085150,HYDROMORPHONE (PF) 10 MG/ML INJECTION SOLUTION,1020.3,765.22,12.24,918.27,119
NDC,63323085203,HYDROMORPHONE (PF) 1 MG/ML INJECTION SOLUTION,25.92,19.44,0.31,23.33,119
NDC,63323087715,PENTAMIDINE 300 MG SOLUTION FOR INHALATION,692.59,519.45,8.31,623.33,119
NDC,63323088101,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,247.23,185.42,2.97,222.51,119
NDC,63323088116,SODIUM PHOSPHATE 3 MMOL/ML INTRAVENOUS SOLUTION,247.23,185.42,2.97,222.51,119
NDC,63323088510,LEVOTHYROXINE 20 MCG/ML INTRAVENOUS SOLUTION,399.1,299.33,4.79,359.19,119
NDC,63323092688,ROMIDEPSIN 10 MG/2 ML INTRAVENOUS POWDER FOR SOLUTION,8709.04,6531.78,104.51,7838.14,119
NDC,63323093001,VASOPRESSIN 20 UNIT/ML INTRAVENOUS SOLUTION,103.5,77.62,1.24,93.15,119
NDC,63323096501,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,25.02,18.76,0.3,22.52,119
NDC,63323096501,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),25.02,18.76,0.3,22.52,119
NDC,63323096502,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,13.8,10.35,0.17,12.42,119
NDC,63323096502,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),13.8,10.35,0.17,12.42,119
NDC,63323096503,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,12.06,9.04,0.14,10.85,119
NDC,63323096503,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),12.06,9.04,0.14,10.85,119
NDC,63323096510,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,13.74,10.3,0.16,12.37,119
NDC,63323096510,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),13.74,10.3,0.16,12.37,119
NDC,63323096520,POTASSIUM CHLORIDE 2 MEQ/ML INTRAVENOUS SOLUTION,13.8,10.35,0.17,12.42,119
NDC,63323096520,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN (UW),13.8,10.35,0.17,12.42,119
NDC,63402020230,ESLICARBAZEPINE 200 MG TABLET,202.06,151.54,2.42,181.85,119
NDC,63402020430,ESLICARBAZEPINE 400 MG TABLET,202.06,151.54,2.42,181.85,119
NDC,63459010310,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,2576.81,1932.61,30.92,2319.13,119
NDC,63459010450,RITUXIMAB-ABBS 10 MG/ML INTRAVENOUS SOLUTION,12884.07,9663.05,154.61,11595.66,119
NDC,63459034804,BENDAMUSTINE 25 MG/ML INTRAVENOUS SOLUTION,7040.44,5280.33,84.49,6336.4,119
NDC,63459060106,ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLUTION,3657.0,2742.75,43.88,3291.3,119
NDC,63459060111,ARSENIC TRIOXIDE 2 MG/ML INTRAVENOUS SOLUTION,3657.0,2742.75,43.88,3291.3,119
NDC,63459091011,TBO-FILGRASTIM 300 MCG/0.5 ML SUBCUTANEOUS SYRINGE,711.1,533.33,8.53,639.99,119
NDC,63459091211,TBO-FILGRASTIM 480 MCG/0.8 ML SUBCUTANEOUS SYRINGE,1138.09,853.57,13.66,1024.28,119
NDC,63629916201,PRAVASTATIN 10 MG TABLET,0.84,0.63,0.01,0.76,119
NDC,63739008610,VALPROIC ACID 250 MG CAPSULE,2.57,1.93,0.03,2.31,119
NDC,63739014510,MIDODRINE 5 MG TABLET,2.53,1.9,0.03,2.28,119
NDC,63739017013,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,17.76,13.32,0.21,15.98,119
NDC,63739047910,BACLOFEN 10 MG TABLET,2.78,2.08,0.03,2.5,119
NDC,63739048610,HYDROXYZINE HCL 25 MG TABLET,1.55,1.17,0.02,1.4,119
NDC,63739054410,SPIRONOLACTONE 25 MG TABLET,1.38,1.03,0.02,1.24,119
NDC,63739056710,TAMSULOSIN 0.4 MG CAPSULE,2.38,1.78,0.03,2.14,119
NDC,63739098832,ZIPRASIDONE 20 MG CAPSULE,16.69,12.51,0.2,15.02,119
NDC,63739099764,LIDOCAINE HCL 4 % (40 MG/ML) MUCOSAL SOLUTION,198.0,148.5,2.38,178.2,119
NDC,63807060055,"HEPARIN, PORCINE (PF) 100 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
NDC,63833038602,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,119
NDC,63833038702,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,119
NDC,63833039601,"HUMAN PROTHROMBIN COMPLEX,4-FACTOR 500 UNIT (400-620 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,119
NDC,63833039701,"HUM PROTHROMBIN CPLX, 4-FACTOR 1,000 UNIT (800-1,240 UNIT) IV SOLUTION",12.66,9.5,0.15,11.39,119
NDC,63833061502,ANTIHEMOPHILIC FACTOR-VWF 250 UNIT-600 UNIT INTRAVENOUS SOLUTION,7.01,5.26,0.08,6.31,119
NDC,63833061602,"ANTIHEMOPHILIC FACTOR-VWF 500 UNIT-1,200 UNIT INTRAVENOUS SOLUTION",7.01,5.26,0.08,6.31,119
NDC,63833083501,C1 ESTERASE INHIBITOR 500 UNIT (10 ML) INTRAVENOUS SOLUTION,11740.52,8805.39,140.89,10566.47,119
NDC,64193042402,"ANTI-INHIBITOR COAGULANT COMPLEX 700 UNIT-1,300 UNIT INTRAVENOUS SOLN",11.48,8.61,0.14,10.33,119
NDC,64253022235,"HEPARIN, PORCINE (PF) 10 UNIT/ML INTRAVENOUS SYRINGE",3.6,2.7,0.04,3.24,119
NDC,64253044425,"HEPARIN, PORCINE (PF) 1 UNIT/ML INTRAVENOUS SYRINGE",6.0,4.5,0.07,5.4,119
NDC,64281010000,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,344.45,258.34,4.13,310.0,119
NDC,64281010006,METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION,344.45,258.34,4.13,310.0,119
NDC,64380015201,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,38.01,28.51,0.46,34.21,119
NDC,64380015202,TESTOSTERONE 1 % (50 MG/5 GRAM) TRANSDERMAL GEL PACKET,38.01,28.51,0.46,34.21,119
NDC,64380016001,MEGESTROL 400 MG/10 ML (40 MG/ML) ORAL SUSPENSION,216.0,162.0,2.59,194.4,119
NDC,64380016601,PHENOBARBITAL 20 MG/5 ML (4 MG/ML) ORAL ELIXIR,215.69,161.77,2.59,194.12,119
NDC,64380017601,TRANYLCYPROMINE 10 MG TABLET,6.41,4.81,0.08,5.77,119
NDC,64380072206,"TACROLIMUS 5 MG CAPSULE, IMMEDIATE-RELEASE",6.0,4.5,0.07,5.4,119
NDC,64380072406,CALCITRIOL 0.5 MCG CAPSULE,2.54,1.91,0.03,2.29,119
NDC,64380072606,MYCOPHENOLATE MOFETIL 250 MG CAPSULE,1.19,0.89,0.01,1.07,119
NDC,64380075906,ACARBOSE 50 MG TABLET,1.98,1.48,0.02,1.78,119
NDC,64380088304,CINACALCET 30 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,64380091806,URSODIOL 250 MG TABLET,4.5,3.38,0.05,4.05,119
NDC,64406000801,NATALIZUMAB 300 MG/15 ML INTRAVENOUS SOLUTION,24298.34,18223.75,291.58,21868.51,119
NDC,64406010303,KIT FOR YTTRIUM-90-IBRITUMOMAB 3.2 MG/2 ML INTRAVENOUS,83640.38,62730.28,1003.68,75276.34,119
NDC,64764030020,VEDOLIZUMAB 300 MG INTRAVENOUS SOLUTION,24083.05,18062.29,289.0,21674.74,119
NDC,64764072030,VORTIOXETINE 5 MG TABLET,77.12,57.84,0.93,69.41,119
NDC,64764075030,VORTIOXETINE 20 MG TABLET,77.12,57.84,0.93,69.41,119
NDC,64764080028,MARIBAVIR 200 MG TABLET,879.32,659.49,10.55,791.39,119
NDC,64850050201,DEXTROAMPHETAMINE-AMPHETAMINE 10 MG TABLET,1.21,0.9,0.01,1.09,119
NDC,64875000101,MIFEPRISTONE 200 MG TABLET,193.5,145.12,2.32,174.15,119
NDC,64950036204,COCAINE 4 % NASAL SOLUTION,1016.75,762.56,12.2,915.08,119
NDC,64980033990,MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) TABLET,0.63,0.47,0.01,0.57,119
NDC,64980037303,ATOMOXETINE 10 MG CAPSULE,9.77,7.33,0.12,8.79,119
NDC,64980037403,ATOMOXETINE 18 MG CAPSULE,9.77,7.33,0.12,8.79,119
NDC,64980037703,ATOMOXETINE 60 MG CAPSULE,10.62,7.96,0.13,9.56,119
NDC,64980044903,FINGOLIMOD 0.5 MG CAPSULE,50.0,37.5,0.6,45.0,119
NDC,64980050448,CYPROHEPTADINE 2 MG/5 ML ORAL SYRUP,320.69,240.52,3.85,288.62,119
NDC,64980050924,DEXAMETHASONE 0.5 MG/5 ML ORAL ELIXIR,264.49,198.37,3.17,238.04,119
NDC,64980051305,TIMOLOL MALEATE 0.25 % EYE DROPS,31.2,23.4,0.37,28.08,119
NDC,64980051405,TIMOLOL MALEATE 0.5 % EYE DROPS,58.2,43.65,0.7,52.38,119
NDC,64980052660,NITAZOXANIDE 500 MG TABLET,539.88,404.91,6.48,485.89,119
NDC,64980056310,FUROSEMIDE 40 MG TABLET,0.3,0.22,0.01,0.27,119
NDC,64980056401,FUROSEMIDE 80 MG TABLET,0.39,0.29,0.01,0.35,119
NDC,64980056601,DAPSONE 100 MG TABLET,9.3,6.98,0.11,8.37,119
NDC,65162018810,NAPROXEN 250 MG TABLET,0.42,0.32,0.01,0.38,119
NDC,65162024709,CHLORTHALIDONE 25 MG TABLET,0.9,0.68,0.01,0.81,119
NDC,65162068210,PHENAZOPYRIDINE 200 MG TABLET,2.88,2.16,0.03,2.59,119
NDC,65162068784,LORAZEPAM 2 MG/ML ORAL CONCENTRATE,189.36,142.02,2.27,170.42,119
NDC,65162071009,COLCHICINE 0.6 MG TABLET,4.1,3.07,0.05,3.69,119
NDC,65162087903,LURASIDONE 20 MG TABLET,4.0,3.0,0.05,3.6,119
NDC,65162091446,TOBRAMYCIN 300 MG/5 ML IN 0.225 % SODIUM CHLORIDE FOR NEBULIZATION,101.79,76.34,1.22,91.61,119
NDC,65162099704,ESTRADIOL 0.1 MG/24 HR SEMIWEEKLY TRANSDERMAL PATCH,54.5,40.87,0.65,49.05,119
NDC,65174002110,RUBIDIUM RB-82 CHLORIDE INTRAVENOUS SOLUTION,754.72,566.04,9.06,679.25,119
NDC,65174013101,KIT FOR PREPARATION OF TC 99M-SODIUM THIOSULFATE 2 MG SOLUTION,1632.0,1224.0,19.58,1468.8,119
NDC,65174026101,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,357.94,268.45,4.3,322.15,119
NDC,65174027030,KIT FOR PREPARATION OF TC 99M-ALBUMIN 2.5 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,119
NDC,65174028801,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,65174028805,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,65174028830,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,65174046105,SODIUM IODIDE-131 (I-131) 3.7 MBQ (100 MICROCI) CAPSULE (THERANOSTIC),99.0,74.25,1.19,89.1,119
NDC,65174066030,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 25 MG IV SOLUTION,60.0,45.0,0.72,54.0,119
NDC,65174088025,SODIUM IODIDE-131 (I-131) 250 MCI/0.25 ML ORAL KIT (THERANOSTIC),435.75,326.81,5.23,392.18,119
NDC,65219001401,AMPICILLIN 250 MG SOLUTION FOR INJECTION,9.56,7.17,0.11,8.6,119
NDC,65219001401,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),9.56,7.17,0.11,8.6,119
NDC,65219001410,AMPICILLIN 250 MG SOLUTION FOR INJECTION,9.56,7.17,0.11,8.6,119
NDC,65219001410,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),9.56,7.17,0.11,8.6,119
NDC,65219012012,DALBAVANCIN 500 MG INTRAVENOUS SOLUTION,6564.51,4923.38,78.77,5908.06,119
NDC,65219019030,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,119
NDC,65219053301,FAT EMULSION 20 % INTRAVENOUS,264.0,198.0,3.17,237.6,119
NDC,65219057201,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,25.5,19.12,0.31,22.95,119
NDC,65219057210,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,25.5,19.12,0.31,22.95,119
NDC,65219059004,TOCILIZUMAB-AAZG 80 MG/4 ML (20 MG/ML) INTRAVENOUS SOLUTION,1193.64,895.23,14.32,1074.28,119
NDC,65219059210,TOCILIZUMAB-AAZG 200 MG/10 ML (20 MG/ML) INTRAVENOUS SOLUTION,2984.11,2238.08,35.81,2685.7,119
NDC,65219059420,TOCILIZUMAB-AAZG 400 MG/20 ML (20 MG/ML) INTRAVENOUS SOLUTION,5968.22,4476.17,71.62,5371.4,119
NDC,65219062420,ACYCLOVIR SODIUM 50 MG/ML INTRAVENOUS SOLUTION,172.08,129.06,2.06,154.87,119
NDC,65250013309,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1085.8,814.35,13.03,977.22,119
NDC,65250013310,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1085.8,814.35,13.03,977.22,119
NDC,65250026609,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1794.06,1345.54,21.53,1614.65,119
NDC,65250026620,BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION,1794.06,1345.54,21.53,1614.65,119
NDC,65282160501,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,20.34,15.26,0.24,18.31,119
NDC,65597040601,FAM-TRASTUZUMAB DERUXTECAN-NXKI 100 MG INTRAVENOUS SOLUTION,8066.16,6049.62,96.79,7259.54,119
NDC,65649030103,RIFAXIMIN 200 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,65649030302,RIFAXIMIN 550 MG TABLET,239.54,179.66,2.87,215.59,119
NDC,65649031112,CHLOROTHIAZIDE 250 MG/5 ML ORAL SUSPENSION,413.8,310.35,4.97,372.42,119
NDC,65649055102,METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SOLUTION,652.53,489.4,7.83,587.28,119
NDC,65857010030,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,2945.28,2208.96,35.34,2650.75,119
NDC,65857040001,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1804.8,1353.6,21.66,1624.32,119
NDC,65857045005,KIT FOR THE PREP OF TC-99M-TILMANOCEPT 250 MCG SOLUTION FOR INJECTION,1804.8,1353.6,21.66,1624.32,119
NDC,65857050510,KIT FOR PREPARATION OF TC-99M-MEDRONATE SODIUM 20 MG IV SOLUTION,180.0,135.0,2.16,162.0,119
NDC,65862000905,METFORMIN 850 MG TABLET,0.17,0.13,0.01,0.15,119
NDC,65862002106,MIRTAZAPINE 15 MG DISINTEGRATING TABLET,2.56,1.92,0.03,2.3,119
NDC,65862007101,AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION,38.4,28.8,0.46,34.56,119
NDC,65862007601,CIPROFLOXACIN 250 MG TABLET,1.35,1.01,0.02,1.22,119
NDC,65862007705,CIPROFLOXACIN 500 MG TABLET,1.11,0.83,0.01,1.0,119
NDC,65862014990,FINASTERIDE 5 MG TABLET,0.8,0.6,0.01,0.72,119
NDC,65862022660,CLARITHROMYCIN 500 MG TABLET,5.6,4.2,0.07,5.04,119
NDC,65862037505,ESCITALOPRAM 20 MG TABLET,0.9,0.68,0.01,0.81,119
NDC,65862039010,ONDANSETRON 4 MG DISINTEGRATING TABLET,3.67,2.75,0.04,3.3,119
NDC,65862045860,GALANTAMINE 4 MG TABLET,3.95,2.96,0.05,3.56,119
NDC,65862049647,SULFAMETHOXAZOLE 200 MG-TRIMETHOPRIM 40 MG/5 ML ORAL SUSPENSION,258.26,193.69,3.1,232.43,119
NDC,65862051230,PIOGLITAZONE 15 MG TABLET,0.8,0.6,0.01,0.72,119
NDC,65862052890,"VENLAFAXINE ER 75 MG CAPSULE,EXTENDED RELEASE 24 HR",1.4,1.05,0.02,1.26,119
NDC,65862060130,MODAFINIL 100 MG TABLET,2.4,1.8,0.03,2.16,119
NDC,65862060330,MOXIFLOXACIN 400 MG TABLET,17.65,13.23,0.21,15.88,119
NDC,65862062503,RIZATRIPTAN 5 MG DISINTEGRATING TABLET,12.24,9.18,0.15,11.02,119
NDC,65862062603,RIZATRIPTAN 10 MG DISINTEGRATING TABLET,12.24,9.18,0.15,11.02,119
NDC,65862068730,RITONAVIR 100 MG TABLET,16.0,12.0,0.19,14.4,119
NDC,65862069201,PHENYTOIN SODIUM EXTENDED 100 MG CAPSULE,2.03,1.52,0.02,1.83,119
NDC,65862069790,"VENLAFAXINE ER 150 MG CAPSULE,EXTENDED RELEASE 24 HR",1.67,1.25,0.02,1.5,119
NDC,65862070755,AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION,29.7,22.28,0.36,26.73,119
NDC,65862075360,VALGANCICLOVIR 450 MG TABLET,23.81,17.86,0.29,21.43,119
NDC,65862083030,PRASUGREL HCL 10 MG TABLET,4.95,3.71,0.06,4.46,119
NDC,65862090901,CELECOXIB 200 MG CAPSULE,1.08,0.81,0.01,0.97,119
NDC,65862092730,FINASTERIDE 1 MG TABLET,0.5,0.37,0.01,0.45,119
NDC,65862093108,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,11.33,8.5,0.14,10.2,119
NDC,65862093190,SEVELAMER CARBONATE 2.4 GRAM ORAL POWDER PACKET,11.33,8.5,0.14,10.2,119
NDC,66215040201,EPOPROSTENOL 1.5 MG INTRAVENOUS SOLUTION,225.0,168.75,2.7,202.5,119
NDC,66215040301,EPOPROSTENOL 0.5 MG INTRAVENOUS SOLUTION,124.34,93.25,1.49,111.91,119
NDC,66215050115,MACITENTAN 10 MG TABLET,1617.32,1212.99,19.41,1455.59,119
NDC,66215060206,SELEXIPAG 200 MCG TABLET,943.06,707.3,11.32,848.75,119
NDC,66215060806,SELEXIPAG 800 MCG TABLET,1466.62,1099.96,17.6,1319.96,119
NDC,66220031511,TELAVANCIN 750 MG INTRAVENOUS SOLUTION,1868.91,1401.68,22.43,1682.02,119
NDC,66302010101,TREPROSTINIL SODIUM 1 MG/ML INJECTION SOLUTION,5284.28,3963.21,63.41,4755.85,119
NDC,66302020603,TREPROSTINIL 1.74 MG/2.9 ML (0.6 MG/ML) SOLUTION FOR NEBULIZATION,12145.1,9108.83,145.74,10930.59,119
NDC,66553000401,CALCIUM 200 MG (AS CALCIUM CARBONATE 500 MG) CHEWABLE TABLET,0.34,0.25,0.01,0.31,119
NDC,66621079002,ANTIVENIN CROTALIDAE (EQUINE) SOLUTION FOR INJECTION,3628.02,2721.02,43.54,3265.22,119
NDC,66658023401,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,599.61,449.71,7.2,539.65,119
NDC,66658023407,ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,599.61,449.71,7.2,539.65,119
NDC,66689020304,ACTIVATED CHARCOAL-SORBITOL 25 GRAM/120 ML ORAL SUSPENSION,131.76,98.82,1.58,118.58,119
NDC,66689030708,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,2714.88,2036.16,32.58,2443.39,119
NDC,66689069479,METHADONE 10 MG/ML ORAL CONCENTRATE,516.0,387.0,6.19,464.4,119
NDC,66733094823,CETUXIMAB 100 MG/50 ML INTRAVENOUS SOLUTION,2659.79,1994.84,31.92,2393.81,119
NDC,66733095823,CETUXIMAB 200 MG/100 ML INTRAVENOUS SOLUTION,5319.58,3989.69,63.83,4787.62,119
NDC,66794001725,ISOFLURANE 99.9 % INHALATION LIQUID,100.0,75.0,1.2,90.0,119
NDC,66794021963,LINEZOLID IN 5% DEXTROSE IN WATER 600 MG/300 ML INTRAVENOUS PIGGYBACK,113.4,85.05,1.36,102.06,119
NDC,66794023002,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,31.5,23.62,0.38,28.35,119
NDC,66794023042,DEXMEDETOMIDINE 100 MCG/ML INTRAVENOUS SOLUTION,31.5,23.62,0.38,28.35,119
NDC,66794025502,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,100.56,75.42,1.21,90.5,119
NDC,66794025542,ZINC SULFATE 1 MG/ML INTRAVENOUS SOLUTION,100.56,75.42,1.21,90.5,119
NDC,66794025841,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,29.34,22.0,0.35,26.41,119
NDC,66869020490,PITAVASTATIN CALCIUM 2 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,66993007896,FLUTICASONE PROPIONATE 44 MCG/ACTUATION HFA AEROSOL INHALER,636.0,477.0,7.63,572.4,119
NDC,66993008096,FLUTICASONE PROPIONATE 220 MCG/ACTUATION HFA AEROSOL INHALER,1244.05,933.04,14.93,1119.64,119
NDC,66993045630,DAPAGLIFLOZIN PROPANEDIOL 5 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,66993049036,IBUPROFEN LYSINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,1751.96,1313.97,21.02,1576.76,119
NDC,66993058497,FLUTICASONE 100 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,562.32,421.74,6.75,506.09,119
NDC,66993058697,FLUTICASONE 500 MCG-SALMETEROL 50 MCG/DOSE BLISTR POWDR FOR INHALATION,918.72,689.04,11.02,826.85,119
NDC,67157010150,ASCORBIC ACID (VITAMIN C) 500 MG/ML INTRAVENOUS SOLUTION,1623.6,1217.7,19.48,1461.24,119
NDC,67253065110,PROPYLTHIOURACIL 50 MG TABLET,4.5,3.38,0.05,4.05,119
NDC,67386013051,EPTINEZUMAB-JJMR 100 MG/ML INTRAVENOUS SOLUTION,5189.58,3892.19,62.27,4670.62,119
NDC,67457015300,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,22.99,17.24,0.28,20.69,119
NDC,67457015303,AMIODARONE 50 MG/ML INTRAVENOUS SOLUTION,22.99,17.24,0.28,20.69,119
NDC,67457016302,SODIUM TETRADECYL SULFATE 3 % (30 MG/ML) INTRAVENOUS SOLUTION,351.57,263.68,4.22,316.41,119
NDC,67457017750,DIMETHYL SULFOXIDE 50 % INTRAVESICAL SOLUTION,3127.5,2345.62,37.53,2814.75,119
NDC,67457021202,ARGATROBAN 100 MG/ML INTRAVENOUS SOLUTION,1523.75,1142.81,18.28,1371.38,119
NDC,67457021720,METHADONE 10 MG/ML INJECTION SOLUTION,1923.75,1442.81,23.08,1731.38,119
NDC,67457022005,ISOSULFAN BLUE 1 % SUBCUTANEOUS SOLUTION,4662.49,3496.87,55.95,4196.24,119
NDC,67457022899,ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION,42.0,31.5,0.5,37.8,119
NDC,67457029200,NALOXONE 0.4 MG/ML INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,67457029202,NALOXONE 0.4 MG/ML INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,67457034000,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",72.18,54.14,0.87,64.96,119
NDC,67457034001,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",72.18,54.14,0.87,64.96,119
NDC,67457042300,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.66,3.49,0.06,4.19,119
NDC,67457042312,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,4.66,3.49,0.06,4.19,119
NDC,67457043010,PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION,162.0,121.5,1.94,145.8,119
NDC,67457043300,FAMOTIDINE (PF) 20 MG/2 ML INTRAVENOUS SOLUTION,5.34,4.0,0.06,4.81,119
NDC,67457043650,DOXORUBICIN 50 MG INTRAVENOUS SOLUTION,748.58,561.44,8.98,673.72,119
NDC,67457044610,PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION,561.36,421.02,6.74,505.22,119
NDC,67457047322,TOBRAMYCIN 40 MG/ML INJECTION SOLUTION,11.88,8.91,0.14,10.69,119
NDC,67457047500,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,67457047520,VECURONIUM BROMIDE 20 MG INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,67457052810,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,65.5,49.12,0.79,58.95,119
NDC,67457053208,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,524.0,393.0,6.29,471.6,119
NDC,67457058406,FONDAPARINUX 7.5 MG/0.6 ML SUBCUTANEOUS SOLUTION SYRINGE,242.77,182.08,2.91,218.49,119
NDC,67457061730,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,163.75,122.81,1.96,147.38,119
NDC,67457065725,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",1938.0,1453.5,23.26,1744.2,119
NDC,67457067502,CALCITONIN (SALMON) 200 UNIT/ML INJECTION SOLUTION,11557.45,8668.09,138.69,10401.71,119
NDC,67457077930,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,225.72,169.29,2.71,203.15,119
NDC,67457085200,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,104.76,78.57,1.26,94.28,119
NDC,67457085204,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,104.76,78.57,1.26,94.28,119
NDC,67457085500,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,67457085502,ADENOSINE 3 MG/ML INTRAVENOUS SOLUTION,36.0,27.0,0.43,32.4,119
NDC,67457088799,MEDROXYPROGESTERONE 150 MG/ML INTRAMUSCULAR SUSPENSION,154.76,116.07,1.86,139.28,119
NDC,67457099115,TRASTUZUMAB-DKST 150 MG INTRAVENOUS SOLUTION,2676.69,2007.52,32.12,2409.02,119
NDC,67618000005,"MAGNESIUM 71.5 MG (MAGNESIUM CHLORIDE) TABLET,DELAYED RELEASE",0.85,0.64,0.01,0.76,119
NDC,67877012485,SILVER SULFADIAZINE 1 % TOPICAL CREAM,132.09,99.07,1.59,118.88,119
NDC,67877019705,AMLODIPINE 2.5 MG TABLET,0.07,0.05,0.01,0.06,119
NDC,67877019790,AMLODIPINE 2.5 MG TABLET,0.11,0.09,0.01,0.1,119
NDC,67877024610,QUETIAPINE 200 MG TABLET,0.73,0.54,0.01,0.66,119
NDC,67877028660,RILUZOLE 50 MG TABLET,3.99,2.99,0.05,3.59,119
NDC,67877041933,LINEZOLID 600 MG TABLET,21.0,15.75,0.25,18.9,119
NDC,67877043105,ARIPIPRAZOLE 5 MG TABLET,1.4,1.05,0.02,1.26,119
NDC,67877054107,TEMOZOLOMIDE 180 MG CAPSULE,264.73,198.55,3.18,238.26,119
NDC,67877054360,CEFDINIR 300 MG CAPSULE,5.0,3.75,0.06,4.5,119
NDC,67877072031,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,67877072033,EVEROLIMUS (IMMUNOSUPPRESSIVE) 0.75 MG TABLET,60.0,45.0,0.72,54.0,119
NDC,67877075360,DRONABINOL 2.5 MG CAPSULE,11.18,8.38,0.13,10.06,119
NDC,67919003001,CEFTOLOZANE-TAZOBACTAM 1.5 GRAM INTRAVENOUS SOLUTION,658.4,493.8,7.9,592.56,119
NDC,68084007511,TRETINOIN (ANTINEOPLASTIC) 10 MG CAPSULE,123.87,92.9,1.49,111.48,119
NDC,68084022911,AZATHIOPRINE 50 MG TABLET,4.06,3.04,0.05,3.65,119
NDC,68084028411,HYDROXYUREA 500 MG CAPSULE,5.52,4.14,0.07,4.97,119
NDC,68084031311,"DIVALPROEX 125 MG CAPSULE,DELAYED RELEASE SPRINKLE",5.03,3.77,0.06,4.53,119
NDC,68084044711,HYDRALAZINE 10 MG TABLET,1.16,0.87,0.01,1.04,119
NDC,68084049411,PYRIDOSTIGMINE BROMIDE 60 MG TABLET,8.3,6.23,0.1,7.47,119
NDC,68084078211,"DIVALPROEX 500 MG TABLET,DELAYED RELEASE",2.14,1.6,0.03,1.93,119
NDC,68084089695,VENLAFAXINE 25 MG TABLET,6.3,4.72,0.08,5.67,119
NDC,68084090711,"MYCOPHENOLATE SODIUM 180 MG TABLET,DELAYED RELEASE",22.35,16.76,0.27,20.12,119
NDC,68084091895,"MYCOPHENOLATE SODIUM 360 MG TABLET,DELAYED RELEASE",45.65,34.24,0.55,41.08,119
NDC,68094000159,MORPHINE 10 MG/5 ML ORAL SOLUTION,8.16,6.12,0.1,7.34,119
NDC,68094000459,CETIRIZINE 5 MG/5 ML ORAL SOLUTION,14.34,10.76,0.17,12.91,119
NDC,68094023159,ACETAMINOPHEN 160 MG/5 ML (5 ML) ORAL SUSPENSION,5.4,4.05,0.06,4.86,119
NDC,68094050359,IBUPROFEN 100 MG/5 ML ORAL SUSPENSION,7.86,5.9,0.09,7.07,119
NDC,68094086759,FUROSEMIDE 40 MG/5 ML (8 MG/ML) ORAL SOLUTION,12.3,9.23,0.15,11.07,119
NDC,68152010303,KIT FOR YTTRIUM-90-IBRITUMOMAB 3.2 MG/2 ML INTRAVENOUS,190068.69,142551.52,2280.82,171061.82,119
NDC,68176000010,PEDIATRIC MULTIVITAMIN NO.128-VITAMIN K 500 MCG/ML ORAL LIQUID,162.0,121.5,1.94,145.8,119
NDC,68180012202,CEPHALEXIN 500 MG CAPSULE,1.73,1.3,0.02,1.56,119
NDC,68180015001,FAMOTIDINE 40 MG/5 ML (8 MG/ML) ORAL SUSPENSION,180.0,135.0,2.16,162.0,119
NDC,68180015109,"MIRABEGRON ER 25 MG TABLET,EXTENDED RELEASE 24 HR",60.0,45.0,0.72,54.0,119
NDC,68180016611,VANCOMYCIN 125 MG CAPSULE,15.0,11.25,0.18,13.5,119
NDC,68180032009,"BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE",1.37,1.03,0.02,1.23,119
NDC,68180042311,CEFIXIME 400 MG CAPSULE,60.0,45.0,0.72,54.0,119
NDC,68180044102,CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION,246.0,184.5,2.95,221.4,119
NDC,68180046801,LOVASTATIN 20 MG TABLET,1.28,0.96,0.02,1.15,119
NDC,68180060406,"DESVENLAFAXINE SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",5.85,4.39,0.07,5.26,119
NDC,68180065906,RIFAMPIN 300 MG CAPSULE,22.04,16.53,0.26,19.84,119
NDC,68180069706,"TRAMADOL ER 100 MG TABLET,EXTENDED RELEASE 24 HR",16.17,12.13,0.19,14.55,119
NDC,68180081952,LANTHANUM 500 MG CHEWABLE TABLET,33.34,25.0,0.4,30.01,119
NDC,68180096301,ALBUTEROL SULFATE HFA 90 MCG/ACTUATION AEROSOL INHALER,215.88,161.91,2.59,194.29,119
NDC,68180096801,LEVOTHYROXINE 88 MCG TABLET,0.88,0.66,0.01,0.79,119
NDC,68180097001,LEVOTHYROXINE 112 MCG TABLET,0.99,0.74,0.01,0.89,119
NDC,68180097301,LEVOTHYROXINE 150 MCG TABLET,0.94,0.7,0.01,0.85,119
NDC,68180097401,LEVOTHYROXINE 175 MCG TABLET,1.4,1.05,0.02,1.26,119
NDC,68180097501,LEVOTHYROXINE 200 MCG TABLET,1.22,0.91,0.01,1.1,119
NDC,68308015215,"NYSTATIN 100,000 UNIT/GRAM TOPICAL POWDER",42.03,31.52,0.5,37.83,119
NDC,68382005001,MELOXICAM 7.5 MG TABLET,0.24,0.18,0.01,0.22,119
NDC,68382005101,MELOXICAM 15 MG TABLET,0.3,0.22,0.01,0.27,119
NDC,68382012116,AMLODIPINE 2.5 MG TABLET,0.16,0.12,0.01,0.14,119
NDC,68382014406,RAMIPRIL 1.25 MG CAPSULE,1.86,1.4,0.02,1.67,119
NDC,68382014601,RAMIPRIL 5 MG CAPSULE,1.25,0.94,0.02,1.12,119
NDC,68382025501,"OXYBUTYNIN CHLORIDE ER 5 MG TABLET,EXTENDED RELEASE 24 HR",2.08,1.56,0.02,1.87,119
NDC,68382053701,"POTASSIUM CITRATE ER 10 MEQ (1,080 MG) TABLET,EXTENDED RELEASE",3.38,2.53,0.04,3.04,119
NDC,68382077230,"LANSOPRAZOLE 30 MG DELAYED RELEASE,DISINTEGRATING TABLET",37.9,28.42,0.45,34.11,119
NDC,68382078501,DOXAZOSIN 4 MG TABLET,0.95,0.71,0.01,0.86,119
NDC,68382079901,LABETALOL 200 MG TABLET,1.71,1.28,0.02,1.54,119
NDC,68382080505,TRAZODONE 50 MG TABLET,0.28,0.21,0.01,0.25,119
NDC,68382080705,TRAZODONE 150 MG TABLET,1.43,1.08,0.02,1.29,119
NDC,68382085601,TRIAMTERENE 37.5 MG-HYDROCHLOROTHIAZIDE 25 MG TABLET,1.24,0.93,0.01,1.12,119
NDC,68382091601,METHYLPREDNISOLONE 4 MG TABLET,2.47,1.85,0.03,2.22,119
NDC,68382091711,METHYLPREDNISOLONE 8 MG TABLET,8.65,6.48,0.1,7.78,119
NDC,68382098106,"LAMOTRIGINE ER 100 MG TABLET,EXTENDED RELEASE 24 HR",11.0,8.25,0.13,9.9,119
NDC,68382099701,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,119
NDC,68382099710,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,119
NDC,68462012801,ZONISAMIDE 25 MG CAPSULE,0.94,0.71,0.01,0.85,119
NDC,68462013001,ZONISAMIDE 100 MG CAPSULE,2.21,1.66,0.03,1.99,119
NDC,68462013701,OXCARBAZEPINE 150 MG TABLET,1.8,1.35,0.02,1.62,119
NDC,68462014301,CLINDAMYCIN HCL 150 MG CAPSULE,0.86,0.65,0.01,0.77,119
NDC,68462018022,MUPIROCIN 2 % TOPICAL OINTMENT,53.99,40.49,0.65,48.59,119
NDC,68462019005,NAPROXEN 500 MG TABLET,0.73,0.54,0.01,0.66,119
NDC,68462022101,LITHIUM CARBONATE 300 MG CAPSULE,0.53,0.4,0.01,0.48,119
NDC,68462022301,"LITHIUM CARBONATE ER 300 MG TABLET,EXTENDED RELEASE",1.34,1.01,0.02,1.21,119
NDC,68462022401,"LITHIUM CARBONATE ER 450 MG TABLET,EXTENDED RELEASE",1.78,1.33,0.02,1.6,119
NDC,68462022901,LAMOTRIGINE 25 MG CHEWABLE DISPERSIBLE TABLET,2.65,1.98,0.03,2.38,119
NDC,68462025301,ROPINIROLE 0.25 MG TABLET,0.72,0.54,0.01,0.65,119
NDC,68462025401,ROPINIROLE 0.5 MG TABLET,0.72,0.54,0.01,0.65,119
NDC,68462026530,ATOMOXETINE 10 MG CAPSULE,9.52,7.14,0.11,8.57,119
NDC,68462030450,NORETHINDRONE ACETATE 5 MG TABLET,3.6,2.7,0.04,3.24,119
NDC,68462040467,ATOVAQUONE 250 MG-PROGUANIL 100 MG TABLET,35.02,26.27,0.42,31.52,119
NDC,68462046160,TROSPIUM 20 MG TABLET,4.76,3.57,0.06,4.28,119
NDC,68462058340,APREPITANT 40 MG CAPSULE,364.99,273.74,4.38,328.49,119
NDC,68462058385,APREPITANT 40 MG CAPSULE,364.98,273.74,4.38,328.48,119
NDC,68462063925,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,15.6,11.7,0.19,14.04,119
NDC,68462063945,NITROGLYCERIN 0.4 MG SUBLINGUAL TABLET,15.6,11.7,0.19,14.04,119
NDC,68462071171,ESTRADIOL 10 MCG VAGINAL TABLET,87.29,65.47,1.05,78.56,119
NDC,68462071182,ESTRADIOL 10 MCG VAGINAL TABLET,87.29,65.47,1.05,78.56,119
NDC,68462074617,ACYCLOVIR 5 % TOPICAL OINTMENT,180.0,135.0,2.16,162.0,119
NDC,68462090401,POSACONAZOLE 300 MG/16.7 ML INTRAVENOUS SOLUTION,1215.03,911.27,14.58,1093.53,119
NDC,68462094403,LATANOPROST 0.005 % EYE DROPS,31.56,23.67,0.38,28.4,119
NDC,68516521405,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",196.8,147.6,2.36,177.12,119
NDC,68516521406,"ALBUMIN, HUMAN 5 % INTRAVENOUS SOLUTION",196.8,147.6,2.36,177.12,119
NDC,68585000575,"MAGNESIUM 64 MG (MAGNESIUM CHLORIDE) TABLET,DELAYED RELEASE",0.5,0.37,0.01,0.45,119
NDC,68682046410,"BRINZOLAMIDE 1 % EYE DROPS,SUSPENSION",1388.56,1041.42,16.66,1249.7,119
NDC,68727071201,LURBINECTEDIN 4 MG INTRAVENOUS SOLUTION,20661.19,15495.89,247.93,18595.07,119
NDC,68803061210,TRYPAN BLUE 0.06 % INTRAOCULAR SYRINGE,332.42,249.31,3.99,299.18,119
NDC,68803072225,C.I. ACID BLUE 90  0.025 % INTRAOCULAR SYRINGE,447.96,335.97,5.38,403.16,119
NDC,68982034701,"FIBRINOGEN 1 GRAM (700 MG-1,300 MG) INTRAVENOUS SOLUTION",6.6,4.95,0.08,5.94,119
NDC,68992301003,"TACROLIMUS XR 1 MG TABLET,EXTENDED RELEASE 24 HR",41.71,31.28,0.5,37.54,119
NDC,68992304003,"TACROLIMUS XR 4 MG TABLET,EXTENDED RELEASE 24 HR",125.14,93.85,1.5,112.63,119
NDC,68992307503,"TACROLIMUS XR 0.75 MG TABLET,EXTENDED RELEASE 24 HR",31.28,23.46,0.38,28.15,119
NDC,69051030001,MILTEFOSINE 50 MG CAPSULE,2262.86,1697.14,27.15,2036.57,119
NDC,69097000845,NICARDIPINE 40 MG/200 ML(0.2 MG/ML) IN SOD CHLOR(ISO) INTRAVENOUS SOLN,480.0,360.0,5.76,432.0,119
NDC,69097012203,TOPIRAMATE 25 MG TABLET,0.4,0.3,0.01,0.36,119
NDC,69097012303,TOPIRAMATE 50 MG TABLET,0.55,0.41,0.01,0.5,119
NDC,69097012403,TOPIRAMATE 100 MG TABLET,0.7,0.53,0.01,0.63,119
NDC,69097012605,AMLODIPINE 2.5 MG TABLET,0.17,0.13,0.01,0.15,119
NDC,69097031932,BUDESONIDE 0.5 MG/2 ML SUSPENSION FOR NEBULIZATION,55.82,41.87,0.67,50.24,119
NDC,69097036202,ABACAVIR 600 MG-LAMIVUDINE 300 MG TABLET,20.0,15.0,0.24,18.0,119
NDC,69097057967,FOSFOMYCIN TROMETHAMINE 3 GRAM ORAL PACKET,249.0,186.75,2.99,224.1,119
NDC,69097064448,SUMATRIPTAN 20 MG/ACTUATION NASAL SPRAY,131.25,98.44,1.58,118.12,119
NDC,69097080232,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,60.75,45.56,0.73,54.68,119
NDC,69097087067,LANREOTIDE 120 MG/0.5 ML SUBCUTANEOUS SYRINGE,20106.3,15079.73,241.28,18095.67,119
NDC,69126000301,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,2945.28,2208.96,35.34,2650.75,119
NDC,69238112601,ETHACRYNIC ACID 25 MG TABLET,13.5,10.12,0.16,12.15,119
NDC,69238116609,DOXEPIN 10 MG CAPSULE,1.03,0.77,0.01,0.93,119
NDC,69238153205,CLOBETASOL 0.05 % TOPICAL CREAM,27.0,20.25,0.32,24.3,119
NDC,69238157401,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,719.71,539.78,8.64,647.74,119
NDC,69238159502,MYCOPHENOLATE MOFETIL 200 MG/ML ORAL POWDER FOR SUSPENSION,2714.88,2036.16,32.58,2443.39,119
NDC,69238160502,METHYLERGONOVINE 0.2 MG TABLET,74.25,55.69,0.89,66.82,119
NDC,69292060560,DIGOXIN 50 MCG/ML (0.05 MG/ML) ORAL SOLUTION,852.12,639.09,10.23,766.91,119
NDC,69292072225,FLURBIPROFEN 0.03 % EYE DROPS,162.0,121.5,1.94,145.8,119
NDC,69315013501,IMIPRAMINE 50 MG TABLET,1.86,1.4,0.02,1.67,119
NDC,69315013601,BENZTROPINE 0.5 MG TABLET,0.83,0.63,0.01,0.75,119
NDC,69315013701,BENZTROPINE 1 MG TABLET,0.97,0.72,0.01,0.87,119
NDC,69315021101,NIFEDIPINE 10 MG CAPSULE,5.13,3.85,0.06,4.62,119
NDC,69315031228,HYDROCORTISONE 2.5 % TOPICAL CREAM WITH PERINEAL APPLICATOR,420.0,315.0,5.04,378.0,119
NDC,69315070150,ETHACRYNATE SODIUM 50 MG INTRAVENOUS SOLUTION,7011.0,5258.25,84.13,6309.9,119
NDC,69339013815,CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH (REPACKAGING),11.43,8.57,0.14,10.29,119
NDC,69355041203,LACTOBAC NO.2-BIFIDOBAC NO.1-S. THERMO 112.5 BILLION CELL CAPSULE,4.4,3.3,0.05,3.96,119
NDC,69367025001,SODIUM DI- AND MONOPHOSPHATE-POTASSIUM PHOS MONOBASIC 250 MG TABLET,2.03,1.53,0.02,1.83,119
NDC,69367028302,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",176.76,132.57,2.12,159.08,119
NDC,69374098810,ARGININE 25 MG/ML-LYSINE 25 MG/ML IN 0.9 % NACL INTRAVENOUS SOLUTION,510.0,382.5,6.12,459.0,119
NDC,69452015220,ETHOSUXIMIDE 250 MG CAPSULE,2.52,1.89,0.03,2.27,119
NDC,69452020713,CALCITRIOL 0.25 MCG CAPSULE,1.63,1.22,0.02,1.47,119
NDC,69488000140,KIT FOR THE PREPARATION OF GA-68-DOTATATE 40 MCG INTRAVENOUS SOLN,11512.8,8634.6,138.15,10361.52,119
NDC,69488000301,LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION,191164.32,143373.24,2293.97,172047.89,119
NDC,69488000370,LUTETIUM LU 177 DOTATATE 10 MCI/ML (370 MBQ/ML) INTRAVENOUS SOLUTION,191164.32,143373.24,2293.97,172047.89,119
NDC,69488001061,"LUTETIUM LU-177 VIPIVOTIDE TETRAXETAN 27 MCI/ML (1,000 MBQ/ML) IV SOLN",155669.85,116752.39,1868.04,140102.87,119
NDC,69488001761,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,15202.8,11402.1,182.43,13682.52,119
NDC,69543023460,"ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS",362.88,272.16,4.35,326.59,119
NDC,69584068410,PRIMIDONE 50 MG TABLET,1.46,1.09,0.02,1.31,119
NDC,69584084210,SOTALOL 120 MG TABLET,0.41,0.31,0.01,0.37,119
NDC,69587000101,FLUDEOXYGLUCOSE F-18 20 MCI TO 300 MCI/ML INTRAVENOUS SOLUTION,2945.28,2208.96,35.34,2650.75,119
NDC,69616027230,PERAMPANEL 2 MG TABLET,93.15,69.86,1.12,83.84,119
NDC,69616027430,PERAMPANEL 4 MG TABLET,184.05,138.04,2.21,165.64,119
NDC,69680013060,"PROPAFENONE ER 225 MG CAPSULE,EXTENDED RELEASE 12 HR",4.9,3.68,0.06,4.41,119
NDC,69784023020,SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION,108.9,81.68,1.31,98.01,119
NDC,69800420301,"HEPATITIS B IMMUNE GLOBULIN > 1,560 UNIT/5 ML INTRAMUSCULAR SOLUTION",3123.83,2342.87,37.49,2811.45,119
NDC,69918030130,TRANEXAMIC ACID 650 MG TABLET,26.07,19.55,0.31,23.46,119
NDC,69918073501,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,1080.0,810.0,12.96,972.0,119
NDC,69918073510,ISOPROTERENOL 0.2 MG/ML INJECTION SOLUTION,1080.0,810.0,12.96,972.0,119
NDC,69918090110,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,2470.08,1852.56,29.64,2223.07,119
NDC,69932000101,FLUCICLOVINE F18 10 MCI (370 MBQ) INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
NDC,69932000201,"FLOTUFOLASTAT F 18 GALLIUM 296-5,846 MBQ/ML (8-158 MCI/ML) IV SOLUTION",18450.0,13837.5,221.4,16605.0,119
NDC,69945005040,INDIUM 111-PENTETREOTIDE 3 MCI/ML-10 MCG INTRAVENOUS KIT,14169.6,10627.2,170.04,12752.64,119
NDC,69945006401,COPPER CU-64 DOTATATE 148 MBQ/4 ML (4 MCI/4 ML) INTRAVENOUS SOLUTION,3840.0,2880.0,46.08,3456.0,119
NDC,69945006820,KIT FOR TC 99M-LABELED RED BLOOD CELLS INTRAVENOUS SOLUTION,796.8,597.6,9.56,717.12,119
NDC,69945009120,KIT FOR PREPARATION OF TC-99M-SODIUM OXIDRONATE 3.15 MG IV SOLUTION,198.0,148.5,2.38,178.2,119
NDC,69945009140,KIT FOR PREPARATION OF TC-99M-SODIUM OXIDRONATE 3.15 MG IV SOLUTION,198.0,148.5,2.38,178.2,119
NDC,69945009220,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,602.08,451.56,7.22,541.87,119
NDC,69945009240,KIT PREPARATION OF TC 99M-SESTAMIBI COMBO NO.1 IV SOLUTION,602.08,451.56,7.22,541.87,119
NDC,69945009620,KIT FOR PREP TC-99M-MERTIATIDE (BETIATIDE) 1 MG INTRAVENOUS SOLUTION,357.94,268.45,4.3,322.15,119
NDC,69945031401,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,69945031405,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,69945031430,KIT FOR PREPARATION OF TC 99M-PENTETIC ACID 20 MG IV SOLUTION,135.0,101.25,1.62,121.5,119
NDC,69945060220,SODIUM IODIDE-123 7.4 MBQ (200 MICROCI) CAPSULE,4418.41,3313.8,53.02,3976.57,119
NDC,70004020022,"FENTANYL 2,500 MCG IN NS 50 ML (50 MCG/ML) DRIP",152.1,114.07,1.83,136.89,119
NDC,70004020222,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV DRIP,117.9,88.43,1.41,106.11,119
NDC,70004020222,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV PCA SYRINGE,117.9,88.43,1.41,106.11,119
NDC,70004027122,FENTANYL(PF) 100 MCG/50 ML (2 MCG/ML)-BUPIV 0.125 % NACL EPIDURAL SYRG,83.51,62.63,1.0,75.16,119
NDC,70004030022,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,51.0,38.25,0.61,45.9,119
NDC,70004030022,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,51.0,38.25,0.61,45.9,119
NDC,70004038005,METHADONE 10 MG/ML INTRAVENOUS SYRINGE,96.19,72.14,1.15,86.57,119
NDC,70010001301,"METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE",13.45,10.09,0.16,12.1,119
NDC,70010075401,METHOCARBAMOL 500 MG TABLET,0.3,0.22,0.01,0.27,119
NDC,70010077005,METHOCARBAMOL 750 MG TABLET,0.37,0.28,0.01,0.33,119
NDC,70069002101,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,31.44,23.58,0.38,28.3,119
NDC,70069002125,DEXAMETHASONE SODIUM PHOSPHATE (PF) 10 MG/ML INJECTION SOLUTION,31.44,23.58,0.38,28.3,119
NDC,70069012101,TROPICAMIDE 1 % EYE DROPS,51.03,38.27,0.61,45.93,119
NDC,70069013101,TOBRAMYCIN 0.3 % EYE DROPS,30.0,22.5,0.36,27.0,119
NDC,70069018101,PILOCARPINE 1 % EYE DROPS,445.14,333.86,5.34,400.63,119
NDC,70069019101,PILOCARPINE 2 % EYE DROPS,455.31,341.48,5.46,409.78,119
NDC,70069023101,BRIMONIDINE 0.2 % EYE DROPS,36.66,27.49,0.44,32.99,119
NDC,70069036301,SULFAMETHOXAZOLE 400 MG-TRIMETHOPRIM 80 MG/5 ML INTRAVENOUS SOLUTION,218.88,164.16,2.63,196.99,119
NDC,70069056601,BRIMONIDINE 0.1 % EYE DROPS,547.42,410.57,6.57,492.68,119
NDC,70069067110,NALBUPHINE 10 MG/ML INJECTION SOLUTION,37.12,27.84,0.45,33.41,119
NDC,70069080601,NEOSTIGMINE METHYLSULFATE 1 MG/ML INTRAVENOUS SOLUTION,45.0,33.75,0.54,40.5,119
NDC,70092111450,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,73.5,55.12,0.88,66.15,119
NDC,70092111450,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,73.5,55.12,0.88,66.15,119
NDC,70092112850,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV DRIP,58.5,43.88,0.7,52.65,119
NDC,70092112850,MORPHINE 50 MG/50 ML (1 MG/ML) IN 0.9 % SODIUM CHLORIDE IV PCA SYRINGE,58.5,43.88,0.7,52.65,119
NDC,70092131046,METHOHEXITAL 100 MG/10 ML (10 MG/ML) IN STERILE WATER (PF)  IV SYRINGE,139.5,104.62,1.67,125.55,119
NDC,70092152350,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV DRIP,47.4,35.55,0.57,42.66,119
NDC,70092152350,MORPHINE (PF) 50 MG/50 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,47.4,35.55,0.57,42.66,119
NDC,70092161746,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,35.58,26.68,0.43,32.02,119
NDC,70092168846,EPINEPHRINE HCL 100 MCG/10 ML (10 MCG/ML) IN D5W INTRAVENOUS SYRINGE,44.58,33.44,0.53,40.12,119
NDC,70092911450,HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN 0.9% NACL IV PCA SYRINGE,73.5,55.12,0.88,66.15,119
NDC,70092911450,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,73.5,55.12,0.88,66.15,119
NDC,70095003101,DESMOPRESSIN 4 MCG/ML INJECTION SOLUTION,1446.34,1084.76,17.36,1301.71,119
NDC,70095005001,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,130.8,98.1,1.57,117.72,119
NDC,70095005003,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,130.8,98.1,1.57,117.72,119
NDC,70100042401,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,830.0,622.5,9.96,747.0,119
NDC,70100042402,INDOCYANINE GREEN 25 MG SOLUTION FOR INJECTION,830.0,622.5,9.96,747.0,119
NDC,70114010101,PEGFILGRASTIM-CBQV 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,10742.28,8056.71,128.91,9668.05,119
NDC,70114034001,TORIPALIMAB-TPZI 240 MG/6 ML (40 MG/ML) INTRAVENOUS SOLUTION,24928.54,18696.4,299.14,22435.69,119
NDC,70121104901,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,51.0,38.25,0.61,45.9,119
NDC,70121104905,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,51.0,38.25,0.61,45.9,119
NDC,70121116801,TRIAMCINOLONE ACETONIDE 40 MG/ML SUSPENSION FOR INJECTION,260.1,195.08,3.12,234.09,119
NDC,70121157401,METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION,73.44,55.08,0.88,66.1,119
NDC,70121157701,PHENYLEPHRINE 10 MG/ML INJECTION SOLUTION,23.41,17.56,0.28,21.07,119
NDC,70121162701,PEGFILGRASTIM-PBBK 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,6871.25,5153.44,82.46,6184.12,119
NDC,70121171601,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
NDC,70121171607,"ESMOLOL 2,500 MG/250 ML (10 MG/ML) IN SODIUM CHLORIDE (ISO-OSMOTIC) IV",900.0,675.0,10.8,810.0,119
NDC,70127010060,CANNABIDIOL 100 MG/ML ORAL SOLUTION,4414.5,3310.88,52.97,3973.05,119
NDC,70436001982,AZITHROMYCIN 500 MG INTRAVENOUS SOLUTION,19.98,14.98,0.24,17.98,119
NDC,70436008955,GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION,198.0,148.5,2.38,178.2,119
NDC,70436020380,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,38.88,29.16,0.47,34.99,119
NDC,70436020382,DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLUTION,38.88,29.16,0.47,34.99,119
NDC,70594002301,COLISTIN (COLISTIMETHATE SODIUM) 150 MG SOLUTION FOR INJECTION,126.0,94.5,1.51,113.4,119
NDC,70594008402,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),8.5,6.38,0.1,7.65,119
NDC,70677103701,OXYMETAZOLINE 0.05 % NASAL SPRAY,10.8,8.1,0.13,9.72,119
NDC,70677121001,MAGNESIUM SULFATE (LAXATIVE) 495 MG/5 GRAM ORAL GRANULES,10.9,8.17,0.13,9.81,119
NDC,70677122301,"MICONAZOLE NITRATE 4 % (200 MG)-2 % (9 GRAM)VAGINAL,PREFILL APPL,CREAM",55.15,41.36,0.66,49.64,119
NDC,70700011684,LEVONORGESTREL 0.15 MG-ETHINYL ESTRADIOL 0.03 MG TABLET,1.1,0.82,0.01,0.99,119
NDC,70700016922,IRINOTECAN 40 MG/2 ML INTRAVENOUS SOLUTION,61.8,46.35,0.74,55.62,119
NDC,70700018622,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,28.05,21.04,0.34,25.24,119
NDC,70700018623,FLUOROURACIL 500 MG/10 ML INTRAVENOUS SOLUTION,28.05,21.04,0.34,25.24,119
NDC,70700018822,FLUOROURACIL 2.5 GRAM/50 ML INTRAVENOUS SOLUTION,126.22,94.67,1.51,113.6,119
NDC,70700028922,TESTOSTERONE CYPIONATE 200 MG/ML INTRAMUSCULAR OIL,60.0,45.0,0.72,54.0,119
NDC,70710111001,CYPROHEPTADINE 4 MG TABLET,2.66,1.99,0.03,2.39,119
NDC,70710116201,MECLIZINE 25 MG TABLET,1.15,0.86,0.01,1.03,119
NDC,70710188601,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,393.12,294.84,4.72,353.81,119
NDC,70710188606,LACOSAMIDE 200 MG/20 ML INTRAVENOUS SOLUTION,393.12,294.84,4.72,353.81,119
NDC,70710189501,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,119
NDC,70710189506,ARSENIC TRIOXIDE 1 MG/ML INTRAVENOUS SOLUTION,1241.39,931.04,14.9,1117.25,119
NDC,70710190003,SITAGLIPTIN 50 MG TABLET,16.0,12.0,0.19,14.4,119
NDC,70720095036,GOSERELIN 3.6 MG SUBCUTANEOUS IMPLANT,2889.77,2167.33,34.68,2600.79,119
NDC,70720095130,GOSERELIN 10.8 MG SUBCUTANEOUS IMPLANT,8025.68,6019.26,96.31,7223.11,119
NDC,70748012906,LEFLUNOMIDE 10 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,70748013006,LEFLUNOMIDE 20 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,70748025807,"POSACONAZOLE 100 MG TABLET,DELAYED RELEASE",45.0,33.75,0.54,40.5,119
NDC,70748033202,"PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION",264.0,198.0,3.17,237.6,119
NDC,70752013812,PROMETHAZINE 6.25 MG/5 ML ORAL SYRUP,232.72,174.54,2.79,209.45,119
NDC,70756000411,HALOPERIDOL 5 MG TABLET,0.6,0.45,0.01,0.54,119
NDC,70756060525,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,70756060582,VERAPAMIL 2.5 MG/ML INTRAVENOUS SOLUTION,60.0,45.0,0.72,54.0,119
NDC,70756060915,OFLOXACIN 0.3 % EAR DROPS,90.0,67.5,1.08,81.0,119
NDC,70756061212,ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION,14.0,10.5,0.17,12.6,119
NDC,70756061270,ARFORMOTEROL 15 MCG/2 ML SOLUTION FOR NEBULIZATION,14.0,10.5,0.17,12.6,119
NDC,70756061430,PHENYLEPHRINE 10 % EYE DROPS,240.0,180.0,2.88,216.0,119
NDC,70756062925,PHENYLEPHRINE 2.5 % EYE DROPS,146.25,109.69,1.76,131.62,119
NDC,70756064325,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,13.38,10.04,0.16,12.04,119
NDC,70756064385,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,13.38,10.04,0.16,12.04,119
NDC,70756065225,ATROPINE 1 % EYE DROPS,262.74,197.06,3.15,236.47,119
NDC,70756080790,"LANSOPRAZOLE 30 MG CAPSULE,DELAYED RELEASE",0.58,0.43,0.01,0.52,119
NDC,70842016001,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,917.76,688.32,11.01,825.98,119
NDC,70842016010,MINOCYCLINE 100 MG INTRAVENOUS SOLUTION,992.64,744.48,11.91,893.38,119
NDC,70860011215,AMPICILLIN 250 MG/2.5 ML SOLUTION FOR INJECTION (UW),11.69,8.77,0.14,10.52,119
NDC,70954000510,OXYBUTYNIN CHLORIDE 5 MG TABLET,0.53,0.4,0.01,0.48,119
NDC,70954000530,OXYBUTYNIN CHLORIDE 5 MG TABLET,0.53,0.4,0.01,0.48,119
NDC,70954002110,PRAZOSIN 5 MG CAPSULE,1.63,1.22,0.02,1.47,119
NDC,70954004110,RIFABUTIN 150 MG CAPSULE,60.0,45.0,0.72,54.0,119
NDC,70954013510,DAPSONE 25 MG TABLET,5.9,4.42,0.07,5.31,119
NDC,70954016810,SILDENAFIL (PULMONARY HYPERTENSION) 10 MG/ML ORAL POWDR FOR SUSPENSION,659.9,494.93,7.92,593.91,119
NDC,70954024010,CARBAMAZEPINE 100 MG/5 ML ORAL SUSPENSION,423.9,317.92,5.09,381.51,119
NDC,70954031910,PAROXETINE 10 MG/5 ML ORAL SUSPENSION,2203.5,1652.62,26.44,1983.15,119
NDC,70954036510,PHENOXYBENZAMINE 10 MG CAPSULE,123.75,92.81,1.48,111.38,119
NDC,70954044420,MISOPROSTOL 200 MCG TABLET,5.79,4.34,0.07,5.21,119
NDC,70954048420,PYRAZINAMIDE 500 MG TABLET,27.11,20.34,0.33,24.4,119
NDC,70954049210,LEVOCARNITINE 330 MG TABLET,5.27,3.95,0.06,4.74,119
NDC,70954055920,LEVOMEFOLATE CALCIUM 7.5 MG TABLET,11.81,8.86,0.14,10.63,119
NDC,71083002001,KIT FOR PREPARATION TC-99M-SUCCIMER 1 MG INTRAVENOUS SOLUTION,5535.0,4151.25,66.42,4981.5,119
NDC,71083002005,KIT FOR PREPARATION TC-99M-SUCCIMER 1 MG INTRAVENOUS SOLUTION,5535.0,4151.25,66.42,4981.5,119
NDC,71205090900,DIPHENOXYLATE-ATROPINE 2.5 MG-0.025 MG TABLET,1.04,0.78,0.01,0.94,119
NDC,71258002200,PIFLUFOLASTAT F 18  296 MBQ TO 370 MBQ (8 MCI TO 10 MCI) IV SYRINGE,18931.48,14198.61,227.18,17038.33,119
NDC,71258002201,"PIFLUFOLASTAT F 18 37 MBQ/ML TO 2,960 MBQ/ML (1-80 MCI/ML) IV SOLUTION",17483.22,13112.42,209.8,15734.9,119
NDC,71266629001,LIDOCAINE 4 %-EPINEPHRINE 0.18 %-TETRACAINE 0.5 % TOPICAL GEL,95.99,72.0,1.15,86.39,119
NDC,71266911003,"HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL, ISO-OSM IV PCA SYR",234.9,176.18,2.82,211.41,119
NDC,71266911003,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,234.9,176.18,2.82,211.41,119
NDC,71288001615,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,119
NDC,71288002210,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,18.0,13.5,0.22,16.2,119
NDC,71288002211,VANCOMYCIN 500 MG INTRAVENOUS SOLUTION,18.0,13.5,0.22,16.2,119
NDC,71288010120,OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION,85.0,63.75,1.02,76.5,119
NDC,71288010720,BLEOMYCIN 30 UNIT SOLUTION FOR INJECTION,203.24,152.43,2.44,182.92,119
NDC,71288011530,AZACITIDINE 100 MG SOLUTION FOR INJECTION,147.38,110.53,1.77,132.64,119
NDC,71288011706,GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION,31.88,23.91,0.38,28.69,119
NDC,71288011728,GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION,93.56,70.17,1.12,84.2,119
NDC,71288011754,GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION,189.12,141.84,2.27,170.21,119
NDC,71288016120,LEUCOVORIN CALCIUM 100 MG SOLUTION FOR INJECTION,52.4,39.3,0.63,47.16,119
NDC,71288016610,PEMETREXED DISODIUM 100 MG INTRAVENOUS POWDER FOR SOLUTION,98.25,73.69,1.18,88.42,119
NDC,71288016750,PEMETREXED DISODIUM 500 MG INTRAVENOUS POWDER FOR SOLUTION,457.12,342.84,5.49,411.41,119
NDC,71288020185,REGADENOSON 0.4 MG/5 ML INTRAVENOUS SYRINGE,120.0,90.0,1.44,108.0,119
NDC,71288020304,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,8.11,6.08,0.1,7.3,119
NDC,71288020305,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,8.11,6.08,0.1,7.3,119
NDC,71288020310,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,12.0,9.0,0.14,10.8,119
NDC,71288020311,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,12.0,9.0,0.14,10.8,119
NDC,71288030301,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",10.68,8.01,0.13,9.61,119
NDC,71288030302,"CYANOCOBALAMIN (VIT B-12) 1,000 MCG/ML INJECTION SOLUTION",10.68,8.01,0.13,9.61,119
NDC,71288042095,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",15.78,11.84,0.19,14.2,119
NDC,71288042096,"HEPARIN (PORCINE) 1,000 UNIT/ML INJECTION SOLUTION",15.78,11.84,0.19,14.2,119
NDC,71288042710,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,290.5,217.88,3.49,261.45,119
NDC,71288042711,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,290.5,217.88,3.49,261.45,119
NDC,71288060010,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,17.82,13.36,0.21,16.04,119
NDC,71288080320,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,220.94,165.71,2.65,198.85,119
NDC,71288080321,MYCOPHENOLATE 500 MG INTRAVENOUS SOLUTION,220.94,165.71,2.65,198.85,119
NDC,71288081110,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,119
NDC,71288081111,METHYLENE BLUE (ANTIDOTE) 5 MG/ML INTRAVENOUS SOLUTION,1054.76,791.07,12.66,949.28,119
NDC,71321080230,"VITAMIN E (DL, ACETATE) 22.5 MG (50 UNIT)/ML ORAL DROPS",164.7,123.52,1.98,148.23,119
NDC,71351001460,BALSAM PERU-CASTOR OIL TOPICAL OINTMENT,160.56,120.42,1.93,144.5,119
NDC,71399012204,VITAMINS A AND D-WHITE PETROLATUM-LANOLIN TOPICAL OINTMENT,23.73,17.8,0.28,21.36,119
NDC,71399282901,DIBUCAINE 1 % TOPICAL OINTMENT,19.15,14.36,0.23,17.24,119
NDC,71399740105,CHOLECALCIFEROL (VITAMIN D3) 10 MCG/ML (400 UNIT/ML) ORAL DROPS,18.0,13.5,0.22,16.2,119
NDC,71449000115,PHENYLEPHRINE 1 MG/10 ML (100 MCG/ML) IN 0.9 % SOD.CHLORIDE IV SYRINGE,18.84,14.13,0.23,16.96,119
NDC,71449001332,"FENTANYL 1,500 MCG/30 ML (50 MCG/ML) IV DRIP NEO/PED CMPD",95.76,71.82,1.15,86.18,119
NDC,71449006811,KETAMINE 50 MG/5 ML (10 MG/ML) IN 0.9 % SODIUM CHLORIDE IV SYRINGE,45.0,33.75,0.54,40.5,119
NDC,71449007025,ROPIVACAINE (PF) 2 MG/ML (0.2 %) EPIDURAL SOLUTION 50 ML,100.2,75.15,1.2,90.18,119
NDC,71449012615,"SUCCINYLCHOLINE(PF)200 MG/10 ML(20 MG/ML)-NACL,ISO INTRAVENOUS SYRINGE",90.0,67.5,1.08,81.0,119
NDC,71661000136,ALOE VERA TOPICAL GEL,26.52,19.89,0.32,23.87,119
NDC,71699005030,CENOBAMATE 50 MG TABLET,177.0,132.75,2.12,159.3,119
NDC,71699010030,CENOBAMATE 100 MG TABLET,177.0,132.75,2.12,159.3,119
NDC,71921022610,DORZOLAMIDE 22.3 MG-TIMOLOL 6.8 MG/ML EYE DROPS,210.0,157.5,2.52,189.0,119
NDC,72078003400,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,254.36,190.77,3.05,228.92,119
NDC,72078003401,REMIFENTANIL 1 MG INTRAVENOUS SOLUTION,254.36,190.77,3.05,228.92,119
NDC,72078003502,REMIFENTANIL 2 MG INTRAVENOUS SOLUTION,508.71,381.53,6.1,457.84,119
NDC,72078004008,DOCETAXEL 80 MG/8 ML (10 MG/ML) INTRAVENOUS SOLUTION,524.0,393.0,6.29,471.6,119
NDC,72140003147,WHITE PETROLATUM 41 % TOPICAL OINTMENT,78.41,58.81,0.94,70.57,119
NDC,72140045231,WHITE PETROLATUM 41 % TOPICAL OINTMENT,29.4,22.05,0.35,26.46,119
NDC,72140063377,WHITE PETROLATUM 41 % TOPICAL OINTMENT,42.84,32.13,0.51,38.56,119
NDC,72205000792,CAPECITABINE 500 MG TABLET,3.0,2.25,0.04,2.7,119
NDC,72205003101,DECITABINE 50 MG INTRAVENOUS SOLUTION,603.4,452.55,7.24,543.06,119
NDC,72205003601,DECITABINE 50 MG INTRAVENOUS SOLUTION,603.4,452.55,7.24,543.06,119
NDC,72205003960,DOFETILIDE 125 MCG CAPSULE,2.0,1.5,0.02,1.8,119
NDC,72205004211,OSELTAMIVIR 30 MG CAPSULE,9.9,7.43,0.12,8.91,119
NDC,72205008430,TIAGABINE 2 MG TABLET,38.09,28.57,0.46,34.28,119
NDC,72205008530,TIAGABINE 4 MG TABLET,38.09,28.57,0.46,34.28,119
NDC,72205009978,SIROLIMUS 1 MG/ML ORAL SOLUTION,3570.12,2677.59,42.84,3213.11,119
NDC,72205020830,LURASIDONE 40 MG TABLET,4.0,3.0,0.05,3.6,119
NDC,72205026130,VILAZODONE 20 MG TABLET,6.75,5.06,0.08,6.08,119
NDC,72205028018,SACUBITRIL 24 MG-VALSARTAN 26 MG TABLET,8.33,6.25,0.1,7.5,119
NDC,72205028118,SACUBITRIL 49 MG-VALSARTAN 51 MG TABLET,8.33,6.25,0.1,7.5,119
NDC,72205028260,SACUBITRIL 97 MG-VALSARTAN 103 MG TABLET,10.0,7.5,0.12,9.0,119
NDC,72266016001,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,107.39,80.54,1.29,96.65,119
NDC,72266016010,ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION,107.39,80.54,1.29,96.65,119
NDC,72266024801,SINCALIDE 5 MCG SOLUTION FOR INJECTION,567.02,425.26,6.8,510.32,119
NDC,72266024805,SINCALIDE 5 MCG SOLUTION FOR INJECTION,567.02,425.26,6.8,510.32,119
NDC,72485010410,CAFFEINE CITRATE 60 MG/3 ML (20 MG/ML) INTRAVENOUS SOLUTION,66.01,49.5,0.79,59.41,119
NDC,72485010501,SODIUM NITROPRUSSIDE 25 MG/ML INTRAVENOUS SOLUTION,120.0,90.0,1.44,108.0,119
NDC,72485041701,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,31.8,23.85,0.38,28.62,119
NDC,72485041701,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (2 GM AMP NEO/PED)(UW),31.8,23.85,0.38,28.62,119
NDC,72485041710,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION,31.8,23.85,0.38,28.62,119
NDC,72485041710,AMPICILLIN-SULBACTAM 3 GRAM SOLUTION FOR INJECTION (2 GM AMP NEO/PED)(UW),31.8,23.85,0.38,28.62,119
NDC,72485061710,KETOTIFEN 0.025 % (0.035 %) EYE DROPS,39.0,29.25,0.47,35.1,119
NDC,72572001501,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,33.24,24.93,0.4,29.92,119
NDC,72572001525,AMINOCAPROIC ACID 250 MG/ML INTRAVENOUS SOLUTION,33.24,24.93,0.4,29.92,119
NDC,72572001701,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,13.98,10.48,0.17,12.58,119
NDC,72572001710,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,13.98,10.48,0.17,12.58,119
NDC,72572003501,BIVALIRUDIN 250 MG INTRAVENOUS POWDER FOR SOLUTION,332.96,249.72,4.0,299.66,119
NDC,72572004001,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,18.12,13.59,0.22,16.31,119
NDC,72572004010,BUMETANIDE 0.25 MG/ML INJECTION SOLUTION,18.12,13.59,0.22,16.31,119
NDC,72572005501,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.02,5.26,0.08,6.32,119
NDC,72572005525,CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION,7.02,5.26,0.08,6.32,119
NDC,72572007401,CLINDAMYCIN 600 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,24.0,18.0,0.29,21.6,119
NDC,72572007601,CLINDAMYCIN 18 MG/ML IN D5W IVPB NEO/PED,30.0,22.5,0.36,27.0,119
NDC,72572007601,CLINDAMYCIN 900 MG/50 ML IN 5 % DEXTROSE INTRAVENOUS PIGGYBACK,30.0,22.5,0.36,27.0,119
NDC,72572009401,AMPICILLIN 2 GRAM SOLUTION FOR INJECTION,13.98,10.48,0.17,12.58,119
NDC,72572012025,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJECTION SOLUTION,5.4,4.05,0.06,4.86,119
NDC,72572012801,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,149.4,112.05,1.79,134.46,119
NDC,72572012808,DEXMEDETOMIDINE 400 MCG/100 ML (4 MCG/ML) IN 0.9 % SODIUM CHLORIDE IV,149.4,112.05,1.79,134.46,119
NDC,72572014001,DIAZEPAM 5 MG/ML INJECTION SYRINGE,111.84,83.88,1.34,100.66,119
NDC,72572014002,DIAZEPAM 5 MG/ML INJECTION SYRINGE,111.84,83.88,1.34,100.66,119
NDC,72572016001,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,21.78,16.34,0.26,19.6,119
NDC,72572016010,ETOMIDATE 2 MG/ML INTRAVENOUS SOLUTION,21.78,16.34,0.26,19.6,119
NDC,72572017001,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,10.44,7.83,0.13,9.4,119
NDC,72572017025,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,8.64,6.48,0.1,7.78,119
NDC,72572017101,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,16.62,12.46,0.2,14.96,119
NDC,72572017110,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,16.62,12.46,0.2,14.96,119
NDC,72572017201,FENTANYL (PF) 50 MCG/ML INJECTION SOLUTION,129.6,97.2,1.56,116.64,119
NDC,72572025501,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",10.44,7.83,0.13,9.4,119
NDC,72572025525,"HEPARIN (PORCINE) 5,000 UNIT/ML INJECTION SOLUTION",10.44,7.83,0.13,9.4,119
NDC,72572032001,KETAMINE 50 MG/ML INJECTION SOLUTION,27.66,20.74,0.33,24.89,119
NDC,72572032010,KETAMINE 50 MG/ML INJECTION SOLUTION,27.66,20.74,0.33,24.89,119
NDC,72572032110,KETAMINE 100 MG/ML INJECTION SOLUTION,61.62,46.22,0.74,55.46,119
NDC,72572035001,LABETALOL 5 MG/ML INTRAVENOUS SOLUTION,17.28,12.96,0.21,15.55,119
NDC,72572035501,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,5.52,4.14,0.07,4.97,119
NDC,72572035525,KETOROLAC 30 MG/ML (1 ML) INJECTION SOLUTION,5.52,4.14,0.07,4.97,119
NDC,72572036001,LEVETIRACETAM 500 MG/5 ML INTRAVENOUS SOLUTION,8.1,6.07,0.1,7.29,119
NDC,72572037001,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,7.44,5.58,0.09,6.7,119
NDC,72572037025,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,7.44,5.58,0.09,6.7,119
NDC,72572037201,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,6.78,5.08,0.08,6.1,119
NDC,72572037225,LIDOCAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION,6.78,5.08,0.08,6.1,119
NDC,72572038001,LORAZEPAM 2 MG/ML INJECTION SOLUTION,6.36,4.77,0.08,5.72,119
NDC,72572038025,LORAZEPAM 2 MG/ML INJECTION SOLUTION,9.3,6.98,0.11,8.37,119
NDC,72572041401,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.29,22.09,119
NDC,72572041410,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.29,22.09,119
NDC,72572041501,MEROPENEM 500 MG INTRAVENOUS SOLUTION,22.68,17.01,0.27,20.41,119
NDC,72572041510,MEROPENEM 500 MG INTRAVENOUS SOLUTION,22.68,17.01,0.27,20.41,119
NDC,72572041601,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,42.66,31.99,0.51,38.39,119
NDC,72572041610,MEROPENEM 1 GRAM INTRAVENOUS SOLUTION,42.66,31.99,0.51,38.39,119
NDC,72572041801,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,33.66,25.24,0.4,30.29,119
NDC,72572041810,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,33.66,25.24,0.4,30.29,119
NDC,72572042001,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,4.86,3.65,0.06,4.37,119
NDC,72572042010,METOPROLOL TARTRATE 5 MG/5 ML INTRAVENOUS SOLUTION,4.86,3.65,0.06,4.37,119
NDC,72572043001,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,4.08,3.06,0.05,3.67,119
NDC,72572043025,MIDAZOLAM 1 MG/ML INJECTION SOLUTION,4.08,3.06,0.05,3.67,119
NDC,72572044001,MORPHINE 4 MG/ML INTRAVENOUS SOLUTION,12.06,9.04,0.14,10.85,119
NDC,72572045001,NALOXONE 0.4 MG/ML INJECTION SOLUTION,26.34,19.76,0.32,23.71,119
NDC,72572045025,NALOXONE 0.4 MG/ML INJECTION SOLUTION,26.34,19.76,0.32,23.71,119
NDC,72572052001,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,4.08,3.06,0.05,3.67,119
NDC,72572052025,ONDANSETRON HCL (PF) 4 MG/2 ML INJECTION SOLUTION,4.08,3.06,0.05,3.67,119
NDC,72572055301,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,72572055310,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,72572057301,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.29,22.09,119
NDC,72572057310,PIPERACILLIN-TAZOBACTAM 3.375 GRAM INTRAVENOUS SOLUTION,24.54,18.4,0.29,22.09,119
NDC,72572057401,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,33.66,25.24,0.4,30.29,119
NDC,72572057401,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (4 GM PIP NEO/PED)(UW),33.66,25.24,0.4,30.29,119
NDC,72572057410,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION,33.66,25.24,0.4,30.29,119
NDC,72572057410,PIPERACILLIN-TAZOBACTAM 4.5 GRAM INTRAVENOUS SOLUTION (4 GM PIP NEO/PED)(UW),33.66,25.24,0.4,30.29,119
NDC,72572058001,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,36.18,27.14,0.43,32.56,119
NDC,72572058025,PROCHLORPERAZINE EDISYLATE 10 MG/2 ML (5 MG/ML) INJECTION SOLUTION,36.18,27.14,0.43,32.56,119
NDC,72572059001,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,13.8,10.35,0.17,12.42,119
NDC,72572059001,PROPOFOL 10 MG/ML IV BOLUS (UW),13.8,10.35,0.17,12.42,119
NDC,72572061201,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,67.8,50.85,0.81,61.02,119
NDC,72572061210,PROPOFOL 10 MG/ML INTRAVENOUS EMULSION,60.6,45.45,0.73,54.54,119
NDC,72572061210,PROPOFOL 10 MG/ML IV BOLUS (UW),60.6,45.45,0.73,54.54,119
NDC,72572074001,SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION,37.8,28.35,0.45,34.02,119
NDC,72572080101,"VANCOMYCIN 1,000 MG INTRAVENOUS INJECTION",20.7,15.52,0.25,18.63,119
NDC,72572080501,VANCOMYCIN 10 GRAM INTRAVENOUS SOLUTION,146.93,110.19,1.76,132.24,119
NDC,72572087501,VORICONAZOLE 200 MG INTRAVENOUS SOLUTION,103.1,77.32,1.24,92.79,119
NDC,72578005616,FELBAMATE 400 MG TABLET,8.86,6.65,0.11,7.97,119
NDC,72578012908,METRONIDAZOLE 0.75 % TOPICAL CREAM,180.09,135.07,2.16,162.08,119
NDC,72578013606,FEBUXOSTAT 40 MG TABLET,3.16,2.37,0.04,2.84,119
NDC,72603011001,ABIRATERONE 250 MG TABLET,11.25,8.44,0.14,10.12,119
NDC,72603011201,CLORAZEPATE DIPOTASSIUM 3.75 MG TABLET,8.66,6.49,0.1,7.79,119
NDC,72603013301,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,16.31,12.23,0.2,14.68,119
NDC,72603013325,FUROSEMIDE 10 MG/ML INJECTION SOLUTION,16.31,12.23,0.2,14.68,119
NDC,72603013602,SPIRONOLACTONE 100 MG TABLET,3.21,2.41,0.04,2.89,119
NDC,72603013901,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,56.32,42.24,0.68,50.69,119
NDC,72603013925,THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION,56.32,42.24,0.68,50.69,119
NDC,72603014202,"METOPROLOL SUCCINATE ER 25 MG TABLET,EXTENDED RELEASE 24 HR",3.13,2.35,0.04,2.82,119
NDC,72603016301,TIMOLOL MALEATE 0.5 % EYE GEL FORMING SOLUTION,852.26,639.19,10.23,767.03,119
NDC,72603016401,DESONIDE 0.05 % TOPICAL OINTMENT,120.87,90.65,1.45,108.78,119
NDC,72603016901,PROCHLORPERAZINE MALEATE 10 MG TABLET,3.12,2.34,0.04,2.81,119
NDC,72603017401,VALGANCICLOVIR 50 MG/ML ORAL SOLUTION,4789.49,3592.12,57.47,4310.54,119
NDC,72603017601,NITROFURANTOIN 25 MG/5 ML ORAL SUSPENSION,8572.56,6429.42,102.87,7715.3,119
NDC,72603018010,NOREPINEPHRINE BITARTRATE 1 MG/ML INTRAVENOUS SOLUTION,76.68,57.51,0.92,69.01,119
NDC,72603018301,NITROFURANTOIN MACROCRYSTAL 50 MG CAPSULE,4.13,3.1,0.05,3.72,119
NDC,72603019201,OFLOXACIN 0.3 % EYE DROPS,90.0,67.5,1.08,81.0,119
NDC,72603021201,DEXAMETHASONE 0.5 MG TABLET,0.69,0.52,0.01,0.62,119
NDC,72603026401,ATROPINE 1 % EYE DROPS,162.27,121.7,1.95,146.04,119
NDC,72603026402,ATROPINE 1 % EYE DROPS,265.38,199.04,3.18,238.84,119
NDC,72603027802,"SODIUM,POTASSIUM,MAG SULFATES 17.5 GRAM-3.13 GRAM-1.6 GRAM ORAL SOLN",522.5,391.88,6.27,470.25,119
NDC,72603030501,LACOSAMIDE 10 MG/ML ORAL SOLUTION,572.4,429.3,6.87,515.16,119
NDC,72603031601,METHIMAZOLE 10 MG TABLET,2.58,1.94,0.03,2.32,119
NDC,72603040501,ATORVASTATIN 40 MG TABLET,2.26,1.69,0.03,2.03,119
NDC,72603041301,"FESOTERODINE ER 4 MG TABLET,EXTENDED RELEASE 24 HR",14.28,10.71,0.17,12.85,119
NDC,72603044501,ARIPIPRAZOLE 1 MG/ML ORAL SOLUTION,1293.3,969.97,15.52,1163.97,119
NDC,72603052001,PHENYLEPHRINE 2.5 % EYE DROPS,146.25,109.69,1.76,131.62,119
NDC,72611071601,DEXRAZOXANE HCL 500 MG INTRAVENOUS SOLUTION,1135.55,851.67,13.63,1022.0,119
NDC,72626270101,SOFOSBUVIR 400 MG-VELPATASVIR 100 MG TABLET,1097.14,822.86,13.17,987.43,119
NDC,72893000704,KIT FOR YTTRIUM-90-IBRITUMOMAB 3.2 MG/2 ML INTRAVENOUS,231898.95,173924.21,2782.79,208709.06,119
NDC,73043002001,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,73043002025,PANTOPRAZOLE 40 MG INTRAVENOUS SOLUTION,16.8,12.6,0.2,15.12,119
NDC,73150015006,UBLITUXIMAB-XIIY 25 MG/ML INTRAVENOUS SOLUTION,28783.67,21587.75,345.4,25905.3,119
NDC,73177010201,FENTANYL (PF) 20 MCG/2 ML (10 MCG/ML) IN 0.9 % SOD CHLORIDE IV SYRINGE,35.94,26.96,0.43,32.35,119
NDC,73177010205,FENTANYL (PF) 500 MCG/50 ML (10 MCG/ML) IN 0.9 % NACL IV DRIP,199.8,149.85,2.4,179.82,119
NDC,73177010405,"HYDROMORPHONE (PF) 10 MG/50 ML (0.2 MG/ML) IN NACL, ISO-OSM IV PCA SYR",84.0,63.0,1.01,75.6,119
NDC,73177010405,HYDROMORPHONE 10 MG (0.2 MG/ML) IN 50 ML NS IV DRIP,84.0,63.0,1.01,75.6,119
NDC,73177010530,MORPHINE (PF) 30 MG/30 ML(1 MG/ML) IN 0.9% SOD.CHLORIDE IV PCA SYRINGE,81.54,61.16,0.98,73.39,119
NDC,73177014633,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,15.0,11.25,0.18,13.5,119
NDC,73177015602,"KETAMINE 50 MG/5 ML (10 MG/ML) IN SODIUM CHLOR,ISO-OSMOTIC IV SYRINGE",39.66,29.74,0.48,35.69,119
NDC,73177015902,ROCURONIUM 50 MG/5 ML (10 MG/ML) INTRAVENOUS SYRINGE,53.7,40.28,0.64,48.33,119
NDC,73177016333,ALBUTEROL SULFATE CONCENTRATE 5 MG/ML(0.5 %) SOLUTION FOR NEBULIZATION,300.0,225.0,3.6,270.0,119
NDC,73293000101,LIDOCAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION,9.0,6.75,0.11,8.1,119
NDC,73302045601,ULIPRISTAL 30 MG TABLET,174.38,130.78,2.09,156.94,119
NDC,73475304105,EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION,17617.82,13213.37,211.41,15856.04,119
NDC,73475310203,"EFGARTIGIMOD ALFA 1008 MG-HYALURON-QVFC 11,200 UNIT/5.6 ML SUBCUT SOLN",44219.13,33164.35,530.63,39797.22,119
NDC,73562011201,"LIPASE-PROTEASE-AMYLASE (PORK) 20,000-63,000-84K UNIT CAPSULE, DEL REL",49.52,37.14,0.59,44.57,119
NDC,73607001111,ARTESUNATE 110 MG INTRAVENOUS SOLUTION,13838.88,10379.16,166.07,12454.99,119
NDC,73702014071,INDOMETHACIN 100 MG RECTAL SUPPOSITORY,1152.0,864.0,13.82,1036.8,119
NDC,74300000301,ZINC OXIDE 13 % TOPICAL CREAM,33.22,24.92,0.4,29.9,119
NDC,74312000640,RIBOFLAVIN (VITAMIN B2) 100 MG TABLET,0.28,0.21,0.01,0.25,119
NDC,74725010025,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
NDC,74725010064,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,18450.0,13837.5,221.4,16605.0,119
NDC,75834015801,"VERAPAMIL ER (SR) 180 MG TABLET,EXTENDED RELEASE",1.45,1.09,0.02,1.3,119
NDC,75834029401,ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION,1757.4,1318.05,21.09,1581.66,119
NDC,75834032001,"VERAPAMIL ER (SR) 120 MG TABLET,EXTENDED RELEASE",3.61,2.71,0.04,3.25,119
NDC,75907002548,CLONIDINE 0.3 MG/24 HR WEEKLY TRANSDERMAL PATCH,139.41,104.56,1.67,125.47,119
NDC,75907018935,CYCLOPHOSPHAMIDE 200 MG/ML INTRAVENOUS SOLUTION,4464.59,3348.44,53.58,4018.13,119
NDC,75987008010,PEGLOTICASE 8 MG/ML INTRAVENOUS SOLUTION,66289.81,49717.36,795.48,59660.83,119
NDC,75987013015,TEPROTUMUMAB-TRBW 500 MG INTRAVENOUS SOLUTION,38476.84,28857.63,461.72,34629.16,119
NDC,75987015003,INEBILIZUMAB-CDON 10 MG/ML INTRAVENOUS SOLUTION,125602.14,94201.6,1507.23,113041.93,119
NDC,76045000401,MORPHINE 2 MG/ML PF INJECTION SYRINGE,17.22,12.92,0.21,15.5,119
NDC,76045000411,MORPHINE 2 MG/ML PF INJECTION SYRINGE,17.22,12.92,0.21,15.5,119
NDC,76045000901,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,24.9,18.67,0.3,22.41,119
NDC,76045000905,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,21.6,16.2,0.26,19.44,119
NDC,76045000906,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,24.9,18.67,0.3,22.41,119
NDC,76045000910,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,21.6,16.2,0.26,19.44,119
NDC,76045000911,HYDROMORPHONE (PF) 1 MG/ML INJECTION SYRINGE,24.9,18.67,0.3,22.41,119
NDC,76045000996,HYDROMORPHONE (PF) 0.5 MG/0.5 ML INJECTION SYRINGE,24.9,18.67,0.3,22.41,119
NDC,76075010101,CARFILZOMIB 60 MG INTRAVENOUS SOLUTION,9001.83,6751.37,108.02,8101.65,119
NDC,76075010201,CARFILZOMIB 30 MG INTRAVENOUS SOLUTION,4500.92,3375.69,54.01,4050.83,119
NDC,76075010301,CARFILZOMIB 10 MG INTRAVENOUS SOLUTION,1553.52,1165.14,18.64,1398.17,119
NDC,76204002160,SODIUM CHLORIDE 7 % FOR NEBULIZATION,3.6,2.7,0.04,3.24,119
NDC,76204002701,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,10.5,7.88,0.13,9.45,119
NDC,76204002711,ALBUTEROL SULFATE CONCENTRATE 2.5 MG/0.5 ML SOLUTION FOR NEBULIZATION,10.5,7.88,0.13,9.45,119
NDC,76204010001,IPRATROPIUM BROMIDE 0.02 % SOLUTION FOR INHALATION,2.4,1.8,0.03,2.16,119
NDC,76204080001,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,9.59,7.2,0.12,8.63,119
NDC,76204080011,LEVALBUTEROL 0.63 MG/3 ML SOLUTION FOR NEBULIZATION,9.59,7.2,0.12,8.63,119
NDC,76282033310,WARFARIN 6 MG TABLET,1.81,1.35,0.02,1.63,119
NDC,76282033501,WARFARIN 10 MG TABLET,1.81,1.35,0.02,1.63,119
NDC,76310002411,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,2009.19,1506.89,24.11,1808.27,119
NDC,76310002415,FOSCARNET 24 MG/ML INTRAVENOUS SOLUTION,2040.0,1530.0,24.48,1836.0,119
NDC,76329124001,PHYTONADIONE (VITAMIN K1) 1 MG/0.5 ML INJECTION SYRINGE,111.28,83.46,1.34,100.15,119
NDC,76329191101,MORPHINE 30 MG/30 ML (1 MG/ML) IN D5W IV DRIP (NEO/PED),72.0,54.0,0.86,64.8,119
NDC,76329330201,DEXTROSE 50 % IN WATER (D50W) INTRAVENOUS SYRINGE,110.4,82.8,1.32,99.36,119
NDC,76329330401,CALCIUM CHLORIDE 100 MG/ML (10 %) INTRAVENOUS SYRINGE,44.62,33.47,0.54,40.16,119
NDC,76329331801,EPINEPHRINE 0.1 MG/ML INJECTION SYRINGE,75.0,56.25,0.9,67.5,119
NDC,76329334001,ATROPINE 0.1 MG/ML INJECTION SYRINGE,68.7,51.53,0.82,61.83,119
NDC,76329335201,SODIUM BICARBONATE 50 MEQ/50 ML (8.4 %) INTRAVENOUS SYRINGE,118.2,88.65,1.42,106.38,119
NDC,76329339001,LIDOCAINE (PF) 100 MG/5 ML (2 %) INTRAVENOUS SYRINGE,48.9,36.67,0.59,44.01,119
NDC,76329826100,LORAZEPAM 2 MG/ML INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,76329826101,LORAZEPAM 2 MG/ML INJECTION SOLUTION,60.0,45.0,0.72,54.0,119
NDC,76385010201,PRIMAQUINE 26.3 MG (15 MG BASE) TABLET,8.03,6.02,0.1,7.23,119
NDC,77333036025,GUAIFENESIN 400 MG TABLET,2.07,1.55,0.02,1.86,119
NDC,77333082725,SODIUM BICARBONATE 650 MG TABLET,1.22,0.91,0.01,1.1,119
NDC,77333084410,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",1.37,1.03,0.02,1.23,119
NDC,77333084425,"SODIUM CHLORIDE 1,000 MG SOLUBLE TABLET",1.37,1.03,0.02,1.23,119
NDC,78112001106,BENZOCAINE 6 MG-MENTHOL 10 MG LOZENGES,0.88,0.66,0.01,0.79,119
NDC,78206014501,ETONOGESTREL 68 MG SUBDERMAL IMPLANT,4481.98,3361.49,53.78,4033.78,119
NDC,78206016201,INFLIXIMAB-ABDA 100 MG INTRAVENOUS SOLUTION,2144.15,1608.11,25.73,1929.74,119
NDC,78670000367,DANTROLENE 20 MG INTRAVENOUS SOLUTION,290.5,217.88,3.49,261.45,119
NDC,79854003985,BIOTIN 1 MG TABLET,0.29,0.22,0.01,0.26,119
NDC,79854004097,ACETYLCYSTEINE 600 MG CAPSULE,0.44,0.33,0.01,0.4,119
NDC,79854010005,"VITAMIN A 2,400 MCG CAPSULE",0.2,0.15,0.01,0.18,119
NDC,80491785003,DARIDOREXANT 50 MG TABLET,76.36,57.27,0.92,68.72,119
NDC,80681000400,"CALCIUM 500 MG (AS CALCIUM CARBONATE 1,250 MG) TABLET",0.2,0.15,0.01,0.18,119
NDC,80681002500,PYRIDOXINE (VITAMIN B6) 100 MG TABLET,0.14,0.1,0.01,0.13,119
NDC,80681005700,NIACIN 100 MG TABLET,0.1,0.07,0.01,0.09,119
NDC,80681010000,GLUCOSE 4 GRAM CHEWABLE TABLET,1.41,1.06,0.02,1.27,119
NDC,80681014000,CALCIUM 200 MG (AS CALCIUM CITRATE 950 MG) TABLET,0.21,0.16,0.01,0.19,119
NDC,80681015500,LANOLIN ALCOHOLS-MINERAL OIL-W.PETROLATUM-CERESIN TOPICAL CREAM,16.27,12.2,0.2,14.64,119
NDC,80681017400,"CHOLECALCIFEROL (VITAMIN D3) 1,250 MCG (50,000 UNIT) CAPSULE",0.98,0.74,0.01,0.88,119
NDC,80773501190,ZINC SULFATE 5 MG/ML ORAL LIQUID,187.53,140.65,2.25,168.78,119
NDC,80830169101,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML INTRAVENOUS SOLUTION,270.0,202.5,3.24,243.0,119
NDC,80830232901,"TRANEXAMIC ACID 1,000 MG/100 ML(10 MG/ML)IN SOD CHLOR,ISO IV PIGGYBACK",123.0,92.25,1.48,110.7,119
NDC,81033006620,METRONIDAZOLE 500 MG/5 ML ORAL SUSPENSION,3270.0,2452.5,39.24,2943.0,119
NDC,81284041100,DIHYDROERGOTAMINE 1 MG/ML INJECTION SOLUTION,323.7,242.77,3.88,291.33,119
NDC,81284061100,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",33.0,24.75,0.4,29.7,119
NDC,81284061110,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",33.0,24.75,0.4,29.7,119
NDC,81284061200,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",22.8,17.1,0.27,20.52,119
NDC,81284061210,"TRANEXAMIC ACID 1,000 MG/10 ML (100 MG/ML) INTRAVENOUS SOLUTION",22.8,17.1,0.27,20.52,119
NDC,81643927001,FLOXURIDINE 0.5 GRAM SOLUTION FOR INJECTION,10356.43,7767.32,124.28,9320.79,119
NDC,81665010210,ISOSORBIDE MONONITRATE 10 MG TABLET,17.7,13.27,0.21,15.93,119
NDC,82182032105,BRIMONIDINE 0.1 % EYE DROPS,558.58,418.94,6.7,502.72,119
NDC,82584079201,LIDOCAINE (PF) 3.5 % EYE GEL,105.12,78.84,1.26,94.61,119
NDC,82584079225,LIDOCAINE (PF) 3.5 % EYE GEL,105.13,78.85,1.26,94.62,119
NDC,82625880101,NALOXEGOL 12.5 MG TABLET,65.46,49.09,0.79,58.91,119
NDC,82625880203,NALOXEGOL 25 MG TABLET,65.46,49.1,0.79,58.91,119
NDC,82667060005,"DEXAMETHASONE 0.1 % EYE DROPS,SUSPENSION",310.5,232.88,3.73,279.45,119
NDC,82667070003,MOXIFLOXACIN 0.5 % EYE DROPS,445.5,334.12,5.35,400.95,119
NDC,83090001101,DAPTOMYCIN 500 MG INTRAVENOUS SOLUTION,135.0,101.25,1.62,121.5,119
NDC,83257000412,TRASTUZUMAB-DKST 420 MG INTRAVENOUS SOLUTION,7214.95,5411.21,86.58,6493.46,119
NDC,83257000541,PEGFILGRASTIM-JMDB 6 MG/0.6 ML SUBCUTANEOUS SYRINGE,5737.5,4303.12,68.85,5163.75,119
NDC,83490030760,SODIUM CHLORIDE 7 % FOR NEBULIZATION,1.66,1.24,0.02,1.49,119
NDC,84552050025,KIT FOR PREPARATION OF GA-68-GOZETOTIDE 25 MCG INTRAVENOUS SOLUTION,22674.6,17005.95,272.1,20407.14,119
NDC,87701040073,GENTIAN VIOLET 1 % TOPICAL SOLUTION,20.53,15.4,0.25,18.48,119
NDC,8888043904,LOPERAMIDE 1 MG/7.5 ML ORAL LIQUID,2.16,1.62,0.03,1.94,119
NDC,9999002001,METOPROLOL TARTRATE 6.25 MG (1/4 OF 25 MG) TABLET,0.14,0.11,0.01,0.13,119
NDC,99999013700,WARFARIN 0.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),2.22,1.66,0.03,2.0,119
NDC,99999013800,WARFARIN 3.75 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),17.91,13.43,0.21,16.12,119
NDC,99999018300,VANCOMYCIN RETENTION IS 500 MG IN 100 ML OF NS,0.04,0.03,0.01,0.04,119
NDC,99999036282,WARFARIN 1.25 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),12.89,9.67,0.15,11.6,119
NDC,99999036816,EPISHUGARCAINE IRRIGATION,12.0,9.0,0.14,10.8,119
NDC,99999036866,ALUMINUM-MAG HYDROXIDE-SIMETHICONE 400 MG-400 MG-40 MG/5 ML ORAL SUSP (REPACKAGING),1.44,1.08,0.02,1.3,119
NDC,99999036916,ASCORBIC ACID (VITAMIN C) 500 MG/5 ML ORAL SYRUP,0.08,0.06,0.01,0.07,119
NDC,99999037299,FLUCONAZOLE PEDIATRIC IVPB (2 MG/ML)(UW),18.41,13.81,0.22,16.57,119
NDC,99999037313,POTASSIUM PHOSPHATES-MBASIC AND DIBASIC 3 MMOL/ML IV FOR CUSTOM RULE,102.6,76.95,1.23,92.34,119
NDC,99999037515,INV NIVOLUMAB 100 MG/10 ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999037516,INV DURVALUMAB 50 MG/ML INTRAVENOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999037665,SODIUM CITRATE 4 % (3 ML) INTRA-CATHETER INJECTION SYRINGE,0.13,0.09,0.01,0.12,119
NDC,99999037842,WARFARIN 1.25 MG PRE SPLIT TABLET,12.89,9.67,0.15,11.6,119
NDC,99999037842,WARFARIN 1.25 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),12.89,9.67,0.15,11.6,119
NDC,99999038053,WARFARIN 0.25 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),0.56,0.42,0.01,0.5,119
NDC,99999038054,WARFARIN 0.75 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),2.22,1.66,0.03,2.0,119
NDC,99999038055,WARFARIN 1.5 MG PRE SPLIT TABLET (FOR IP USE ONLY)(UW),0.71,0.53,0.01,0.64,119
NDC,99999038099,INSULIN REGULAR 100 UNIT/100 ML (1 UNIT/ML) IN 0.9 % NACL IV SOLUTION,210.0,157.5,2.52,189.0,119
NDC,99999038127,FENTANYL (PF) 2 MCG/ML NEONATAL IV SYRINGE,0.41,0.31,0.01,0.37,119
NDC,99999038133,MORPHINE 0.2 MG/ML NEONATAL IV SYRINGE,0.07,0.05,0.01,0.06,119
NDC,99999038186,MORPHINE 6 MG/30 ML (0.2 MG/ML) IN NS IV DRIP (NEO/PED),2.04,1.53,0.02,1.84,119
NDC,99999038189,DAPTOMYCIN 50 MG/ML IN NS IV SYRINGE,180.0,135.0,2.16,162.0,119
NDC,99999038211,CEFAZOLIN 100 MG/ML IN SWFI IVPB (NEO/PED) CMPD,0.63,0.47,0.01,0.57,119
NDC,99999038231,NOREPINEPHRINE 48 MCG/3 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,2.66,2.0,0.03,2.39,119
NDC,99999038232,NOREPINEPHRINE 480 MCG/30 ML (16 MCG/ML) IN NS IV DRIP (NEO/PED) CMPD,26.64,19.98,0.32,23.98,119
NDC,99999038271,KETAMINE 10 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS SOLUTION,249.0,186.75,2.99,224.1,119
NDC,99999038836,INV TOVORAFENIB 100 MG TABLET,0.01,0.01,0.01,0.01,119
NDC,99999038837,INV TOVORAFENIB 25 MG/ML ORAL SUSPENSION,0.01,0.01,0.01,0.01,119
NDC,99999038846,INV GENERIC NON-CHEMOTHERAPY,0.01,0.01,0.01,0.01,119
NDC,99999038852,INV SIGVOTATUG VEDOTIN 10 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038853,INV AMG 509 0.1 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038854,INV AMG 509 0.5 MG IV SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038868,INV ION356/PLACEBO INTRATHECAL SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038869,INV 27T51 CAR-T INJECTION,0.01,0.01,0.01,0.01,119
NDC,99999038870,INV TOCILIZUMAB 20 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038871,INV TOCILIZUMAB 20 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038872,INV TOCILIZUMAB 20 MG/ML INTRAVENEOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038874,INV RESMETIROM (MGL-3196) OR PLACEBO 60 MG TABLET,0.01,0.01,0.01,0.01,119
NDC,99999038875,INV RESMETIROM (MGL-3196) OR PLACEBO 80 MG TABLET,0.01,0.01,0.01,0.01,119
NDC,99999038876,INV RESMETIROM (MGL-3196) OR PLACEBO 100 MG TABLET,0.01,0.01,0.01,0.01,119
NDC,99999038881,INV ALBUTEROL SULFATE HFA 90 MCG/ACTUATION INHALER,0.01,0.01,0.01,0.01,119
NDC,99999038882,INV PIRFENIDONE (AP-LTE-008 SAIL) INHALATION SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038883,INV DEXAMETHASONE 10 MG/ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038884,INV ANAKINRA 100 MG/0.67 ML SUBCUTANEOUS SYRINGE,0.01,0.01,0.01,0.01,119
NDC,99999038885,INV PLERIXAFOR 20 MG/ML SUBCUTANEOUS SOLUTION,0.01,0.01,0.01,0.01,119
NDC,99999038886,INV FILGRASTIM 480 MCG/1.6 ML INJECTION SOLUTION,0.01,0.01,0.01,0.01,119
NDC,9999938146,INV DAUNORUBICIN 44 MG AND CYTARABINE 100 MG IN LIPOSOME IV SOLUTION,0.01,0.01,0.01,0.01,119
RC,0118,Room & Board - Private (One Bed) - Rehabilitation,,,,,0
RC,0128,Room & Board - Semi-private (Two Beds) - Rehabilitation,,,,,0
RC,0274,Medical/Surgical Supplies and Devices (Also See 062x  An Extension of 027x) - Prosthetic/Orthotic Devices,,,,,0
RC,0275,Medical/Surgical Supplies and Devices (Also See 062 X  An Extension of 027x) - Pacemaker,,,,,0
RC,0278,Medical/Surgical Supplies and Devices (Also See 062x  An Extension of 027x) - Other Implant,,,,,0
RC,0300,Laboratory - General Classification,,,,,0
RC,0301,Laboratory - Chemistry,,,,,0
RC,0302,Laboratory - Immunology,,,,,0
RC,0303,Laboratory - Renal Patient (Home),,,,,0
RC,0304,Laboratory - Non-Routine Dialysis,,,,,0
RC,0305,Laboratory - Hematology,,,,,0
RC,0306,Laboratory - Bacteriology & Microbiology,,,,,0
RC,0307,Laboratory - Urology,,,,,0
RC,0309,Laboratory - Other Laboratory,,,,,0
RC,0310,Laboratory Pathology - General Classification,,,,,0
RC,0311,Laboratory Pathology - Cytology,,,,,0
RC,0312,Laboratory Pathology - Histology,,,,,0
RC,0314,Laboratory Pathology - Biopsy,,,,,0
RC,0319,Laboratory Pathology - Other Laboratory Pathology,,,,,0
RC,0360,Operating Room Services - General Classification,,,,,0
RC,0361,Operating Room Services - Minor Surgery,,,,,0
RC,0450,Emergency Room - General Classification,,,,,0
RC,0451,Emergency Room - Emtala Emergency Medical Screening Services,,,,,0
RC,0452,Emergency Room - Er Beyond Emtala Screening,,,,,0
RC,0456,Emergency Room - Urgent Care,,,127.14,127.14,2
RC,0459,Emergency Room - Other Emergency Room,,,,,0
RC,0480,Cardiology - General Classification,,,,,0
RC,0481,Cardiology - Cardiac Cath Lab,,,,,0
RC,0545,Ambulance - Air Ambulance,,,,,0
RC,0750,Gastrointestinal,,,,,0
RC,0759,Gastrointestinal: Other gastrointestinal,,,,,0
RC,0762,Specialty Services - Observation Hours,,,,,0
RC,0905,Behavioral Health Treatment/Services (Also See 091x  An Extension of 090x) - Intensive Outpatient Services - Psychiatric,,,,,0
RC,0906,Behavioral Health Treatment/Services (Also See 091x  An Extension of 090x) - Intensive Outpatient Services - Chemical Dependency,,,,,0
RC,0907,Behavioral Health Treatment/Services (Also See 091x  An Extension of 090x) - Community Behavioral Health Program (Day Treatment),,,803.0,851.0,8
RC,0912,Behavioral Health Treatment/Services - Extension of 090x - Partial Hospitalization - Less Intensive,,,811.0,860.0,8
RC,0913,Behavioral Health Treatment/Services - Extension of 090x - Partial Hospitalization - Intensive,,,811.0,860.0,8